Intermediate system and blood purification system

Abstract

Provided is an intermediate system that, when a CRRT system is connected to an ECMO system, is capable of reducing the effect of pressure received by the CRRT system from the ECMO system. An intermediate system (300) provided to a connection site between an ECMO system (100) and a CRRT system (200), the upstream end of the CRRT system (200) being connected downstream of an ECMO blood pump (120) in the ECMO system (100), the intermediate system (300) being provided with: an intermediate blood return line (320), the upstream end of which is connected to the downstream end of the CRRT system (200) and the downstream end of which is connected to the ECMO system (100); a blood return pump (321); a blood return side pressure buffer section (322) provided upstream of the blood return pump (321); and a control unit (330) that controls the storage amount of the liquid in accordance with the storage state of the return-side pressure buffer unit (322) so that the storage amount falls within a predetermined range.

Description

Technical Field

[0001] The present invention relates to an intermediate system arranged at the connection position of an extracorporeal membrane type artificial lung system and a blood purification system, and a blood purification system connected to the extracorporeal membrane type artificial lung system. Background Art

[0002] In the intensive care area, patients with weak heart and lung functions are treated with an extracorporeal membrane oxygenator (hereinafter also referred to as ECMO: extracorporeal membrane oxygenation). Among such patients, continuous renal replacement therapy (hereinafter also referred to as CRRT) for blood purification is sometimes required due to complications of renal failure. Patients who are undergoing ECMO are administered anticoagulants in the ECMO circuit, and have a tendency to bleed. Here, if blood is delivered and removed from other blood vessels for CRRT, it is sometimes necessary to further administer anticoagulants in the CRRT circuit, which increases the tendency to bleed, and is therefore not preferred. In addition, in addition to blood delivery and removal of blood from ECMO, multiple catheters are often inserted in the central vein for systemic management, and it is difficult to newly insert a vascular access for CRRT. Therefore, attempts have been made to directly connect the CRRT circuit to the ECMO circuit at the clinical site (see Patent Document 1).

[0003] In the ECMO system, since blood is removed at a high flow rate, the upstream side of the pump becomes excessive negative pressure and the downstream side becomes excessive positive pressure. On the other hand, the CRRT system as a blood purification system has less blood flow than the ECMO system, and the circuit pressure on the downstream side of the pump operates at a low positive pressure. Therefore, in order to prevent the CRRT circuit from being affected by the excessive positive and negative pressure of the ECMO circuit, it is necessary to connect the CRRT circuit to the part with a smaller size of the circuit pressure in the ECMO circuit. In this regard, as a suitable connection method, the following method is proposed: a bypass line is provided in the ECMO circuit to connect the upstream side of the pump to the downstream side of the artificial lung, and the blood removal line of the CRRT circuit is connected to the side of the artificial lung close to the ECMO circuit in the relatively low pressure part on the bypass line, and the blood return line is connected to the side of the pump close to the ECMO circuit (refer to non-patent document 1). In addition, as other connection methods, a method of connecting the blood removal line of the CRRT circuit to the rear side of the pump of the ECMO circuit and connecting the blood return line of the CRRT circuit to the front side of the artificial lung of the ECMO circuit is proposed (refer to non-patent document 2).

[0004] Prior art literature

[0005] Patent Literature

[0006] Patent Document 1: Japanese Patent Application No. 2010-528781

[0007] Non-patent literature

[0008] Non-patent document 1: Suga N, Matsumura Y, Abe R, et al "A safe procedure for connecting a continuous renal replacement therapy device into anextracorporeal membrane oxygenation circuit." J Artif Organs 2017

[0009] Non-patent literature 2: Christian de Tymowski, et al. “CRRT Connected to ECMO: Managing High Pressures” ASAIO Journal 2017 Summary of the invention

[0010] Problem that the invention aims to solve

[0011] In the connection method described in the above-mentioned non-patent document 1, the blood removal line and blood return line of the CRRT circuit can be connected to the low positive pressure part of the ECMO circuit. However, in the case of a high degree of poor blood removal in the ECMO circuit, there is also a risk of negative pressure in the CRRT circuit. When negative pressure is transmitted to the CRRT circuit, there is the possibility that the air introduced by the CRRT circuit is delivered to the patient through the ECMO circuit, thereby causing air embolism.

[0012] On the other hand, in the connection method described in the above-mentioned non-patent document 2, since the CRRT circuit is connected to the positive pressure part of the ECMO circuit, it will not be affected by the negative pressure from the ECMO circuit, and recirculation will not occur. However, the circuit pressure of the CRRT circuit becomes a positive pressure higher than usual, so it becomes difficult to monitor the circuit pressure during the operation of the CRRT system. Specifically, when the circuit pressure exceeds the specified value, the operation of the CRRT system will be stopped at the same time as the alarm. Therefore, there is a problem that coagulation and blockage are prone to occur in the CRRT circuit. In addition, when the operation of the ECMO system is continued when the CRRT system is stopped, it is possible that the thrombus generated in the branch part with the ECMO circuit due to the cessation of blood flow in the CRRT circuit will be sent to the ECMO system side.

[0013] Therefore, an object of the present invention is to provide an intermediate system and a blood purification system that can reduce the influence of pressure on the blood purification system from the ECMO system when the blood purification system is connected to the ECMO system.

[0014] Solutions for solving problems

[0015] The present invention relates to an intermediate system, which is an intermediate system arranged at the connection part of an extracorporeal membrane type artificial lung system and a blood purification system, wherein the extracorporeal membrane type artificial lung system has an ECMO blood pump and an artificial lung arranged on the downstream side of the ECMO blood pump, and the blood purification system has a blood purification pump and a blood purifier arranged on the downstream side of the blood purification pump, wherein the upstream end of the blood purification system is connected to the downstream side of the ECMO blood pump in the extracorporeal membrane type artificial lung system, and the intermediate system has: an intermediate blood return line, the upstream end of which is connected to the blood purification system a downstream end thereof, the downstream end of which is connected to the extracorporeal membrane artificial lung system; a blood return pump, which is arranged in the intermediate blood return line; a blood return side pressure buffer section, which is arranged in the intermediate blood return line on the upstream side of the blood return pump and can store a specified amount of liquid; a blood return side detection section, which detects the storage state of the liquid in the blood return side pressure buffer section; and a control section, which adjusts the flow rate of the blood return pump according to the storage state of the blood return side pressure buffer section detected by the blood return side detection section, so as to control the storage amount of the liquid in the blood return side pressure buffer section to be within a specified range.

[0016] In addition, preferably, the intermediate system also comprises: an intermediate blood desorption circuit, whose upstream end is connected to the downstream side of the ECMO blood pump in the extracorporeal membrane artificial lung system, and whose downstream end is connected to the upstream end of the blood purification system; a flow adjustment unit, which is arranged in the intermediate blood desorption circuit to adjust the flow of the intermediate blood desorption circuit; a blood desorption side pressure buffer unit, which is arranged in the intermediate blood desorption circuit on the downstream side of the flow adjustment unit and can store a specified amount of liquid; and a blood desorption side detection unit, which detects the storage state of the blood desorption side pressure buffer unit, and the control unit adjusts the flow of the flow adjustment unit according to the storage state of the blood desorption side pressure buffer unit detected by the blood desorption side detection unit, so as to control the storage amount of the liquid in the blood desorption side pressure buffer unit in a specified range.

[0017] In addition, preferably, the downstream end of the intermediate blood return line is connected to the artificial lung or the artificial lung in the extracorporeal membrane artificial lung system, which is upstream of the artificial lung.

[0018] In addition, the present invention relates to a blood purification system, which is a blood purification system connected to an extracorporeal membrane type artificial lung system, wherein the extracorporeal membrane type artificial lung system has an ECMO blood pump and an artificial lung arranged on the downstream side of the ECMO blood pump, and the blood purification system comprises: a blood removal circuit, whose upstream end is connected to the downstream side of the extracorporeal membrane type artificial lung system than the ECMO blood pump; a blood purifier, which is connected to the downstream end of the blood removal circuit; a liquid delivery unit, which delivers liquid to the blood purifier; a blood return circuit, whose upstream end is connected to the blood A purifier, the downstream end of which is connected to the extracorporeal membrane artificial lung system; a blood return pump, which is arranged in the blood return line; a blood return side pressure buffer, which is arranged in the blood return line on the upstream side of the blood return pump and can store a specified amount of liquid; a blood return side detection unit, which detects the storage state of the blood return side pressure buffer; and a control unit, which adjusts the flow rate of the blood return pump according to the storage state of the blood return side pressure buffer detected by the blood return side detection unit, so as to control the storage amount of the liquid in the blood return side pressure buffer to be within a specified range.

[0019] In addition, preferably, the blood purification system further comprises: a flow adjustment unit, which is arranged on the upstream side of the blood desorption line to adjust the flow of the blood desorption line; a blood desorption side pressure buffer unit, which is arranged on the downstream side of the blood desorption line and can store a specified amount of liquid; and a blood desorption side detection unit, which detects the storage state of the blood desorption side pressure buffer unit, and the control unit adjusts the flow of the flow adjustment unit according to the storage state of the blood desorption side pressure buffer unit detected by the blood desorption side detection unit, so as to control the storage amount of the liquid in the blood desorption side pressure buffer unit to be within a specified range.

[0020] In addition, preferably, the liquid delivery unit is a blood purification pump provided on the blood removal line at a downstream side of the blood removal-side pressure buffer section.

[0021] In addition, preferably, the liquid supply unit includes a height difference adjustment unit capable of relatively changing the position of the blood removal-side pressure buffer section in the height direction and the position of the blood return-side pressure buffer section in the height direction.

[0022] In addition, preferably, the downstream end of the blood return line is connected to the extracorporeal membrane artificial lung system on the upstream side of the artificial lung.

[0023] In addition, the present invention relates to a blood purification system, which is a blood purification system connected to an extracorporeal membrane-type artificial lung system, the extracorporeal membrane-type artificial lung system having a blood pump and an artificial lung arranged on the downstream side of the blood pump, the blood purification system comprising: a blood removal circuit, whose upstream end is connected to the downstream side of the blood pump in the extracorporeal membrane-type artificial lung system; a blood purifier, which is connected to the downstream end of the blood removal circuit; a flow adjustment unit, which is arranged to the blood removal circuit to adjust the flow of the blood removal circuit; a blood return circuit, whose upstream end is connected to the blood purifier and the downstream end is connected to the extracorporeal membrane-type artificial lung system; a blood return pump, which is arranged to the blood return circuit; a pressure gauge, which measures the pressure in the blood return circuit on the upstream side of the blood return pump; and a control unit, which adjusts the flow rates of the flow adjustment unit and the blood return pump so as to control the measured value of the pressure gauge in a prescribed range.

