JPH03254755A - Priming method for external circulation circuit - Google Patents
Priming method for external circulation circuitInfo
- Publication number
- JPH03254755A JPH03254755A JP2051739A JP5173990A JPH03254755A JP H03254755 A JPH03254755 A JP H03254755A JP 2051739 A JP2051739 A JP 2051739A JP 5173990 A JP5173990 A JP 5173990A JP H03254755 A JPH03254755 A JP H03254755A
- Authority
- JP
- Japan
- Prior art keywords
- priming
- hollow fiber
- fiber membrane
- blood
- valve
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 230000037452 priming Effects 0.000 title claims abstract description 74
- 238000000034 method Methods 0.000 title claims description 36
- 230000004087 circulation Effects 0.000 title claims description 11
- 239000012510 hollow fiber Substances 0.000 claims abstract description 69
- 239000008280 blood Substances 0.000 claims abstract description 59
- 210000004369 blood Anatomy 0.000 claims abstract description 59
- 239000007864 aqueous solution Substances 0.000 claims abstract description 39
- 230000017531 blood circulation Effects 0.000 claims abstract description 29
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 18
- 239000012528 membrane Substances 0.000 claims description 75
- 239000008223 sterile water Substances 0.000 claims description 9
- 238000004140 cleaning Methods 0.000 claims description 2
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 abstract description 3
- 238000002347 injection Methods 0.000 abstract description 3
- 239000007924 injection Substances 0.000 abstract description 3
- 210000001367 artery Anatomy 0.000 abstract description 2
- 239000000243 solution Substances 0.000 abstract description 2
- 239000000835 fiber Substances 0.000 abstract 6
- 210000003462 vein Anatomy 0.000 abstract 1
- 239000007788 liquid Substances 0.000 description 17
- 239000002504 physiological saline solution Substances 0.000 description 7
- 238000010586 diagram Methods 0.000 description 4
- 238000001802 infusion Methods 0.000 description 4
- 238000011013 endotoxin removal Methods 0.000 description 3
- 238000007796 conventional method Methods 0.000 description 2
- 239000012153 distilled water Substances 0.000 description 2
- 239000011780 sodium chloride Substances 0.000 description 2
- IAYPIBMASNFSPL-UHFFFAOYSA-N Ethylene oxide Chemical compound C1CO1 IAYPIBMASNFSPL-UHFFFAOYSA-N 0.000 description 1
- 206010018910 Haemolysis Diseases 0.000 description 1
- 239000003463 adsorbent Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000002158 endotoxin Substances 0.000 description 1
- 238000001914 filtration Methods 0.000 description 1
- JEGUKCSWCFPDGT-UHFFFAOYSA-N h2o hydrate Chemical compound O.O JEGUKCSWCFPDGT-UHFFFAOYSA-N 0.000 description 1
- 238000001631 haemodialysis Methods 0.000 description 1
- 230000000322 hemodialysis Effects 0.000 description 1
- 230000008588 hemolysis Effects 0.000 description 1
- 230000003340 mental effect Effects 0.000 description 1
- 238000000746 purification Methods 0.000 description 1
- 238000001179 sorption measurement Methods 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
Landscapes
- External Artificial Organs (AREA)
Abstract
Description
【発明の詳細な説明】
（産業上の利用分野）
本発明は、中空系膜型血液浄化器を接続してなる体外循
環回路のプライミング方法に関する。DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a method for priming an extracorporeal circulation circuit connected to a hollow membrane type blood purifier.
（従来の技術）
中空糸膜型血液浄化器を用いた血液浄化療法においては
、治療開始前に必ず血液が接触する部分、つまり中空糸
膜内側及び血液循環用チューブ内を洗浄し且つエアー抜
きをする為にプライミングと呼ばれる操作を行なわなけ
ればならない。このプライミングは中空糸膜内側及び血
液循環用チューブ内に残存している滅菌剤や異物を洗い
流すと同時にエアーを追い出して、体外循環治療中に血
液中に異物や空気が混入したり溶血が起こるのを防ぐこ
とを目的としている。(Prior art) In blood purification therapy using a hollow fiber membrane type blood purifier, before the start of treatment, the parts that come into contact with blood, that is, the inside of the hollow fiber membrane and the inside of the blood circulation tube, must be cleaned and air removed. In order to do this, an operation called priming must be performed. This priming flushes out sterilizers and foreign matter remaining inside the hollow fiber membrane and inside the blood circulation tube, and at the same time expels air to prevent foreign matter or air from getting into the blood or causing hemolysis during extracorporeal circulation treatment. The purpose is to prevent
従来よりプライミング操作には、血液浄化器の滅菌法に
応じて大別して２通りの方法が採用されている。Conventionally, two methods have been adopted for the priming operation, which are roughly classified depending on the sterilization method of the blood purifier.
エチレンオキサイドガス或いは高圧蒸気等で滅菌された
、中空糸膜内外が実質的に乾燥した状態にある、いわゆ
るドライタイプの血液浄化器では、共に乾燥状態にある
血液浄化器と血液循環チューブとを接続した後、血液浄
化器を鉛直にした状態で下方の血液側入口に接続されて
いる血液循環チューブ側から、プライミング用水溶液を
徐々に供給して中空糸膜内側のエアーを該プライミング
用水溶液で上方へ押し上げて行き、血液側出口、延いて
は血液循環チューブ外へ追い出し、同時に中空糸膜内側
及び血液循環チューブ内の洗浄を行っている。In a so-called dry type blood purifier, in which the inside and outside of the hollow fiber membrane are sterilized using ethylene oxide gas or high-pressure steam, etc., the inside and outside of the membrane are substantially dry, the blood purifier and the blood circulation tube, both of which are in a dry state, are connected. After that, with the blood purifier in a vertical position, a priming aqueous solution is gradually supplied from the blood circulation tube side connected to the lower blood side inlet, and the air inside the hollow fiber membrane is drawn upward with the priming aqueous solution. The blood is pushed up to the blood side outlet and then expelled out of the blood circulation tube, and at the same time, the inside of the hollow fiber membrane and the inside of the blood circulation tube are cleaned.
（発明が解決しようとする問題点）
しかし、このプライミング操作には、中空糸膜内側のエ
アーをプライミング用水溶液と完全に置換する点に技術
的な難しさがあり、通常は熟練の専門技術者が血液浄化
器に外側から振動を与える等して、中空糸膜内側のエア
ーを血液側出口へ追い出しているのが実情である。しか
もこの様な人的操作に頼ったプライミング操作は、操作
完了迄にかなりの時間を要する。(Problem to be Solved by the Invention) However, this priming operation has technical difficulties in completely replacing the air inside the hollow fiber membrane with the priming aqueous solution, and usually requires only a skilled professional engineer. The actual situation is that the air inside the hollow fiber membrane is expelled to the blood side outlet by applying vibrations to the blood purifier from the outside. Furthermore, such a priming operation that relies on human operations requires a considerable amount of time to complete.
又、中空糸膜の内外両側に滅菌水或は蒸留水か満たされ
た状態で供給される、いわゆるウェットタイプの血液浄
化器のプライミング操作では、中空系膜内側のエアーが
予め抜かれた状態にあるので、前述の様な中空糸膜内側
のエアー抜きに関する困難性は無いが、代わりに乾燥状
態で供給される血液循環チューブと血液浄化器を接続す
る前に、先ず、血液循環チューブ内にプライミング用水
溶液を通液してチューブ端部ぎりぎり迄水溶液を満たし
ておき、この端部と血液浄化器の血液側人口の端部とを
エアーが入らない様に注意しながら、且つ、中空糸膜内
側に予め充填されている滅菌水或いは蒸留水を漏らさな
い様にしながら、接続するという煩雑さがある。即ち、
従来より行なわれているプライミング操作は、ドライタ
イプ、ウェットタイプの何れの血液浄化器を含んだ体外
循環回路について行なう場合も、専門技術者の熟練した
腕に依存したものである。Furthermore, in the priming operation of a so-called wet type blood purifier, in which both the inside and outside of the hollow fiber membrane are filled with sterile water or distilled water, the air inside the hollow membrane is already removed. , there is no difficulty in removing air from the inside of the hollow fiber membrane as described above, but instead, before connecting the blood circulation tube supplied in a dry state to the blood purifier, an aqueous priming solution is first applied to the blood circulation tube. Fill the aqueous solution up to the very edge of the tube by passing the liquid through it, and then connect this end and the end of the blood side of the blood purifier to the inside of the hollow fiber membrane, being careful not to let air in. There is the hassle of connecting while ensuring that the sterilized water or distilled water that is filled in the device does not leak. That is,
The conventional priming operation, when performed on an extracorporeal circulation circuit including either a dry type or a wet type blood purifier, relies on the skilled hands of a specialist engineer.
従って、同一時間帯に多数の患者に施療することの多い
、血液透析等の為のプライミング操作には、多数の専門
技術者の確保が必要となる上、各技術者には操作の確実
性、迅速性か要求され精神的、肉体的疲労が多大である
等の問題がある。Therefore, priming operations for hemodialysis, etc., which are often performed on a large number of patients at the same time, require a large number of specialized technicians, and each technician needs to be sure that the operation is reliable. There are problems such as speediness is required and mental and physical fatigue is great.