[0024] Preferably, the blood purification system further includes a storage unit, the storage unit being provided upstream of the blood return pump in the blood return line and capable of storing a predetermined amount of liquid, and the pressure gauge measuring the pressure of the storage unit.

[0025] In addition, preferably, the flow adjustment unit is a roller pump or a finger pump, and the control unit adjusts the flow of the roller pump or the finger pump to control the inflow amount of the blood purifier, and adjusts the flow of the return blood pump to control it in a manner so that the measured value of the pressure gauge is within a specified range.

[0026] In addition, preferably, the flow adjustment unit is an adjustment fixture capable of adjusting the opening, the control unit adjusts the flow of the return blood pump to control the inflow of the blood purifier, and adjusts the opening of the adjustment fixture to control the measured value of the pressure gauge within a specified range.

[0027] In addition, preferably, the downstream end of the blood return line is connected to the artificial lung or the artificial lung in the extracorporeal membrane artificial lung system, which is upstream of the artificial lung.

[0028] Effects of the Invention

[0029] According to the present invention, it is possible to provide an intermediate system and a blood purification system that can reduce the influence of pressure on the blood purification system from the ECMO system when the blood purification system is connected to the ECMO system. BRIEF DESCRIPTION OF THE DRAWINGS

[0030] Figure 1 This is a diagram showing the schematic configuration of an ECMO system, a CRRT system, and an intermediate system according to a first embodiment of the present invention.

[0031] Figure 2This is a block diagram of a CRRT system and an intermediate system according to the first embodiment of the present invention.

[0032] Figure 3 It is a diagram showing a schematic configuration of an intermediate system, an ECMO system, and a CRRT system according to a modified example of the first embodiment of the present invention.

[0033] Figure 4 This is a block diagram of a CRRT system and an intermediate system according to a modified example of the first embodiment of the present invention.

[0034] Figure 5 This is a diagram showing a schematic configuration of an ECMO system and a CRRT system according to a second embodiment of the present invention.

[0035] Figure 6 This is a block diagram of a CRRT system according to a second embodiment of the present invention.

[0036] Figure 7 It is a diagram showing a schematic configuration of an ECMO system and a CRRT system according to a first modification of the second embodiment of the present invention.

[0037] Figure 8 This is a block diagram of a CRRT system according to Modification 1 of the second embodiment of the present invention.

[0038] Fig. 9 This is a diagram showing a schematic configuration of an ECMO system and a CRRT system according to a second modification of the second embodiment of the present invention.

[0039] Fig.10 This is a block diagram of a CRRT system according to Modification 2 of the second embodiment of the present invention.

[0040] Fig.11 This is a graph showing the relationship between the measured flow rate and the height difference in the example of the modification 2 of the second embodiment of the present invention.

[0041] Fig. 12A This is a diagram showing another example of a method of connecting an ECMO system and an intermediate system, or an ECMO system and a CRRT system in the first embodiment and the second embodiment and each modification of the first embodiment and the second embodiment of the present invention.

[0042] Fig. 12B This is a diagram showing another example of a method of connecting an ECMO system and an intermediate system, or an ECMO system and a CRRT system in the first embodiment and the second embodiment and each modification of the first embodiment and the second embodiment of the present invention.

[0043] Fig.13This is a diagram showing a schematic configuration of an ECMO system and a CRRT system according to a third embodiment of the present invention.

[0044] Fig.14 This is a block diagram of a CRRT system according to a third embodiment of the present invention.

[0045] Fig.15 This is a diagram showing a schematic configuration of an ECMO system and a CRRT system according to a fourth embodiment of the present invention.

[0046] Fig.16 This is a block diagram of a CRRT system according to a fourth embodiment of the present invention.

[0047] Fig.17 It is a graph showing the relationship between the post-pump pressure of the ECMO system and the flow rate of the CRRT system in Example 4 of the present invention.

[0048] Fig.18 This is a diagram showing another example of the method of connecting the ECMO system and the CRRT system in the third and fourth embodiments of the present invention.

[0049] Fig.19 This is a diagram showing another example of the method of connecting the ECMO system and the CRRT system in the third and fourth embodiments of the present invention. DETAILED DESCRIPTION

[0050] Hereinafter, preferred embodiments of a continuous renal replacement therapy system as an intermediate system and a blood purification system of the present invention will be described with reference to the drawings.

[0051] The intermediate system of the present invention is set to the connection part of the extracorporeal membrane oxygenation (ECMO) system and the continuous renal replacement therapy (CRRT) system. The ECMO system described in this specification is suitable for patients with weak heart and lung functions. A pump is used to transport blood taken from the patient to the artificial lung, and the blood with oxygen added in the artificial lung is returned to the patient to assist the patient's heart function and lung function. The CRRT system is suitable for patients with acute renal dysfunction. In order to prevent the concentration, circulation volume and blood pressure of the blood from changing drastically, it takes time to remove waste and water in the blood little by little. There are types of CRRT including continuous hemodialysis (CHD), continuous hemofiltration (CHF) and continuous hemodiafiltration (CHDF), but in each embodiment described below, the case of using continuous hemodiafiltration (CHDF) is described as an example.

[0052] In addition, in this embodiment, the blood purification system of the present invention is applied to the CRRT system, but is not limited thereto. For example, the blood purification system may also be applied to a blood adsorption therapy (DHP: Direct Hemo Perfusion) system. Blood adsorption therapy is a treatment method that uses an adsorption-type blood purification purifier as a blood purifier to adsorb and remove inflammatory substances. In addition, the blood purification system may also be applied to a plasma adsorption therapy system.

[0053] <First embodiment>

[0054] Reference Figure 1 The first embodiment will be described in detail. Figure 1 1 is a diagram showing a schematic configuration of an ECMO system 100 , a CRRT system 200 , and an intermediate system 300 according to a first embodiment of the present invention. Figure 2 A block diagram of a CRRT system 200 and an intermediate system 300 is shown.

[0055] (ECMO system)

[0056] like Figure 1 As shown, the ECMO system 100 includes an ECMO blood circuit 110 , an ECMO blood pump 120 , an artificial lung 130 , and a control unit 140 .

[0057] The ECMO blood circuit 110 is a circuit for extracorporeal circulation of the patient's blood, and is composed of a blood removal line 110a, a connection line 110b, and a blood return line 110c. One end of the blood removal line 110a is connected to a blood removal cannula 111, and the other end is connected to an ECMO blood pump 120.

[0058] One end of the connection line 110b is connected to the ECMO blood pump 120, and the other end is connected to the artificial lung 130. The connection line 110b has a first branch portion 110b1 and a second branch portion 110b2. Connectors such as three-way stopcocks are respectively mounted on the first branch portion 110b1 and the second branch portion 110b2.

[0059] In addition, in the present embodiment, a bypass line 113 is provided in the connection line 110b to bypass the first branch portion 110b1 and the second branch portion 110b2. The bypass line 113 is connected to the connection portion of the connection line 110b by, for example, a three-way stopcock (not shown). By providing the bypass line 113, when the CRRT system 200 or the intermediate system 300 stops operating due to some fault, the flow path from the ECMO blood pump 120 to the artificial lung 130 is switched to the bypass line 113, so that the ECMO system can be operated more safely.

[0060] One end of the blood return line 110c is connected to the artificial lung 130, and the other end is connected to the blood supply cannula 112. In order to monitor the operating status of the ECMO system 100, a flow meter 114 is installed in the blood return line 110c. In this embodiment, an ultrasonic flow meter is used as the flow meter 114. As the flow meter 114, an optical flow meter or the like can also be used.

[0061] The ECMO blood pump 120 extracts blood from the patient's vein via the blood removal cannula 111 and the blood removal line 110a. The extracted blood is delivered to the artificial lung 130 via the connecting line 110b, and then returned to the patient via the blood return line 110c via the blood delivery cannula 112. As the ECMO blood pump 120, a well-known centrifugal pump is used.

[0062] The artificial lung 130 is provided with a hollow fiber membrane (not shown) formed by bundling hollow fibers having many tiny holes, and oxygen is added to the blood delivered from the ECMO blood pump 120 and carbon dioxide is removed by making oxygen flow inside the hollow fibers and blood flow outside the hollow fibers. In addition, the artificial lung 130 captures bubbles present in the delivered blood and prevents it from flowing downstream of the ECMO circuit. As the artificial lung 130, a known membrane type artificial lung is used. In addition, the artificial lung 130 may also have a heat exchange function.

[0063] The control unit 140 is constituted by an information processing device (computer), and drives each pump included in the ECMO system 100 by executing a control program, thereby controlling the operation of the ECMO system 100 .

[0064] (CRRT System)

[0065] like Figure 1 and Figure 2 As shown, the CRRT system 200 includes a CRRT blood circuit 210 , a CRRT blood pump 220 as a blood purification pump, a blood purifier 230 , a dialysate supply line 240 , a dialysate discharge line 250 , a supplemental fluid line 260 , and a control unit 270 .

[0066] The CRRT blood circuit 210 is a circuit for circulating the extracted blood, and is composed of a blood removal line 210a and a blood return line 210b. One end (upstream end) of the blood removal line 210a is connected to the downstream end of the intermediate blood removal line 310 of the intermediate system 300 described later, and the other end (downstream end) is connected to the blood purifier 230. A CRRT blood pump 220 is provided in the blood removal line 210a. A pressure gauge P1 is installed on the upstream side of the CRRT blood pump 220, and a pressure gauge P2 is installed on the downstream side of the CRRT blood pump 220. One end (upstream end) of the blood return line 210b is connected to the blood purifier 230, and the other end (downstream end) is connected to the upstream end of the intermediate blood return line 320 of the intermediate system 300 described later.

[0067] The blood return line 210b is equipped with a drip tube 211, and a pressure gauge P3 is installed in the drip tube 211. In order to remove air bubbles mixed into the blood, coagulated blood, etc., the drip tube 211 stores a certain amount of blood. The pressure gauge P3 measures the internal pressure of the circuit of the blood return line 210b.

[0068] In addition, in this embodiment, the case where the drip tube 211 is installed in the blood return line 210b is shown as an example, but the present invention is not limited to this. For example, instead of installing the drip tube in the blood return line, the pressure gauge P3 may be installed in the blood return line 210b to measure the circuit internal pressure.