本発明は上記事情に鑑みてなされたものであって、中空
糸膜型血液浄化器を接続してなる体外循環回路のプライ
ミング操作を、簡単にしかも確実に行う方法を提供する
ことを目的とする。The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide a method for simply and reliably priming an extracorporeal circulation circuit connected to a hollow fiber membrane type blood purifier. .
（問題点を解決するための手段）
本発明は、プライミングのための水溶液を中空糸膜型血
液浄化器の中空糸膜外側から供給し、中空糸膜な介して
中空糸膜内側へ通過させることで、エアーの残存の心配
のないプライミング操作を実現するものである。(Means for Solving the Problems) The present invention supplies an aqueous solution for priming from the outside of the hollow fiber membrane of a hollow fiber membrane type blood purifier and allows it to pass through the hollow fiber membrane to the inside of the hollow fiber membrane. This enables priming operation without worrying about residual air.
即ち、本発明の要旨は下記のとおりのものである。That is, the gist of the present invention is as follows.
（１）中空糸膜型血液浄化器と該血液浄化器の血液側入
口及び血液側出口に中空糸膜内側に連通ずる様に接続さ
れた血液循環用チューブとを含む体外循環回路のプライ
ミング方法において、前記中空糸膜型血液浄化器の中空
系膜外側にプライミング用水溶液を供給し、該プライミ
ング用水溶液を中空糸膜壁を通過させ中空糸膜内側へ移
動させて、中空糸膜内側及びそれに連通ずる血液循環用
チューブ内の洗浄及びエアー抜きを行なうことを特徴と
する体外循環回路のプライミング方法。(1) In a method for priming an extracorporeal circulation circuit comprising a hollow fiber membrane type blood purifier and a blood circulation tube connected to the blood side inlet and blood side outlet of the blood purifier so as to communicate with the inside of the hollow fiber membrane. , a priming aqueous solution is supplied to the outside of the hollow membrane of the hollow fiber membrane type blood purifier, and the priming aqueous solution is moved to the inside of the hollow fiber membrane through the hollow fiber membrane wall, and is connected to the inside of the hollow fiber membrane and connected thereto. A method for priming an extracorporeal circulation circuit, characterized by cleaning and removing air from the inside of a blood circulation tube.
（２）請求項（１）において、中空糸膜血液浄化器が血
液透析器であることを特徴とするプライミング方法。(2) The priming method according to claim (1), wherein the hollow fiber membrane blood purifier is a hemodialyzer.
（３）請求項（２）において、血液透析器が滅菌水充填
型血液透析器であることを特徴とするプライミング方法
。(3) The priming method according to claim (2), wherein the hemodialyzer is a sterile water-filled hemodialyzer.
（４）請求項（２）或いは（３）においてプライミング
用水溶液がエンドトキシンフリーの透析液であることを
特徴とするプライミング方法。(4) The priming method according to claim (2) or (3), wherein the priming aqueous solution is an endotoxin-free dialysate.
（作用）
本発明のプライミング方法では、プライミング用水溶液
を血液浄化器の中空糸膜内側と、それに連通ずる血液浄
化器の血液側入口及び血液側出口に接続された血液循環
用チューブとで構成される、いわゆる血液側回路のみに
通液していた従来法と異なり、中空糸膜外側すなわち例
えば血液透析器でいう透析液回路側からプライミング用
水溶液を供給し、該プライミング用水溶液を中空糸膜壁
を通過させて中空糸膜内側へ送り込む為、プライミング
用水溶液にエアーか混入していてもエアーか中空糸膜壁
を通過できないので、血液側回路にはプライミング用水
溶液のみが流れ込みエアーが混入しない。(Function) In the priming method of the present invention, the priming aqueous solution is supplied to the inside of the hollow fiber membrane of the blood purifier, and the blood circulation tube connected to the blood side inlet and blood side outlet of the blood purifier communicates with the inside of the hollow fiber membrane of the blood purifier. Unlike the conventional method in which liquid is passed only through the so-called blood side circuit, the priming aqueous solution is supplied from the outside of the hollow fiber membrane, that is, from the dialysate circuit side of a hemodialyzer, for example, and the priming aqueous solution is passed through the hollow fiber membrane wall. Even if air is mixed in the priming aqueous solution, it cannot pass through the hollow fiber membrane wall, so only the priming aqueous solution flows into the blood side circuit and no air is mixed in.
従って、プライミング用水溶液の導入に、従来法の様に
エアーの混入に関して細心の注意を払う必要が無く、操
作を行なう者に熟練度が要求されない上、−回のプライ
ミング操作に要する手間も激減する。Therefore, when introducing the priming aqueous solution, there is no need to pay close attention to the mixing of air as in the conventional method, and the person performing the operation does not need to be skilled, and the time and effort required for the -times of priming operation is drastically reduced. .