[0069] The CRRT blood pump 220 extracts blood from the ECMO system 100 via the intermediate blood removal line 310. The extracted blood is transported to the blood purifier 230 via the blood removal line 210a, and then returned to the ECMO system 100 via the intermediate blood return line 320 via the blood return line 210b.

[0070] The blood purifier 230 is provided with a dialysis membrane (not shown) housed inside a container body formed into a cylindrical shape. The inside of the container body is divided into a blood side flow path and a dialysate side flow path (neither of which are shown) by the dialysis membrane, and water and wastes move from the blood side flow path to the dialysate side flow path via the dialysis membrane, thereby purifying the blood.

[0071] The dialysate supply line 240 includes a dialysate pump 241, is a line for supplying dialysate to the blood purifier 230, and connects the dialysate supply source D to the dialysate side flow path of the blood purifier 230. As the dialysate pump 241, a well-known roller pump is used.

[0072] The dialysate discharge line 250 is provided with a discharge pump 251 to discharge the dialysate from the blood purifier 230. The dialysate discharge line 250 connects the dialysate side flow path of the blood purifier 230 to the discharge storage part F. A well-known roller pump is used as the discharge pump 251. In addition, the dialysate discharge line 250 is equipped with a pressure gauge P4.

[0073] The supplementing liquid line 260 includes a supplementing liquid pump 261, and supplies the supplementing liquid supplied from the supplementing liquid supply source R to the blood return line 210b via the drip tube 211 provided in the blood return line 210b. As the supplementing liquid, dialysate or physiological saline is used.

[0074] The control unit 270 is composed of an information processing device (computer), and drives each pump of the CRRT system 200 by executing a control program, controls the blood flow, dialysate volume, and discharge volume of the blood purifier 230, and performs continuous hemodiafiltration (CHDF). In addition, the control unit 270 can also monitor the flow rates of the dialysate pump 241 configured in the dialysate supply line 240, the discharge pump 251 configured in the dialysate discharge line 250, and the supplementary liquid pump 261 configured in the supplementary liquid line 260, and control the driving of each pump based on the flow rate measured by a metering unit (not shown) that measures the liquid (dialysate and supplementary liquid) circulating in the CRRT system 200.

[0075] (Intermediate System)

[0076] like Figure 1 and Figure 2 As shown, the intermediate system 300 includes an intermediate blood removal line 310 , a flow rate adjustment unit 311 , an intermediate blood return line 320 , a blood return pump 321 , a blood return side pressure buffer unit 322 , a blood return side detection unit 3221 , and a control unit 330 .

[0077] The intermediate blood removal line 310 is a line for extracting a portion of the blood flowing in the connection line 110b of the ECMO system 100 and delivering it to the CRRT system 200. One end (upstream end) of the intermediate blood removal line 310 is connected to the first branch portion 110b1 provided in the connection line 110b of the ECMO system 100, and the other end (downstream end) is connected to the upstream end of the CRRT system 200. A flow adjustment unit 311 is provided in the intermediate blood removal line 310. A pressure gauge P5 is installed on the upstream side of the flow adjustment unit 311, and a pressure gauge P6 is installed on the downstream side of the flow adjustment unit 311. In addition, in order to monitor whether the flow rate to the connection part (upstream end of the blood removal line 210a) with the CRRT system 200 is normal, and in order to monitor the mixing of bubbles, etc., a flow meter 314 is installed in the intermediate blood removal line 310. In this embodiment, an ultrasonic flow meter is used as the flow meter 314. As the flow meter 314, an optical flow meter or the like can also be used.

[0078] The flow rate adjustment unit 311 adjusts the flow rate of blood flowing in the intermediate blood removal line 310. The flow rate adjustment unit 311 is assembled to a portion of the intermediate blood removal line 310 close to the upstream end. Thus, when it is necessary to close the flow rate adjustment unit 311 to stop the blood flow, the amount of blood discarded due to coagulation can be reduced. The flow rate adjustment unit 311 is composed of a clamp that can adjust the opening. As the flow rate adjustment unit 311, a roller pump can also be used instead of the clamp. By adjusting the flow rate of blood flowing in the intermediate blood removal line 310 by the flow rate adjustment unit 311, the internal pressure of the circuit on the downstream side can be adjusted.

[0079] One end (downstream end) of the intermediate blood return line 320 is connected to the second branch 110b2 provided on the connection line 110b of the ECMO system 100, and the other end (upstream end) is connected to the downstream end of the CRRT blood circuit 210 (blood return line 210b). In the intermediate blood return line 320, a blood return side pressure buffer 322 and a blood return pump 321 are arranged in order from the upstream side. In addition, in the intermediate blood return line 320, a drip tube 323, a liquid exhaustion sensor 324 and a clamp 325 are installed in order on the downstream side of the blood return pump 321. A pressure gauge P7 is installed in the drip tube 323. In order to remove bubbles, coagulated blood, etc. mixed in the intermediate blood return line 320, the drip tube 323 stores a certain amount of blood. The clamp 325 is installed in the intermediate blood return line 320 near the downstream end. The pressure gauge P7 measures the circuit internal pressure on the downstream side of the blood return pump 321 in the intermediate blood return line 320.

[0080] The blood return pump 321 is a pump for sending the blood flowing in the intermediate blood return line 320 to the positive pressure unit of the ECMO system 100. As the blood return pump 321, a well-known roller pump can be used.

[0081] The return blood pressure buffer 322 is provided upstream of the return blood pump 321 in the intermediate return blood line 320 and can store a predetermined amount of liquid. In this embodiment, a reservoir composed of a soft bag is used as the return blood pressure buffer 322 .

[0082] It is desirable that the inlet for blood (liquid) to flow into the blood return side pressure buffer section 322 (reservoir) and the outlet for blood (liquid) from the blood return side pressure buffer section 322 (reservoir) are set at the lower part so as to be filled with blood (liquid). For example, it is sufficient to form two openings at the lower part of the reservoir as the inlet and the outlet. By setting such a structure, when the storage volume of the reservoir decreases sharply due to some reasons, the risk of air being introduced into the intermediate blood return line 320 on the downstream side of the reservoir can be reduced. In addition, a degassing line 3222 (see Figure 1). The degassing line 3222 is closed in principle during operation. In addition to being used to confirm the liquid level during priming, it is also used to degas the air retained in the reservoir during operation. In addition, a heating mechanism (not shown) may be provided in the return blood side pressure buffer section 322. Thereby, the blood returned to the ECMO blood circuit 110 can be heated. In addition, as the return blood side pressure buffer section 322, a small container (such as a pillow) made of soft raw materials may be used instead of the reservoir.

[0083] The return-blood-side detection unit 3221 is assembled to the return-blood-side pressure buffer unit 322 to detect the storage state of the return-blood-side pressure buffer unit 322. In this embodiment, as an example of the return-blood-side detection unit 3221, a weight meter is used to measure the weight (storage state) of the liquid stored in the return-blood-side pressure buffer unit 322 (storage container). In addition, in the case where an air layer is provided in the storage container, a pressure gauge can also be used as the return-blood-side detection unit 3221 to measure the internal pressure that changes according to the storage state of the storage container. In addition, in the case of using a small container such as a pillow as the return-blood-side pressure buffer unit 322, it is sufficient to use a pressure gauge as the return-blood-side detection unit 3221 to detect the expansion and contraction corresponding to the internal pressure of the small container.

[0084] The control unit 330 controls the opening of the clamp serving as the flow adjustment unit 311 so that the pressure measured by the pressure gauge P6 is within a specified pressure range (for example, greater than 40 mmHg and less than 60 mmHg), thereby adjusting the flow rate of blood taken out from the connection line 110b of the ECMO system 100.

[0085] In addition, the control unit 330 adjusts the flow rate of the return blood pump 321 according to the storage state (weight) detected by the return blood side detection unit 3221 (weight meter) so as to control the storage amount of blood stored in the return blood side pressure buffer unit 322 (reservoir) to be within a specified range.

[0086] Furthermore, when the liquid exhaustion sensor 324 detects that the liquid is exhausted, the control unit 330 operates the clamp 325 to block the intermediate blood return line 320 to prevent air bubbles from being mixed into the ECMO system 100 .

[0087] Various lines in the ECMO system 100, CRRT system 200 and intermediate system 300 are mainly composed of flexible soft tubes through which liquid can flow.

[0088] According to the above ECMO system 100, CRRT system 200 and intermediate system 300, the blood taken from the vein of the subject (patient) flows to the blood removal line 110a of the ECMO system 100, a part of the blood in the connecting line 110b flows into the intermediate blood removal line 310 of the intermediate system 300 at a prescribed flow rate, and the rest is transported to the artificial lung 130.

[0089] The blood delivered to the intermediate system 300 is flow-regulated by the flow regulator 311, delivered to the blood removal line 210a of the CRRT system via the intermediate blood removal line 310, and introduced into the blood purifier 230 by the CRRT blood pump 220 at a set predetermined flow rate. Here, the CRRT blood pump 220 functions as a liquid delivery unit that delivers blood to the blood purifier 230, and functions as a pressure partition wall that prevents the high positive pressure transmitted from the ECMO blood circuit 110 from being transmitted to the blood purifier 230. In the blood purifier 230, water and waste are removed via the dialysis membrane, and the purified blood is led out of the blood purifier 230. The blood purified by the blood purifier 230 is supplied with supplementary liquid from the supplementary liquid line 260 according to the amount of water removed, and then delivered to the intermediate blood return line 320 of the intermediate system 300.

[0090] In the intermediate system 300, blood is stored in the return blood side pressure buffer 322 within a prescribed range. The storage amount can be controlled by increasing and decreasing the set flow rate of the return blood pump 321. Specifically, the blood flow rate delivered from the downstream end of the CRRT system 200 becomes a blood flow rate slightly smaller than the set flow rate of the CRRT blood pump 220 by the amount of water removed. Therefore, when the storage amount of the return blood side pressure buffer 322 exceeds the prescribed range, the set flow rate of the return blood pump 321 can be made larger than the set flow rate of the CRRT blood pump 220. In addition, when the storage amount of the return blood side pressure buffer 322 is lower than the prescribed range, the set flow rate of the return blood pump 321 can be made smaller than the set flow rate of the CRRT blood pump 220. As a result, a prescribed amount of blood is stored in the return blood side pressure buffer 322, so that the circuit internal pressure can be reduced by the return blood side pressure buffer 322. Therefore, the downstream end of the CRRT system 200 can be set to a low positive pressure, and thus the CRRT system 200 can be operated at the low positive pressure.

[0091] Since the intermediate blood return line 320 is provided with a blood return pump 321, it can increase the circuit internal pressure reduced by the blood return side pressure buffer 322 and deliver blood to the positive pressure part of the ECMO system 100 (the downstream side of the ECMO blood pump 120). Here, the blood return pump 321 functions as a liquid delivery unit that delivers blood to the positive pressure part of the ECMO system, and functions as a pressure partition wall that makes the upstream side a low positive pressure and the downstream side a high positive pressure.

[0092] The blood returned from the intermediate blood return line 320 of the intermediate system 300 to the connection line 110b of the ECMO system 100 is sent to the artificial lung 130 together with the blood flowing in the connection line 110b, where oxygen is added and carbon dioxide is removed. The blood sent from the artificial lung 130 is returned to the patient's artery or vein via the blood return line 110c and the blood supply cannula 112.

[0093] In addition, in the present embodiment, the flow rate of the blood introduced into the blood circuit 210 of the CRRT system 200 by the CRRT blood pump 220 provided in the CRRT system 200 can be controlled, and therefore the intermediate blood removal line 310 and the flow rate adjustment unit 311 are not necessarily required. In other words, it is also possible to directly connect the upstream end of the blood removal line 210a of the CRRT system 200 to the connection line 110b of the ECMO system 100.

[0094] According to the intermediate system 300 of the first embodiment described above, the following effects (1) and (2) are achieved.

[0095] (1) The intermediate system 300 provided at the connection point between the ECMO system 100 and the CRRT system 200 includes the following components: an intermediate blood return line 320, the upstream end of which is connected to the downstream end of the CRRT system 200, and the downstream end of which is connected to the ECMO system 100; a blood return pump 321 provided in the intermediate blood return line; a blood return side pressure buffer 322 provided in the intermediate blood return line 320 on the upstream side of the blood return pump 321; a blood return side detection unit 3221 for detecting the storage state of the blood return side pressure buffer 322; and a control unit for adjusting the flow rate of the blood return pump 321 according to the storage state of the blood return side pressure buffer 322 detected by the blood return side detection unit 3221, so as to control the storage amount of the liquid in the blood return side pressure buffer 322 to be within a predetermined range. Thus, the pressure can be buffered by the blood return side pressure buffer 322, so that the downstream side of the CRRT blood pump 220 in the CRRT system 200 can be operated at a low positive pressure. In addition, since the intermediate blood return line 320 is provided with a blood return pump 321, blood can be returned to the positive pressure part of the ECMO system 100. In addition, since the CRRT system 200 is connected to the positive pressure part of the ECMO system 100 via the intermediate system 300, even if poor blood loss occurs in the ECMO system 100, the risk of air being introduced from the CRRT system 200 can be reduced.

[0096] In addition, the blood return site from the CRRT system 200 to the ECMO system 100 is set to the downstream side of the blood loss site from the ECMO system 100 to the CRRT system 200. Thus, recirculation does not occur.

[0097] (2) The downstream end of the intermediate blood return line 320 in the intermediate system 300 is connected to the upstream side of the artificial lung 130 in the ECMO system 100. Thus, when bubbles exist in the intermediate blood return line 320, the bubbles can be captured by the artificial lung 130. Therefore, the possibility of air embolism in the patient can be reduced.

[0098] <Modification of the first embodiment>

[0099] Reference Figure 3 and Figure 4 Modifications of the first embodiment will be described in detail.

[0100] The intermediate system 300A of the modification of the first embodiment is different from the first embodiment in that the intermediate blood removal line also includes a pressure buffer. Therefore, the same reference numerals are used for the same configurations as those described in the first embodiment, and the description thereof is omitted, and only the differences are described.

[0101] Figure 3 1 is a diagram showing a schematic configuration of an ECMO system 100 , a CRRT system 200 , and an intermediate system 300A according to a modification of the first embodiment of the present invention. Figure 4 A block diagram of the CRRT system 200 and the intermediate system 300A is shown.

[0102] (Intermediate System)

[0103] The intermediate system 300A includes an intermediate blood removal line 310, a flow adjustment unit 311, a blood removal side pressure buffer unit 312, a blood removal side detection unit 3121, an intermediate blood return line 320, a blood return pump 321, a blood return side pressure buffer unit 322, a blood return side detection unit 3221 and a control unit 330.

[0104] The intermediate blood removal line 310 is a line for extracting a portion of the blood flowing in the connection line 110b of the ECMO system 100 and delivering it to the CRRT system 200. One end (upstream end) of the intermediate blood removal line 310 is connected to the first branch portion 110b1 provided in the connection line 110b of the ECMO system 100, and the other end (downstream end) is connected to the upstream end of the CRRT system 200. The intermediate blood removal line 310 is provided with a flow adjustment unit 311, a blood removal side pressure buffer unit 312, and a blood removal side detection unit 3121, and a pressure gauge P5 is installed on the upstream side of the flow adjustment unit 311. In addition, in order to monitor whether the flow to the blood removal side pressure buffer unit 312 is normal, and in order to monitor the mixing of bubbles, etc., a flow meter 314 is installed in the intermediate blood removal line 310.

[0105] The blood removal side pressure buffer 312 is provided on the downstream side of the flow rate adjustment unit 311 in the intermediate blood removal line 310, and can store a predetermined amount of liquid. The blood removal side pressure buffer 312 can be configured similarly to the blood return side pressure buffer 322 described in the first embodiment. In this embodiment, a reservoir is used as the blood removal side pressure buffer 312, similarly to the first embodiment.

[0106] In addition, a bypass line 313 for bypassing the blood removal side pressure buffer 312 may be provided in the intermediate blood removal line 310. The bypass line 313 and the connecting portion of the intermediate blood removal line 310 are connected by, for example, a three-way stopcock (not shown).

[0107] By providing the bypass line 313, when the intermediate system 300A is operated, the user can select whether to use the blood removal side pressure buffer unit 312 for pressure buffering, or not to use the blood removal side pressure buffer unit 312 and use the bypass line 313 without pressure buffering (in this case, it becomes the same as the first embodiment). When the blood removal side pressure buffer unit 312 is not used, the priming volume can be reduced accordingly.

[0108] The blood removal side detection unit 3121 is attached to the blood removal side pressure buffer unit 312 to detect the storage state of the blood removal side pressure buffer unit 312. The configuration of the blood removal side detection unit 3121 can be the same as the blood return side detection unit 3221 described in the first embodiment. In this embodiment, a weight meter is used as the blood removal side detection unit 3121 as in the first embodiment.

[0109] The control unit 330 controls the opening of the clamp as the flow rate adjustment unit 311 according to the storage state (weight) detected by the blood removal side detection unit 3121 (weight meter), and adjusts the flow rate of the intermediate blood removal line 310 so that the storage amount of blood stored in the blood return side pressure buffer unit 322 (reservoir) is within a predetermined range. The flow rate of blood taken out from the connection line 110b can be set by increasing or decreasing it based on the flow rate of the CRRT blood pump 220.

[0110] In addition, the control unit 330 adjusts the flow rate of the return blood pump 321 according to the storage state (weight) detected by the return blood side detection unit 3221 (weight meter) so as to control the storage amount of blood stored in the return blood side pressure buffer unit 322 (reservoir) to be within a specified range.

[0111] Furthermore, when the liquid exhaustion sensor 324 detects that the liquid is exhausted, the control unit 330 operates the clamp 325 to block the intermediate blood return line 320 to prevent air bubbles from being mixed into the ECMO system 100 .

[0112] According to the above ECMO system 100, CRRT system 200 and intermediate system 300A, the blood taken from the vein of the subject (patient) flows to the blood removal line 110a of the ECMO system 100, and a part of the blood in the connecting line 110b flows into the intermediate blood removal line 310 of the intermediate system 300A at a prescribed flow rate, and the rest is transported to the artificial lung 130.

[0113] The blood transported to the intermediate system 300A is stored in the blood removal side pressure buffer section 312 within a predetermined range. The storage amount can be controlled by increasing and decreasing the set flow rate of the flow rate adjustment section 311. Specifically, the blood flow rate flowing out from the downstream side of the blood removal side pressure buffer section 312 becomes the set flow rate of the blood pump 220. Therefore, when the storage amount of the blood removal side pressure buffer section 312 exceeds the predetermined range, the set flow rate of the flow rate adjustment section 311 can be made smaller than the set flow rate of the blood pump 220. In addition, when the storage amount of the blood removal side pressure buffer section 312 is lower than the predetermined range, the set flow rate of the flow rate adjustment section 311 can be made larger than the set flow rate of the blood pump 220. Thus, a predetermined amount of blood is stored in the blood removal side pressure buffer section 312, so that the circuit internal pressure can be reduced by the blood removal side pressure buffer section 312 provided in the intermediate blood removal line 310.

[0114] The blood stored in the blood removal side pressure buffer 312 is introduced into the blood purifier 230 through the CRRT blood pump 220. Here, due to the blood removal side pressure buffer 312, the circuit internal pressure becomes a low positive pressure, so the upstream side of the CRRT blood pump 220 becomes a low positive pressure. The flow of blood after the blood purifier 230 is the same as that described in the first embodiment. Thus, the circuit internal pressure of the entire blood circuit 210 of the CRRT system 200 can be made into a low positive pressure.

[0115] According to the intermediate system 300A of the modification of the first embodiment described above, in addition to the effects similar to the above-mentioned (1) and (2), the following effect (3) is also achieved.

[0116] (3) The intermediate system 300A is configured to include the following components based on the configuration of the intermediate system 300: an intermediate blood removal line 310 whose upstream end is connected to the downstream side of the blood pump 120 in the ECMO system 100; a flow rate adjustment unit 311 provided in the intermediate blood removal line 310; a blood removal side pressure buffer unit 312 provided in the intermediate blood removal line 310 on the downstream side of the flow rate adjustment unit 311; and a blood removal side detection unit 3121 which detects the storage state of the blood removal side pressure buffer unit 312, and the control unit 330 adjusts the flow rate of the flow rate adjustment unit 311 according to the storage state of the blood removal side pressure buffer unit 312 detected by the blood removal side detection unit 3121, and controls so that the storage amount of the liquid in the blood removal side pressure buffer unit 312 is within a predetermined range. As a result, the pressure can be buffered by the blood removal side pressure buffer unit 312, so that the upstream side including the CRRT blood pump 220 can be operated at a low positive pressure. Thus, it is possible to prevent devices connected to the upstream side of the CRRT blood pump 220 from being exposed to a high-pressure state.