特に、ウェットタイプの血液透析器の場合は、血液透析
器と血液循環用チューブとの接続時に予め中空糸膜内側
に充填されている滅菌水を流出させない点たけ注意すれ
ば、熟練者でなくても簡単に本発明のプライミング操作
を行うことができる。即ち、治療用の体外循環回路を組
み立ててしまい、透析液供給源と血液透析器の透析液入
口とをつなぐ回路に透析液中のエンドトキシンを除去す
る手段を介在させて治療時と同様に透析液を血液透析器
へ供給する操作を行えば、血液透析器の透析液人口には
エンドトキシンフリーの透析液が供給され、これか中空
系膜を介して中空糸膜内側へ流れ込み、エンドトキシン
フリーの透析液によるプライミング操作が実現できる。In particular, in the case of a wet-type hemodialyzer, even non-experts can do this by being careful not to let out the sterile water that has been filled inside the hollow fiber membrane when connecting the hemodialyzer and the blood circulation tube. The priming operation of the present invention can be performed easily. In other words, an extracorporeal circulation circuit for treatment is assembled, and a means for removing endotoxin in the dialysate is interposed in the circuit connecting the dialysate supply source and the dialysate inlet of the hemodialyzer, and the dialysate is removed in the same manner as during treatment. When this operation is performed to supply the dialysate to the hemodialyzer, endotoxin-free dialysate is supplied to the dialysate population of the hemodialyzer, and this flows into the inside of the hollow fiber membrane through the hollow system membrane, resulting in endotoxin-free dialysate. The priming operation can be realized by
この場合、予め血液透析器の透析液側に充填されていた
減菌水も中空糸膜内側へ流れ込み、プライミング用水溶
液の一部として利用される。In this case, sterilized water previously filled on the dialysate side of the hemodialyzer also flows into the hollow fiber membrane and is used as part of the priming aqueous solution.
本発明で使用されるプライミング用水溶液としては、従
来より使用されている生理食塩水の他、上記の如く、エ
ンドトキシンフリーの透析液や、予め血液浄化器に充填
されている滅菌水、及びこれらの混合液が挙げられる。The priming aqueous solution used in the present invention includes, in addition to conventionally used physiological saline, endotoxin-free dialysate, sterile water pre-filled in a blood purifier, and the like mentioned above. A mixed liquid may be mentioned.
なお、プライミング用水溶液を中空糸膜外側へ供給し、
それを更に中空糸膜壁を通過させて中空系膜内側、続い
て血液循環チューブへと移動させる駆動方法としては、
プライミング用水溶液の供給源と血液浄化器との間に落
差を設けて落差圧により供給する方法や、プライミング
用水溶液の供給源と血液浄化器の中空系膜外側とを結ぶ
チューブにしごきポンプ等を設けて送り出す方法、或は
中空糸膜内側に連通ずる血液循環チューブに設けられて
いる、いわゆる血液ポンプを利用してプライミング用水
溶液を中空糸膜内側へ引っばる方法等が挙げられる。In addition, supplying the priming aqueous solution to the outside of the hollow fiber membrane,
The driving method for moving it further through the hollow fiber membrane wall, inside the hollow system membrane, and then into the blood circulation tube is as follows:
There is a method of providing a head difference between the supply source of the priming aqueous solution and the blood purifier and supplying it by differential pressure, or a method of using a squeezing pump etc. in a tube connecting the supply source of the priming aqueous solution and the outside of the hollow membrane of the blood purifier. Examples include a method in which the priming aqueous solution is drawn into the hollow fiber membrane using a so-called blood pump installed in a blood circulation tube communicating with the inside of the hollow fiber membrane.
（実施例）
本発明の実施例の１例として、ウェットタイプの血液透
析器の場合について説明する。(Example) As an example of the embodiment of the present invention, a case of a wet type hemodialyzer will be described.
第１図はプライミング用水溶液に生理食塩水を使用する
場合の構成図であり、第２図はプライミング用水溶液に
エンドトキシンフリーの透析液を使用する場合の構成図
である。FIG. 1 is a configuration diagram when physiological saline is used as the priming aqueous solution, and FIG. 2 is a configuration diagram when endotoxin-free dialysate is used as the priming aqueous solution.
先つ、第１図より説明する。透析器（１）と血液循環用
チューブ（２，３）及びプライミング用水溶液供給チュ
ーブ（１４）を第１図の様に接続し、回路を構成する。First, it will be explained with reference to FIG. A dialyzer (1), blood circulation tubes (2, 3), and priming aqueous solution supply tube (14) are connected as shown in FIG. 1 to form a circuit.