[0117] <Second embodiment>

[0118] Next, refer to Figure 5 and Figure 6 The second embodiment will be described. Figure 5 The schematic configuration of the ECMO system 100 and the CRRT system 200A according to the second embodiment is shown. Figure 6 A block diagram of a CRRT system 200A according to the second embodiment is shown.

[0119] In the first embodiment, the CRRT system and the intermediate system having the blood return side pressure buffer are configured as independent structures. However, in the second embodiment, Figure 5 and Figure 6 As shown, the CRRT system 200A includes a CRRT blood circuit 210, a CRRT blood pump 220 as a liquid delivery unit, a blood purifier 230, a dialysate supply line 240, a dialysate discharge line 250, a supplementary liquid line 260, and a control unit 270. If this embodiment is compared with the first embodiment, the CRRT system 200A is configured to include a return blood side pressure buffer 322, a return blood pump 321, and a drip tube 323 of the intermediate system, and on the other hand, it is configured not to include a drip tube 211 originally provided near the downstream side of the blood purifier 230. In addition, the blood removal line 210a and the blood return line 210b of the CRRT system are used as the intermediate blood removal line 310 and the intermediate blood return line 320 of the intermediate system, respectively.

[0120] In addition, the number of pressure gauges originally installed in total of 7 can be reduced to a total of 5. In addition, the control originally performed by the control unit 330 of the intermediate system in the first embodiment is performed by the control unit 270 of the CRRT system. In this way, by merging or canceling the common components of the CRRT system and the intermediate system, the number of components can be reduced, and the manufacturing cost can be reduced compared with the case where the CRRT system and the intermediate system are manufactured as separate systems.

[0121] In the second embodiment, the CRRT blood pump 220 is arranged at the position where the flow rate adjustment unit 311 is originally provided in the first embodiment. In the second embodiment, the CRRT blood pump 220 plays the role of a liquid delivery unit that delivers liquid to the blood purifier 230 and the role of adjusting the flow rate of blood that branches from the ECMO blood circuit 110 and flows in the blood removal line 210a. In addition, the CRRT blood pump 220 functions as a pressure partition wall that prevents the high positive pressure transmitted from the ECMO blood circuit 110 from being transmitted to the blood purifier 230. In addition, in the second embodiment, the upstream side of the position where the liquid delivery unit is arranged is a high positive pressure, so as a liquid delivery unit, in addition to the roller pump, a clamp that can adjust the opening like the flow rate adjustment unit 311 can also be used. In addition, the CRRT blood pump 220 is assembled to the position near the upstream end of the blood removal line 210a, that is, near the connection part (first branch part 110b1) with the ECMO system 100. Thus, when it is necessary to stop the CRRT blood pump to stop the blood flow, the amount of blood discarded due to coagulation can be reduced. The other configurations are the same as those described in the first embodiment, and thus description thereof is omitted.

[0122] According to the CRRT system 200A of the second embodiment described above, in addition to the same effects as (1) and (2) described above, the following effects are also achieved.

[0123] (4) The CRRT system 200A connected to the ECMO system 100 includes the following components: a blood removal circuit 210a, the upstream end of which is connected to the ECMO system on the downstream side of the ECMO blood pump; a blood purifier 230, which is connected to the downstream end of the blood removal circuit 210a; a CRRT blood pump 220; a blood return circuit 210b, the upstream end of which is connected to the blood purifier 230 and the downstream end of which is connected to the ECMO system; and a blood return pump 321, which is provided to the blood return circuit 210b. 10b; a return blood side pressure buffer 322, which is provided on the upstream side of the return blood pump 321 in the return blood line 210b; a return blood side detection unit 3221, which detects the storage state of the return blood side pressure buffer 322; and a control unit 270, which adjusts the flow rate of the return blood pump 321 according to the storage state of the return blood side pressure buffer 322 detected by the return blood side detection unit 3221, so as to control the storage amount of the liquid in the return blood side pressure buffer 322 to be within a prescribed range. Thus, the internal pressure of the circuit from the downstream side of the CRRT blood pump 220 to the upstream side of the return blood pump 321 can be made into a low positive pressure. In addition, compared with the case where the CRRT system and the intermediate system are manufactured as separate systems, the common components can be merged or cancelled to reduce the components, so that the manufacturing cost can be reduced while having the same function. Moreover, the CRRT system and the intermediate system can be controlled by one control unit, so that the control in the case of a problem in the system can be easily performed.

[0124] <Modification 1 of the Second Embodiment>

[0125] Next, refer to Figure 7 and Figure 8 Modification 1 of the second embodiment will be described. Figure 7 The schematic configuration of an ECMO system 100 and a CRRT system 200B according to a first modification of the second embodiment is shown. Figure 8 A block diagram of a CRRT system 200B according to Modification 1 of the second embodiment is shown.

[0126] In the modification of the first embodiment, the CRRT system and the intermediate system having the blood removal side pressure buffer unit and the blood return side pressure buffer unit are set as independent structures, but in the modification 1 of the second embodiment, as shown in FIG. Figure 7 and Figure 8As shown, the CRRT system 200B includes a CRRT blood circuit 210, a CRRT blood pump 220 as a liquid delivery unit, a blood purifier 230, a dialysate supply line 240, a dialysate discharge line 250, a supplementary liquid line 260, and a control unit 270. If this embodiment is compared with the modified example of the first embodiment, the CRRT system 200B is configured to include a blood removal side pressure buffer 312, a blood return side pressure buffer 322, a blood return pump 321, and a drip tube 323 of the intermediate system, and on the other hand, it is configured not to include a drip tube 211 originally provided near the downstream side of the blood purifier 230.

[0127] In addition, the blood removal line 210a and the blood return line 210b of the CRRT system are used as the intermediate blood removal line 310 and the intermediate blood return line 320 of the intermediate system, respectively. In addition, the pressure gauges originally installed in total of 7 can be reduced to a total of 5. In addition, the control originally performed by the control unit 330 of the intermediate system in the modified example of the first embodiment is performed by the control unit 270 of the CRRT system. In this way, by merging or canceling the common structure of the CRRT system and the intermediate system, compared with the case where the CRRT system and the intermediate system are manufactured as separate systems, the components can be reduced and the manufacturing cost can be reduced.

[0128] In the first variation of the second embodiment, since the blood removal side pressure buffer 312 is provided in the blood removal line 210a, the circuit internal pressure on the downstream side of the blood removal side pressure buffer 312 becomes a low positive pressure. In addition, since the blood return pump 321 is arranged on the downstream side of the blood return side pressure buffer 322, the blood return pump 321 cannot apply a negative pressure to the blood removal side pressure buffer 312. Therefore, in order to transport the liquid to the blood purifier 230, it is necessary to increase the circuit internal pressure by some means, or to make the downstream side of the blood purifier 230 lower than the blood removal side pressure buffer 312.

[0129] In this embodiment, a CRRT blood pump 220 composed of a roller pump is used as a liquid delivery unit to increase the pressure in the circuit. The CRRT blood pump 220 is provided on the downstream side of the blood removal side pressure buffer 312 in the blood removal line 210a to deliver liquid from the blood removal side pressure buffer 312 to the blood purifier 230. The other configurations are the same as those described in the modification of the first embodiment or the second embodiment, and therefore the description thereof is omitted.

[0130] According to the CRRT system 200B of the first modification of the second embodiment described above, in addition to the same effects as (1) to (4) described above, the following effects are achieved.

[0131] (5) The CRRT system 200B connected to the ECMO system 100 is provided with, in addition to the CRRT system 200A, a flow rate adjustment unit 311 provided on the upstream side of the blood removal line 210a to adjust the flow rate of the blood removal line 210a; a blood removal side pressure buffer unit 312 provided on the downstream side of the blood removal line 210a to store a predetermined amount of liquid; and a blood removal side detection unit 3121 to detect the storage state of the blood removal side pressure buffer unit 312. The control unit 270 adjusts the flow rate of the flow rate adjustment unit 311 according to the storage state of the blood removal side pressure buffer unit 312 detected by the blood removal side detection unit 3121, and controls the storage amount of the liquid in the blood removal side pressure buffer unit 312 to be within a predetermined range. Thus, the blood removal side pressure buffer unit 312 can buffer the pressure, so that the upstream side of the CRRT blood pump 220 can be operated at a low positive pressure. Thus, it is possible to prevent devices connected to the upstream side of the CRRT blood pump 220 from being exposed to a high-pressure state.

[0132] (6) In the CRRT system 200B, the liquid supply means is constituted by the CRRT blood pump 220 provided in the blood removal line 210a downstream of the blood removal side pressure buffer 312. Thus, liquid can be supplied from the blood removal side pressure buffer 312 to the blood purifier 230.

[0133] <Modification 2 of the second embodiment>

[0134] Next, refer to Fig. 9 and Fig.10 Modification 2 of the second embodiment will be described. Fig. 9 The schematic configuration of an ECMO system 100 and a CRRT system 200C according to a second modification of the second embodiment is shown. Fig.10 A block diagram of a CRRT system 200C according to a second modification of the second embodiment is shown.

[0135] In the first modification of the second embodiment, the CRRT blood pump 220 is used as the liquid delivery unit. Fig.10 As shown, the CRRT system 200C uses a height difference adjustment unit 280 as a liquid supply unit, which is different from the first modification of the second embodiment.

[0136] In variant 2 of the second embodiment, as in the case of variant 1 of the second embodiment, a blood removal side pressure buffer 312 is provided in the blood removal line 210a, so that the circuit internal pressure on the downstream side of the blood removal side pressure buffer 312 becomes a low positive pressure. In addition, the return blood pump 321 is arranged on the downstream side of the return blood side pressure buffer 322. Thus, when the liquid delivery volume of the return blood pump 321 is increased and a negative pressure is applied to the upstream side of the return blood pump 321, the pressure is buffered by the return blood side pressure buffer 322, so that the return blood pump 321 cannot apply a negative pressure to the blood removal side pressure buffer 312. Therefore, in order to transport liquid to the blood purifier 230, it is necessary to increase the circuit internal pressure by some means, or to make the downstream side of the blood purifier 230 lower than the blood removal side pressure buffer 312.