透析器内には予め滅菌水が充填されており、血液循環用
チューブ内（２，３）及びプライミング用水溶液供給チ
ューブ内（１４）にはエアーか存在している。回路を接
続する前にピンチバルブ（１７）は透析器中空糸膜内側
（４）の滅菌水が血液循環用チューブ（３）内へ流出、
落下するのを防ぐ為閉しておく、回路の接続が終了した
ら、プライミング用水溶液の通液を開始する。ピンチバ
ルブ（１９）を閉し、ピンチバルブ（１７）を開いた状
態で、生理食塩水（１３）を透析器中空系膜外側（５）
へ供給する。The dialyzer is filled with sterile water in advance, and air is present in the blood circulation tubes (2, 3) and the priming aqueous solution supply tube (14). Before connecting the circuit, the pinch valve (17) allows the sterile water inside the dialyzer hollow fiber membrane (4) to flow out into the blood circulation tube (3).
Keep it closed to prevent it from falling. Once the circuit connection is complete, start flowing the priming aqueous solution. With the pinch valve (19) closed and the pinch valve (17) open, pour the physiological saline (13) into the dialyzer hollow system membrane outside (5).
supply to
供給手段は、生理食塩水供給源（１３）と透析器（１〉
との間に落差を設け、落差圧により供給する方法や、プ
ライミング用水溶液供給チューブ（１４）の途中に注入
ポンプ（１６）を設けて送り込む方法、或はいわゆる血
液ポンプ（１１〉を図において時計廻りに回転させて生
理食塩水をチューブ（１４）、中空糸膜外側（５）を経
て中空糸膜内側（４〉へ引き込む方法等がある。The supply means includes a physiological saline supply source (13) and a dialyzer (1).
There is a method of supplying by differential head pressure by providing a head between the priming aqueous solution supply tube (14), a method of providing an infusion pump (16) in the middle of the priming aqueous solution supply tube (14), or a method of supplying the so-called blood pump (11) with a clock in the figure. There is a method of drawing physiological saline into the inside of the hollow fiber membrane (4>) through the tube (14), the outside of the hollow fiber membrane (5), and the like by rotating the tube.
ここでは、注入ポンプ（１６）に依り送り込む方法につ
いて説明する。中空糸膜外側（５）の圧が上昇し、そこ
に充填されている滅菌水は、中空糸膜壁（６）を通過し
中空糸膜内側（４）へ移行する。それにより中空糸膜内
側の滅菌水と生理食塩水との溶液量が増加し、血液循環
用チューブ（２）内へ流れ込み動脈側チャンバー（８）
に達する。動脈側チャンバー（８）には非接液で液面レ
ベルを検知する、液面検知器（９）を設けておき、この
液面検知器（９〉で所定の液面が検知されたらピンチバ
ルブ（１７）が閉じ、ピンチバルブ（１９）が開となる
ように予め制御系を確立しておく。同時に、注入ポンプ
（１６）が停止し、血液ポンプ（１１）が正転（即ち図
において反時計廻り）を始めピンチバルブ（２０）は開
、ピンチバルブ（２１）は閉となる。血液循環用チュー
ブ先端（１２）より、生理食塩水が該チューブ（２〉内
へ流れ込み透析器中空糸膜内側（４）を通過して静脈側
チャンバー（１８）に達する。静脈側チャンバー（１８
）にも前述と同型の液面検知器（２２）を設けておき、
この液面検知器（２２）で液面を検知したらピンチバル
ブ（２０）を閉し、ピンチバルブ（２１）を開とし、液
面を一定に保つ。この状態で血液ポンプ（１１）を廻し
続け、所定量生理食塩水を流したら、自動的に終了する
。この時は、血液ポンプ（１１）は停止し、ピンチバル
ブ（１７，２０）は閉し、ピンチバルブ（１９，２１）
は開と成る。終了の時期を判断する手段としては、タイ
マー等で概ねその所要時間を設定しておく方法でも良い
し、或いは注入ポンプ（１６）及び血液ポンプ（１１）
の回転数から生理食塩水注入量を計算して、所定注入量
に達した事を判断する方法でも良い。以上のプライミン
ブ操作では、開始時の回路接続以外は全て自動的に行わ
れる。Here, a method of feeding using the injection pump (16) will be explained. The pressure on the outside of the hollow fiber membrane (5) increases, and the sterilized water filled there passes through the hollow fiber membrane wall (6) and moves to the inside of the hollow fiber membrane (4). As a result, the amount of sterile water and physiological saline solution inside the hollow fiber membrane increases and flows into the blood circulation tube (2) and into the artery side chamber (8).
reach. The arterial side chamber (8) is equipped with a liquid level detector (9) that detects the liquid level without contacting the liquid, and when the liquid level detector (9) detects a predetermined liquid level, the pinch valve is activated. (17) is closed and the pinch valve (19) is opened.At the same time, the infusion pump (16) is stopped and the blood pump (11) rotates normally (that is, reversely in the figure). (clockwise), the pinch valve (20) is opened, and the pinch valve (21) is closed. Physiological saline flows from the blood circulation tube tip (12) into the tube (2) and the dialyzer hollow fiber membrane. It passes through the inside (4) and reaches the venous chamber (18).The venous chamber (18)
) is also provided with a liquid level detector (22) of the same type as mentioned above,
When the liquid level is detected by this liquid level detector (22), the pinch valve (20) is closed and the pinch valve (21) is opened to keep the liquid level constant. In this state, the blood pump (11) continues to rotate, and once a predetermined amount of saline has been flowed, the process automatically ends. At this time, the blood pump (11) is stopped, the pinch valves (17, 20) are closed, and the pinch valves (19, 21) are closed.
becomes open. As a means of determining the end time, it is possible to set the approximate required time using a timer or the like, or to use the infusion pump (16) and blood pump (11).
Alternatively, the amount of saline to be injected may be calculated from the rotational speed of , and it may be determined that a predetermined amount of injected water has been reached. In the above priming operation, everything except the circuit connection at the start is performed automatically.
次に第２図でプライミング用水溶液にエンドトキシンフ
リー透析液を使用して行う場合の例を説明する。Next, an example in which endotoxin-free dialysate is used as the priming aqueous solution will be explained with reference to FIG.
まず、第２図の様に透析器（１）と血液循環用チューブ
（２，３）及び透析液チューブ（１２，１４）を接続す
る。回路を接続する前にピンチバルブ（１７）を中空糸
膜内側（４）の滅菌水が血液循環用チューブ（３）側へ
流出、落下するのを防ぐ為閉としておく。回路の接続か
完了したらプライミング用水溶液の通液を開始する。ピ
ンチバルブ（１７）は閉としたまま、ピンチバルブ（１
９）を閉じ、ピンチバルブ（７）を開いた状態でエンド
トキシン除去手段（１５）を経てエンドトキシンフリー
となった透析液を中空糸膜外側（５）へ供給する。この
時中空糸膜外側（５）の圧をより高める為に透析液チュ
ーブ（１２）の部に絞り機構（２３）を用いても良い。First, as shown in FIG. 2, the dialyzer (1), blood circulation tubes (2, 3), and dialysate tubes (12, 14) are connected. Before connecting the circuit, close the pinch valve (17) to prevent the sterile water inside the hollow fiber membrane (4) from flowing out and falling into the blood circulation tube (3). After completing the circuit connection, start flowing the priming aqueous solution. Keep the pinch valve (17) closed and open the pinch valve (1).
9) is closed, and with the pinch valve (7) open, the endotoxin-free dialysate is supplied to the outside of the hollow fiber membrane (5) via the endotoxin removal means (15). At this time, a throttling mechanism (23) may be used in the dialysate tube (12) in order to further increase the pressure on the outside of the hollow fiber membrane (5).
中空糸膜外側（５）に予め充填されていた滅菌水は中空
糸膜壁（６）を通通し、中空糸膜内側（４）へ移行し、
更に、血液循環用チューブ（２）側へ流れ込む、この時
、血液ポンプ（１１）は逆転（即ち図において時計廻り
）させても良いし、或いは血液循環用チューブ（２）の
ポンプしごき部（１０）を血液ポンプ（１１）からはず
しておいても良い。The sterilized water previously filled on the outside of the hollow fiber membrane (5) passes through the hollow fiber membrane wall (6) and moves to the inside of the hollow fiber membrane (4),
Further, the blood flows into the blood circulation tube (2) side. At this time, the blood pump (11) may be reversed (that is, clockwise in the figure), or the blood pump (11) may be rotated in the opposite direction (i.e., clockwise in the figure), or the blood pump (11) may be ) may be removed from the blood pump (11).
例えば、タイマー等で設定された時間が経過すると、ピ
ンチバルブ（７，２１）が閉しピンチバルブ（１９，２
０〉が開き、中空糸膜内側の液は血液循環チューブ（３
）側へ流れ込み静脈側チャンバー（１８）に達するよう
にしておく。静脈側チャンバー（１８）には先の例と同
様、非接液型の液面検知器（２２）を設けておき、この
液面検知器（２２）で液面を検知したら、ピンチバルブ
（２０）を閉し、ピンチバルブ（２１）を開とし、更に
流し続ける。終了の時期を判断する手段としては、例え
ばタイマーにて概ね、その所要時間を設定しておく方法
でも良い。終了するとピンチバルブ（７，１９）は閉と
なる。なお、エンドトキシン除去手段（１５）のエンド
トキシン除去の手段としては、中空糸膜等に依る濾過方
式でも良いし、或いは吸着剤に依る吸着方式でも良い。For example, when the time set by a timer or the like elapses, the pinch valve (7, 21) closes and the pinch valve (19, 2) closes.