[0137] In this embodiment, a height difference is provided between the blood removal side pressure buffer section 312 and the blood return side pressure buffer section 322 , and liquid is sent from the blood removal side pressure buffer section 312 to the blood return side pressure buffer section 322 by utilizing the head pressure defined by the height difference.

[0138] The height difference adjustment unit 280 as the liquid delivery unit is configured to set a height difference between the blood removal side pressure buffer 312 and the blood return side pressure buffer 322 so that the two can move relative to each other in the height direction. For example, the blood removal side pressure buffer 312 is fixedly arranged at the upper side in the height direction, and the blood return side pressure buffer 322 is arranged to be movable up and down below the blood removal side pressure buffer 312 to adjust the relative height difference DH between the two (refer to Fig. 9 The height difference DH is calculated from the difference between the upper surface of the liquid stored in the blood removal-side pressure buffer section 312 and the highest position of the liquid surface stored in the blood return-side pressure buffer section 322 .

[0139] The height difference between the blood removal side pressure buffer 312 and the blood return side pressure buffer 322 is adjusted by the height difference adjustment unit 280 so that the actual flow rate measured by the flow meter 314 becomes the desired value. Here, the desired value is the same flow rate as the flow rate set by the CRRT blood pump.

[0140] Furthermore, the height difference adjustment unit 280 may adjust the height difference between the blood removal-side pressure buffer 312 and the blood return-side pressure buffer 322 so that the actual flow rate measured by the flow meter 314 becomes a desired value.

[0141] The other configurations are the same as those described in Modification 1 of the second embodiment, and thus descriptions thereof are omitted.

[0142] According to the CRRT system 200C of the second modification of the second embodiment described above, in addition to the same effects as (1) to (5) described above, the following effects are achieved.

[0143] (7) The CRRT system 200C is configured to include a height difference adjustment unit 280 that enables the blood removal side pressure buffer section 312 and the blood return side pressure buffer section 322 to move relative to each other in the height direction. Thus, by adjusting the height difference between the blood removal side pressure buffer section 312 and the blood return side pressure buffer section 322, the amount of liquid delivered from the blood removal side pressure buffer section 312 to the blood purifier 230 can be adjusted. In addition, a pressurizing device that pressurizes the blood removal side pressure buffer section 312 can also be used as the height difference adjustment unit. In this case, the pressurizing device as the height difference adjustment unit pressurizes the blood removal side pressure buffer section 312 with a pressure equivalent to the head pressure specified by the height difference between the blood removal side pressure buffer section 312 and the blood return side pressure buffer section 322 corresponding to the desired actual flow rate.

[0144] <Third embodiment>

[0145] The blood purification (CRRT) system of the present invention can be connected to the positive pressure part of the extracorporeal membrane oxygenation (ECMO) system. Fig.13 The third embodiment will be described in detail. Fig.13 It is a diagram showing a schematic configuration of an ECMO system 400 and a CRRT system 500 according to the first embodiment of the present invention. Fig.14 A block diagram of a CRRT system 500 is shown.

[0146] (ECMO system)

[0147] Fig.13 The ECMO system 400 shown includes an ECMO blood circuit 410 , an ECMO blood pump 420 (blood pump), an artificial lung 430 , and a control unit 440 .

[0148] The ECMO blood circuit 410 is a circuit for extracorporeal circulation of the patient's blood, and is composed of a blood removal line 410a, a connecting line 410b, and a blood return line 410c. One end of the blood removal line 410a is connected to the blood removal cannula 411, and the other end is connected to the ECMO blood pump 420. One end of the connecting line 410b is connected to the ECMO blood pump 420, and the other end is connected to the artificial lung 430. The connecting line 410b has a first branch 410b1 and a second branch 410b2. Connectors such as three-way stopcocks are respectively installed in these first branch 410b1 and second branch 410b2.

[0149] In addition, in the present embodiment, a bypass line 413 that bypasses the first branch portion 410b1 and the second branch portion 410b2 is provided in the connection line 410b. The bypass line 413 is connected to the connection portion of the connection line 410b by, for example, a three-way stopcock (not shown). By providing the bypass line 413, when the CRRT system 500 stops operating due to some fault, the ECMO system can be operated more safely by switching the flow path from the ECMO blood pump 420 to the artificial lung 430 to the bypass line 413. In addition, in the present embodiment, although the bypass line 413 that bypasses the first branch portion 410b1 and the second branch portion 410b2 is provided, it is not limited thereto. The bypass line 413 may also not be provided.

[0150] One end of the blood return line 410c is connected to the artificial lung 430, and the other end is connected to the blood supply cannula 412. In order to monitor the operating status of the ECMO system 400, a flow meter 414 is installed on the blood return line 410c. In this embodiment, an ultrasonic flow meter is used as the flow meter 414. As the flow meter 414, an optical flow meter or the like can also be used.

[0151] The ECMO blood pump 420 extracts blood from the patient's vein via the blood removal cannula 411 and the blood removal line 410a. The extracted blood is delivered to the artificial lung 430 via the connecting line 410b, and then returned to the patient via the blood return line 410c via the blood delivery cannula 412. As the ECMO blood pump 420, a well-known centrifugal pump is used.

[0152] The artificial lung 430 is provided with a hollow fiber membrane (not shown) formed by bundling hollow fibers having many tiny holes, and oxygen is added to the blood delivered from the ECMO blood pump 420 and carbon dioxide is removed by making oxygen flow inside the hollow fibers and making blood flow outside the hollow fibers. In addition, the artificial lung 430 captures bubbles present in the delivered blood and prevents it from flowing downstream of the ECMO circuit. As the artificial lung 430, a known membrane type artificial lung is used. In addition, the artificial lung 430 may also have a heat exchange function.

[0153] The control unit 440 is composed of an information processing device (computer), and drives each pump provided in the ECMO system 400 by executing a control program, thereby controlling the operation of the ECMO system 400 .

[0154] (CRRT System)

[0155] like Fig.13 and Fig.14As shown, the CRRT system 500 includes a blood removal circuit 510, a flow adjustment unit 511, a blood purifier 520, a blood return circuit 530, a blood return pump 531, a blood chamber 532 as a storage unit, a dialysate supply circuit 540, a dialysate discharge circuit 550, a supplementary fluid circuit 560 and a control unit 570.

[0156] The blood removal line 510 is a line for extracting a portion of the blood flowing in the connection line 410b of the ECMO system 400 and conveying it to the blood purifier 520. One end (upstream end) of the blood removal line 510 is connected to the first branch part 410b1 of the ECMO system 400 provided on the connection line 410b, and the other end (downstream end) is connected to the upstream end of the blood purifier 520. A flow adjustment unit 511 is provided in the blood removal line 510. A pressure gauge P8 is installed on the upstream side of the flow adjustment unit 511, and a pressure gauge P9 is installed on the downstream side of the flow adjustment unit 511. In addition, in order to monitor whether the flow rate to the blood purifier 520 is normal, and in order to monitor the mixing of bubbles, etc., a flow meter 512 is installed in the blood removal line 510. In this embodiment, an ultrasonic flow meter is used as the flow meter 512. As the flow meter 512, an optical flow meter or the like can also be used.

[0157] The flow rate adjustment unit 511 adjusts the flow rate of blood flowing in the blood removal line 510. The flow rate adjustment unit 511 is mounted on a portion of the blood removal line 510 close to the upstream end. Thus, when it is necessary to stop the flow rate adjustment unit 511 to stop the blood flow, the amount of blood discarded due to coagulation can be reduced. In this embodiment, a roller pump or a finger pump is used as the flow rate adjustment unit 511. The roller pump is a pump that sucks blood and ejects blood at a set flow rate by flattening the tube constituting the blood removal line 510 with a roller and rotating the tube. The finger pump is a pump that moves the occlusion point in a certain direction by causing a plurality of fingers to peristalt relative to the tube, thereby squeezing the tube to transfer blood. Although the details will be described later, by adjusting the flow rate of blood flowing in the blood removal line 510 by the flow rate adjustment unit 511 (roller pump, finger pump) and adjusting the flow rate of the blood return pump 531, the circuit internal pressure on the downstream side can be adjusted.

[0158] The blood purifier 520 is provided with a dialysis membrane (not shown) housed inside a container body formed into a cylindrical shape. The inside of the container body is divided into a blood side flow path and a dialysate side flow path (neither of which are shown) by the dialysis membrane, and water and wastes move from the blood side flow path to the dialysate side flow path via the dialysis membrane, thereby purifying the blood.

[0159] One end (upstream end) of the return blood line 530 is connected to the downstream end of the blood purifier 520, and the other end (downstream end) is connected to the second branch 410b2 of the ECMO system 400 provided on the connection line 410b. The second branch 410b2 is a portion of the ECMO system 400 that is closer to the downstream side than the first branch 410b1. In the return blood line 530, a blood chamber 532 (drip tube) as a storage portion, a liquid exhaustion sensor 533, a return blood pump 531, a clamp 534, and a pressure gauge P11 are arranged in order from the upstream side. In this embodiment, a drip tube is used as the blood chamber 532. A pressure gauge P15 is installed in the blood chamber 532. The pressure gauge P10 measures the pressure of the blood chamber 532. In order to remove bubbles, coagulated blood, etc. mixed into the return blood line 530, the blood chamber 532 stores a certain amount of blood. The clamp 534 is installed in the return blood line 530 near the downstream end. Thus, when it is necessary to close the clamp 534 to stop the blood flow, the amount of blood discarded due to coagulation can be reduced. In addition, when the liquid exhaustion sensor 533 detects that the liquid is exhausted or bubbles are present, the clamp 534 is set to a closed state to prevent the bubbles from mixing into the ECMO system 400. The pressure gauge P11 measures the circuit internal pressure on the downstream side of the return blood pump 531 in the return blood line 530.

[0160] In the present embodiment, the downstream end of the blood return line 530 is connected to the second branch portion 410b2, but it may be directly connected to the artificial lung 430. By directly connecting to the upstream side of the artificial lung 430 or the artificial lung 430, when bubbles exist in the blood return line 530, the bubbles can be captured by the artificial lung 430. Therefore, the possibility of air embolism in the patient can be reduced.

[0161] The blood return pump 531 is a pump for sending the blood flowing in the blood return line 530 to the positive pressure unit of the ECMO system 400. As the blood return pump 531, a well-known roller pump can be used.

[0162] The dialysate supply line 540 includes a dialysate pump 541, is a line for supplying dialysate to the blood purifier 520, and connects the dialysate supply source D to the dialysate side flow path of the blood purifier 520. As the dialysate pump 541, a known roller pump or finger pump is used.

[0163] The dialysate discharge line 550 is provided with a discharge pump 551, and discharges the dialysate from the blood purifier 520. The dialysate discharge line 550 connects the dialysate side flow path of the blood purifier 520 with the discharge storage part F. A well-known roller pump is used as the discharge pump 551. In addition, the dialysate discharge line 550 is equipped with a pressure gauge P12.

[0164] The supplementing liquid line 560 includes a supplementing liquid pump 561, and supplies the supplementing liquid supplied from the supplementing liquid supply source R to the blood return line 530 via a blood chamber 532 (intravenous drip tube) provided in the blood return line 530. As the supplementing liquid, dialysate or physiological saline is used.

[0165] The control unit 570 is composed of an information processing device (computer), and drives each pump of the CRRT system 500 by executing a control program, controls the blood flow, dialysate volume, and discharge volume of the blood purifier 520, and performs continuous hemodiafiltration (CHDF). In addition, the control unit 570 can also monitor the flow rates of the dialysate pump 541 configured in the dialysate supply line 540, the discharge pump 551 configured in the dialysate discharge line 550, and the supplementary liquid pump 561 configured in the supplementary liquid line 560, and control the driving of each pump based on the flow rate measured by a metering unit (not shown) that measures the liquid (dialysate and supplementary liquid) circulating in the CRRT system 500.

[0166] The control unit 570 controls the inflow amount to the blood purifier 520 by adjusting the set flow rate of the flow adjustment unit 511 (roller pump or finger pump) so that the measured value of the flow meter 512 becomes a specified flow rate (for example, 150mL / min). In addition, the control unit 570 increases and decreases the set flow rate of the return blood pump 531 and controls it in a manner so that the measured value of the pressure gauge P10 becomes within a specified range (for example, a range of 40mmHg or more and 60mmHg or less). By performing feedback control in this way, blood can flow into the blood purifier 520 at a specified flow rate, and the internal pressure of the circuit can be maintained at a low positive pressure from the downstream side of the flow adjustment unit 511 to the upstream side of the return blood pump 531 in the CRRT system.

[0167] According to the above ECMO system 400 and CRRT system 500, the blood taken from the vein of the subject (patient) flows to the blood removal line 410a of the ECMO system 400, and a part of the blood in the connecting line 410b flows into the blood removal line 510 of the CRRT system 500 at a prescribed flow rate, and the rest is transported to the artificial lung 430.

[0168] The blood delivered to the CRRT system 500 is delivered via the blood removal line 510 after the flow rate is adjusted by the flow regulator 511, and is introduced into the blood purifier 520 at a predetermined flow rate. Here, the flow regulator 511 functions as a liquid delivery unit for delivering blood to the blood purifier 520, and functions as a pressure partition wall that prevents the high positive pressure delivered from the ECMO blood circuit 410 from being delivered to the blood purifier 520. In the blood purifier 520, water and waste are removed via the dialysis membrane, and the purified blood is led out of the blood purifier 520.

[0169] The blood purified by the blood purifier 520 is transported to the blood chamber 532 (drip tube), and the supplementary liquid is supplemented from the supplementary liquid line 560 according to the amount of water removed. The set flow rate of the return blood pump 531 is adjusted so that the measured value of the pressure gauge P10 set in the blood chamber 532 (drip tube) is within a specified range (for example, 40 to 60 mmHg). The capacity of the blood chamber 532 (drip tube) is about 10 mL, and its storage capacity can be controlled by increasing and decreasing the set flow rate of the return blood pump 531. Specifically, the blood flow rate transported from the blood purifier 520 becomes a blood flow rate slightly smaller than the set flow rate of the flow adjustment unit 511 by the amount of water removed. Therefore, when the measured value of the pressure gauge P10 exceeds the specified range, the set flow rate of the return blood pump 531 can be larger than the set flow rate of the flow adjustment unit 511. In addition, when the measured value of the pressure gauge P10 is lower than the specified range, the set flow rate of the return blood pump 531 can be smaller than the set flow rate of the flow adjustment unit 511. This allows the circuit internal pressure upstream of the blood return pump 531 to be low positive pressure. Therefore, the CRRT system 500 can be operated at low positive pressure. Low positive pressure refers to, for example, a circuit internal pressure of 0 to 150 mmHg.

[0170] Since the blood return line 530 is provided with a blood return pump 531, the internal pressure of the circuit on the downstream side of the blood return pump 531 can be increased to deliver blood to the positive pressure part of the ECMO system 400 (downstream side of the ECMO blood pump 420). Here, the blood return pump 531 functions as a liquid delivery unit that delivers blood to the positive pressure part of the ECMO system, and functions as a pressure partition wall that makes the upstream side a low positive pressure and the downstream side a high positive pressure.

[0171] The blood sent from the blood return line 530 of the CRRT system 500 to the connection line 410b of the ECMO system 400 is sent to the artificial lung 430 together with the blood flowing in the connection line 410b, where oxygen is added and carbon dioxide is removed. The blood sent from the artificial lung 430 is returned to the patient's artery or vein via the blood return line 410c and the blood supply cannula 412.

[0172] According to the CRRT system 500 of the third embodiment described above, the following effects (8) and (9) are achieved.

[0173] (8) The CRRT system 500 connected to the ECMO system 400 includes the following parts: a blood removal circuit 510, whose upstream end is connected to the downstream side of the blood pump of the ECMO system; a blood purifier 520, which is connected to the downstream end of the blood removal circuit 510; a flow adjustment unit 511, which is installed in the blood removal circuit 510; a blood return circuit 530, whose upstream end is connected to the blood purifier 520, and whose downstream end is connected to the downstream side of the connection point between the ECMO system and the blood removal circuit 510; a blood return pump 531, which is installed in the blood return circuit 530; a pressure gauge P10, which measures the pressure on the upstream side of the blood return pump 531; and a control unit 570, which adjusts the flow rates of the flow adjustment unit 511 and the blood return pump 531 so as to control the measured value of the pressure gauge P10 to be within a specified range. Thus, the flow regulator 511 and the blood return pump 531 form a pressure partition wall, so that the CRRT system 500 can be operated at a low positive pressure from the downstream side of the flow regulator 511 to the upstream side of the blood return pump 531. In addition, since the blood return line 530 is provided with the blood return pump 531, blood can be returned to the positive pressure part of the ECMO system 400. In addition, since the CRRT system 500 is connected to the positive pressure part of the ECMO system 400, even in the case of poor blood loss in the ECMO system 400, the risk of air being introduced from the CRRT system 500 can be reduced. In addition, since the blood return site from the CRRT system 500 to the ECMO system 400 is on the downstream side of the blood loss site, recirculation does not occur.

[0174] (9) A blood chamber 532 is provided, and the blood chamber 532 is provided on the upstream side of the blood return pump 531 in the blood return line 530, and can store a predetermined amount of liquid, and a pressure gauge P10 measures the pressure of the blood chamber 532. Thus, the pressure on the upstream side of the blood return pump 531 in the blood chamber 532 can be easily measured, and control can be easily performed so that the measured value of the pressure gauge P10 is within a predetermined range.

[0175] (10) The flow rate adjustment unit 511 of the CRRT system 500 is set to a roller pump or a finger pump, and the control unit 570 adjusts the flow rate of the flow rate adjustment unit 511 (roller pump or finger pump) to control the inflow of the blood purifier 520, and adjusts the flow rate of the return blood pump 531 so that the measured value of the pressure gauge P10 is within a specified range. In this way, the CRRT system 500 can be operated at a low positive pressure from the downstream side of the roller pump or the finger pump to the upstream side of the return blood pump 531.

[0176] (11) The downstream end of the blood return line 530 in the CRRT system 500 is connected to the upstream side of the artificial lung 430 in the ECMO system 400 or to the artificial lung 430. Thus, when air bubbles exist in the blood return line 530, the air bubbles can be captured by the artificial lung 430. Therefore, the possibility of air embolism in the patient can be reduced.

[0177] <Fourth embodiment>

[0178] Reference Fig.15 and Fig.16 The fourth embodiment will be described in detail.

[0179] The CRRT system 500A of the fourth embodiment is different in that the flow rate adjustment unit provided in the blood removal line 510 is not a roller pump but an adjustment jig, and the control method of the inflow amount to the blood purifier and the circuit internal pressure is different from that of the third embodiment. Therefore, the same reference numerals are attached to the same configuration as that described in the third embodiment, and the description is omitted, and the differences are described.

[0180] Fig.15 It is a diagram showing a schematic configuration of an ECMO system 400 and a CRRT system 500A according to a fourth embodiment of the present invention. Fig.16 A block diagram of a CRRT system 500A is shown.

[0181] (CRRT System)

[0182] like Fig.15 and Fig.16 As shown, the CRRT system 500A includes a blood removal circuit 510, a flow adjustment unit 511a, a blood purifier 520, a blood return circuit 530, a blood return pump 531, a blood chamber 532 (intravenous drip tube) as a storage unit, a dialysate supply circuit 540, a dialysate discharge circuit 550, a replenishing fluid circuit 560 and a control unit 570.

[0183] The flow rate adjustment unit 511a adjusts the flow rate of blood flowing in the blood removal line 510. The flow rate adjustment unit 511a is assembled to a portion near the upstream end of the blood removal line 510. Thus, when it is necessary to close the flow rate adjustment unit 511a to stop the blood flow, the amount of blood discarded due to coagulation can be reduced. In this embodiment, an adjustment fixture that can adjust the flow rate by adjusting the opening is used as the flow rate adjustment unit 511a. The adjustment fixture adjusts the flow rate of blood flowing in the pipe by adjusting the opening of the pipe constituting the blood removal line 510. The flow rate adjustment unit 511a (adjustment fixture) is arranged near the positive pressure unit of the ECMO system 400 in the blood removal line 510. Therefore, by adjusting the opening using the pressure brought by the blood transported by the ECMO blood pump 420 of the ECMO system 400, the amount of blood flowing into the blood removal line 510 can be adjusted. Furthermore, by adjusting the flow rate of blood flowing through the blood removal line 510 by the flow rate adjustment unit 511 a (adjustment jig) and adjusting the flow rate of the blood return pump 531 , the circuit internal pressure on the downstream side can be adjusted.