0> opens, and the liquid inside the hollow fiber membrane flows through the blood circulation tube (3
) side and reach the venous side chamber (18). As in the previous example, the venous side chamber (18) is provided with a non-wetted type liquid level detector (22), and when the liquid level detector (22) detects the liquid level, the pinch valve (20 ), open the pinch valve (21), and continue flowing. As a means for determining the end time, for example, a method of setting the required time using a timer may be used. When finished, the pinch valves (7, 19) are closed. Note that the endotoxin removal means (15) may use a filtration method using a hollow fiber membrane or the like, or an adsorption method using an adsorbent.
（効果）
本発明のプライミンタ方法では、プライミング用水溶液
を中空糸膜型血液浄化器の中空糸膜外側から供給するの
で、プライミング用水溶液にエアーが混入していてもエ
アーは全て中空糸膜壁でシャットアウトされ、中空糸膜
内側には常にエアーの混入しないプライミング用水溶液
か供給される。(Effects) In the priming method of the present invention, the priming aqueous solution is supplied from the outside of the hollow fiber membrane of the hollow fiber membrane type blood purifier, so even if air is mixed in the priming aqueous solution, all the air is absorbed by the hollow fiber membrane wall. The system is shut out, and a priming aqueous solution containing no air is always supplied to the inside of the hollow fiber membrane.
本発明のプライミング方法は従来、回路の接続の点で特
に熟練が要求されたウェットタイプの血液浄化器を接続
する体外循環回路に適用する時に操作の簡便性、プライ
ミングの確実性の両面で効果が顕著である。また、本発
明のプライミング方法はプライミング用水溶液の通液開
始からプライミング終了までを自動化することができる
。The priming method of the present invention is particularly effective in terms of ease of operation and reliability of priming when applied to an extracorporeal circulation circuit connected to a wet type blood purifier, which conventionally required special skill in connection of the circuit. It is. Further, the priming method of the present invention can automate the process from the start of passing the priming aqueous solution to the end of priming.
第１図は本発明のプライミング方法を行う際の回路接続
方法の１例を示す図、第２図は本発明のプライミング方
法を行う際の回路接続方法の他の１例を示す図である。
１−・中空糸膜型血液浄化器（血液透析器）２．３−・
・血液循環用チューブ
４−中空糸膜内側
５−・中空糸膜外側
６−・中空糸膜
８−動脈側チャンバー
９．２２−液面検知器
１０・・・ポンプしごき部
１１−血液ポンプ
１２−透析液チューブ
１３−プライミング用水溶液
１４−・・プライミング用水溶液供給チューブ１５−・
エンドトキシン除去手段
１６−・・注入ポンプ
７．１７．１９．２０．２１・−ピンチバルブ１８−静
脈側チャンバー
２３−・絞り機構FIG. 1 is a diagram showing one example of a circuit connection method when performing the priming method of the present invention, and FIG. 2 is a diagram showing another example of a circuit connection method when performing the priming method of the present invention. 1-・Hollow fiber membrane type blood purifier (hemodialyzer) 2.3-・
- Blood circulation tube 4 - Hollow fiber membrane inner side 5 - Hollow fiber membrane outer side 6 - Hollow fiber membrane 8 - Arterial side chamber 9.22 - Liquid level detector 10... Pump squeezing section 11 - Blood pump 12 - Dialysate tube 13 - Priming aqueous solution 14 - Priming aqueous solution supply tube 15 -
Endotoxin removal means 16 - Infusion pump 7.17.19.20.21 - Pinch valve 18 - Venous chamber 23 - Squeezing mechanism
Claims (4)
口及び血液側出口に中空糸膜内側に連通する様に接続さ
れた血液循環用チューブとを含む体外循環回路のプライ
ミング方法において、前記中空糸膜型血液浄化器の中空
糸膜外側にプライミング用水溶液を供給し、該プライミ
ング用水溶液を中空糸膜壁を通過させ中空糸膜内側へ移
動させて、中空糸膜内側及びそれに連通する血液循環用
チューブ内の洗浄及びエアー抜きを行なうことを特徴と
する体外循環回路のプライミング方法。(1) In a method for priming an extracorporeal circulation circuit including a hollow fiber membrane type blood purifier and a blood circulation tube connected to the blood side inlet and blood side outlet of the blood purifier so as to communicate with the inside of the hollow fiber membrane. , supplying a priming aqueous solution to the outside of the hollow fiber membrane of the hollow fiber membrane type blood purifier, and moving the priming aqueous solution to the inside of the hollow fiber membrane through the hollow fiber membrane wall to communicate with the inside of the hollow fiber membrane and thereto. 1. A method for priming an extracorporeal circulation circuit, which comprises cleaning and removing air from a blood circulation tube.
液透析器であることを特徴とするプライミング方法。(2) The priming method according to claim (1), wherein the hollow fiber membrane blood purifier is a hemodialyzer.
型血液透析器であることを特徴とするプライミング方法
。(3) The priming method according to claim (2), wherein the hemodialyzer is a sterile water-filled hemodialyzer.
用水溶液がエンドトキシンフリーの透析液であることを
特徴とするプライミング方法。(4) The priming method according to claim (2) or (3), wherein the priming aqueous solution is an endotoxin-free dialysate.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2051739A JP2979234B2 (en) | 1990-03-05 | 1990-03-05 | Hemodialysis machine |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2051739A JP2979234B2 (en) | 1990-03-05 | 1990-03-05 | Hemodialysis machine |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH03254755A true JPH03254755A (en) | 1991-11-13 |
| JP2979234B2 JP2979234B2 (en) | 1999-11-15 |
Family
ID=12895276
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2051739A Expired - Fee Related JP2979234B2 (en) | 1990-03-05 | 1990-03-05 | Hemodialysis machine |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP2979234B2 (en) |
Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6274034B1 (en) | 1998-10-07 | 2001-08-14 | Nipro Corporation | Dialysis system and cleaning and priming method thereof |
| US6277272B1 (en) | 1998-10-07 | 2001-08-21 | Nipro Corporation | Dialysis system and cleaning and priming method thereof |
| JP2005193011A (en) * | 2003-12-08 | 2005-07-21 | Asahi Kasei Medical Co Ltd | Priming method of blood purifying device |
| US7186342B2 (en) | 2001-06-05 | 2007-03-06 | Gambro Lundia Ab | Method for filling and washing a filter for a dialysis machine |
| JP2010125208A (en) * | 2008-11-28 | 2010-06-10 | Asahi Kasei Kuraray Medical Co Ltd | Blood extracorporeal circulation apparatus and method of priming the same |
| JP2012501239A (en) * | 2008-09-02 | 2012-01-19 | フレセニウス・メディカル・ケア・ドイチュラント・ゲーエムベーハー | Apparatus and method for filling a filter |
| JP2014521387A (en) * | 2011-05-24 | 2014-08-28 | フレゼニウス メディカル ケアー ドイチュラント ゲゼルシャフト ミット ベシュレンクテル ハフツング | Method for rinsing and / or filling a blood treatment device and blood treatment device |
-
1990
- 1990-03-05 JP JP2051739A patent/JP2979234B2/en not_active Expired - Fee Related
Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6274034B1 (en) | 1998-10-07 | 2001-08-14 | Nipro Corporation | Dialysis system and cleaning and priming method thereof |
| US6277272B1 (en) | 1998-10-07 | 2001-08-21 | Nipro Corporation | Dialysis system and cleaning and priming method thereof |
| US6551513B2 (en) | 1998-10-07 | 2003-04-22 | Nipro Corporation | Cleaning and priming method for dialysis system |
| US6582604B2 (en) | 1998-10-07 | 2003-06-24 | Nipro Corporation | Method of cleaning and priming dialysis system |
| US7186342B2 (en) | 2001-06-05 | 2007-03-06 | Gambro Lundia Ab | Method for filling and washing a filter for a dialysis machine |
| JP2005193011A (en) * | 2003-12-08 | 2005-07-21 | Asahi Kasei Medical Co Ltd | Priming method of blood purifying device |
| JP2012501239A (en) * | 2008-09-02 | 2012-01-19 | フレセニウス・メディカル・ケア・ドイチュラント・ゲーエムベーハー | Apparatus and method for filling a filter |
| US8875748B2 (en) | 2008-09-02 | 2014-11-04 | Fresenius Medical Care Deutschland Gmbh | Device for filling a filter, and method therefor |
| JP2010125208A (en) * | 2008-11-28 | 2010-06-10 | Asahi Kasei Kuraray Medical Co Ltd | Blood extracorporeal circulation apparatus and method of priming the same |
| JP2014521387A (en) * | 2011-05-24 | 2014-08-28 | フレゼニウス メディカル ケアー ドイチュラント ゲゼルシャフト ミット ベシュレンクテル ハフツング | Method for rinsing and / or filling a blood treatment device and blood treatment device |
Also Published As
| Publication number | Publication date |
|---|---|
| JP2979234B2 (en) | 1999-11-15 |
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