[0184] Here, in the third embodiment, when a roller pump is used as the flow adjustment part 511, since the roller pump is configured to flatten the tube and rotate the tube, the high pressure of the positive pressure part of the ECMO system 400 is applied to the inlet side of the roller pump. In contrast, in the fourth embodiment, when an adjustment fixture is used as the flow adjustment part 511a, since the tube is pressed by the adjustment fixture and the opening is adjusted, it is possible to suppress the high pressure of the positive pressure part of the ECMO system 400 from being applied to the inlet side of the adjustment fixture. Thus, by using the adjustment fixture as the flow adjustment part 511a, the amount of hemolysis can be reduced compared to the case of using a roller pump. In particular, when an adjustment fixture having a fixture part that can flatten the tube within a range of a predetermined length or more in the longitudinal direction of the tube is used as the flow adjustment part 511a, the amount of hemolysis can be further reduced.

[0185] The control unit 570 adjusts the set flow rate of the return blood pump 531 so that the measured value of the flow meter 512 becomes a specified flow rate (for example, 150mL / min) to control the inflow amount of the blood purifier 520. In addition, the control unit 570 adjusts the opening and closing of the flow adjustment unit 511a (adjustment fixture) so that the measured value of the pressure gauge P10 becomes within a specified range (for example, a range of 40mmHg or more and 60mmHg or less). By performing feedback control in this way, blood can flow into the blood purifier 520 at a specified flow rate, and the internal pressure of the circuit can be maintained at a low positive pressure from the downstream side of the flow adjustment unit 511a to the upstream side of the return blood pump 531 in the CRRT system.

[0186] According to the above ECMO system 400 and CRRT system 500A, blood drawn from the vein of the subject (patient) circulates in the ECMO system 400 and CRRT system 500A and is returned to the patient via the blood supply cannula 412 as in the case described in the third embodiment.

[0187] According to the CRRT system 500A of the fourth embodiment described above, in addition to the same effects as the above-mentioned (8) to (11), the following effect (12) is also achieved.

[0188] (12) The flow rate adjustment unit 511a of the CRRT system 500 is set as an adjustment fixture that can be adjusted to open and close, and the control unit 570 adjusts the flow rate of the return blood pump 531 to control the inflow of the blood purifier 520, and the flow rate of the flow rate adjustment unit 511a (adjustment fixture) is adjusted to control the measured value of the pressure gauge P10 in a prescribed range. In this way, the CRRT system 500A can be operated at a low positive pressure from the downstream side of the adjustment fixture to the upstream side of the return blood pump 531. In addition, since the adjustment fixture is used as the flow rate adjustment unit, the amount of hemolysis can be reduced compared to the case of using a roller pump.

[0189] <Example>

[0190] Next, examples of the above-mentioned first embodiment and second embodiment will be described.

[0191] As an example, the circuits of the ECMO system, CRRT system, and intermediate system corresponding to the modified example of the first embodiment were assembled and connected, and various operation confirmations were performed.

[0192] (Reproduction of poor blood loss in the ECMO system)

[0193] The CRRT system sets the set flow rate Qb of the CRRT blood pump to 100mL / min, the dialysate flow rate Qd to 350mL / h, the dialysate drainage flow rate Qf to 1080mL / h, and the supplementary fluid flow rate Qr to 700mL / h and operates. At this time, the inlet pressure Qbi (measured by pressure gauge P2) of the blood purifier is 8.7kPa, the outlet pressure Qbo (measured by pressure gauge P3) is 6.5kPa, and the pressure Qf (measured by pressure gauge P3) of the dialysate drainage line is 7.5kPa. The ECMO system sets the speed of the ECMO blood pump (centrifugal pump) to 5000rpm and operates. At this time, the flow rate of the ECMO blood pump is 3.63L / min, and the pressure (measured by pressure gauge P5) immediately after the ECMO blood pump is 63kPa.

[0194] During the operation under these conditions, an experiment was conducted to reproduce sudden blood loss and sudden decompression in the ECMO system. As a result, it was confirmed that the operating status of the intermediate system and the CRRT system did not change, and the intermediate system and the CRRT system were not affected by the blood loss of the ECMO system.

[0195] (Confirmation of the operation of the flow rate adjustment unit)

[0196] The ECMO system set the blood pump (centrifugal pump) to 3400 rpm and operated. At this time, the internal pressure of the circuit immediately after the blood pump was 35 kPa (measured by pressure gauge P5). A clamp with adjustable opening was used as the flow adjustment part of the intermediate system.

[0197] While the ECMO system was operating under these conditions, the opening of the clamp was adjusted, and it was confirmed that the flow rate could be adjusted to 0 to 130 mL / min.

[0198] (Measurement of internal circuit pressure of CRRT system)

[0199] The circuit configuration corresponding to the first embodiment is taken as Example 1, and the circuit configuration corresponding to the modified example of the first embodiment is taken as Example 2. When the rotation speed of the blood pump (centrifugal pump) of the ECMO system is changed, an experiment is conducted to determine how the circuit internal pressure of the CRRT system changes. The results are shown in Table 1.

[0200] [Table 1]

[0201]

[0202] In Table 1, the speed of the ECMO system represents the speed of the ECMO blood pump (centrifugal pump), the flow rate represents the flow rate of the ECMO blood pump, and the post-pump pressure represents the pressure immediately after the ECMO blood pump (measured by pressure gauge P5). Qb of the CRRT system represents the set flow rate of the CRRT blood pump, Qd represents the set flow rate of the pump of the dialysate line, Qr represents the set flow rate of the pump of the supplementary fluid line, and Qf represents the set flow rate of the pump of the dialysate drainage line. In Example 1 and Example 2, Qb, Qd, Qr, and Qf are respectively set to the same conditions. In addition, the inlet pressure represents the pressure near the upstream end of the CRRT system in Example 1, and in Example 2, it represents the pressure between the CRRT blood pump in the blood removal line and the blood removal side pressure buffer. In addition, Pbi represents the inlet pressure of the blood purifier (measured by pressure gauge P2), Pbo represents the outlet pressure of the blood purifier (measured by pressure gauge P3), and Pf represents the pressure of the dialysate drainage line (measured by pressure gauge P4).

[0203] According to the measurement results in Table 1, in the intermediate system of Example 1 which does not have a blood removal side pressure buffer but has a blood return side pressure buffer, the higher the circuit pressure on the downstream side of the ECMO blood pump, the higher the inlet pressure of the CRRT system. In other words, it can be seen that the upstream side of the CRRT blood pump is affected by the positive pressure part of the ECMO system. However, the circuit pressures of Pbi, Pbo, Pf, etc. on the downstream side of the CRRT blood pump show values ​​lower than the inlet pressure. Therefore, it is shown that the pressure can be buffered by the blood return side pressure buffer.

[0204] In addition, in the intermediate system of Example 2 having a blood removal side pressure buffer and a blood return side pressure buffer, even if the pressure in the circuit on the downstream side of the ECMO blood pump becomes high, the inlet pressure of the CRRT system is maintained at a lower value than that in Example 1. In other words, it can be seen that the upstream side of the CRRT blood pump is hardly affected by the positive pressure part of the ECMO system. In addition, the circuit pressures of Pbi, Pbo, Pf, etc. on the downstream side of the CRRT blood pump show a stable lower value than the inlet pressure and are maintained at a lower value than that in Example 1. Therefore, it is shown that the pressure can be buffered by the blood removal side pressure buffer and the blood return side pressure buffer, and the entire CRRT circuit can be operated at a low positive pressure.

[0205] (Confirmation of the operation of the height difference adjustment unit)

[0206] A circuit corresponding to the second variant of the second embodiment is formed. It is confirmed whether the height difference DH of the liquid level through the blood removal side pressure buffer section 312 and the blood return side pressure buffer section 322 can deliver liquid from the blood removal side pressure buffer section 312 to the blood return side pressure buffer section 322 via the blood purifier 230. At this time, the ECMO blood pump 120, the dialysate pump 241, and the replenishing liquid pump 261 are all stopped, and the clamp of the flow adjustment section 311 is set to a fully open state. They are respectively configured in a manner to form a specified height difference DH, and the flow rate when delivering liquid from the blood removal side pressure buffer section 312 to the blood return side pressure buffer section 322 through the head pressure is measured by the flow meter 314. Table 2 shows the measured flow rates and the measurement results of each pressure gauge.

[0207] [Table 2]

[0208]

[0209] A graph showing the relationship between the measured flow rate (L / min) and the height difference DH (cm) in Table 1 is shown in FIG. Fig.11 As shown in FIG. , an approximate curve is calculated.

[0210] In the CRRT system, a blood flow rate of 0.1L / min to 0.2L / min is required. From the approximate curve, it can be seen that a blood flow rate of 0.1L / min to 0.2L / min can be obtained when the height difference DH is 42cm to 102cm. Therefore, it is shown that by adjusting the height difference DH to 42cm to 102cm by the height difference adjustment unit 280, the required blood flow rate in the CRRT system can be obtained by using the head pressure.

[0211] As mentioned above, each preferred embodiment of the intermediate system and the CRRT system of the present invention has been described, but the present invention is not limited to the above-mentioned embodiments and can be modified appropriately.

[0212] For example, in each of the above-mentioned embodiments and modifications, an example of connecting the intermediate blood removal line and the intermediate blood return line of the intermediate system or the blood removal line and the blood return line of the CRRT system to the connection line of the ECMO system is shown, but it is not limited to this. From the viewpoint of removing bubbles mixed in the blood in the artificial lung, it is desirable to connect the intermediate blood removal line and the intermediate blood return line of the intermediate system or the blood removal line and the blood return line of the CRRT system to the upstream side of the artificial lung, but the blood removal line and the blood return line of the intermediate system may also be connected to the downstream side of the artificial lung of the ECMO system.

[0213] In addition, in each of the above-mentioned embodiments and variations, the intermediate blood return line or the downstream end of the blood return line is connected to the ECMO system at the downstream side of the connection point with the intermediate blood removal line of the intermediate system or the blood removal line of the CRRT system, but the invention is not limited thereto. That is, the intermediate blood return line or the downstream end of the blood return line may be connected to the ECMO system at the upstream side of the connection point with the intermediate blood removal line of the intermediate system or the blood removal line of the CRRT system.

[0214] In addition, in the above-mentioned embodiments and modifications, as an example of connecting the intermediate blood return line of the intermediate system or the blood return line of the CRRT system to the upstream side of the artificial lung, the case of connecting to the branch part on the downstream side of the connection line of the ECMO system is shown, but it is not limited to this.

[0215] For example, Fig. 12AAs shown, both the intermediate blood removal line 310 (or the blood removal line 210a of the CRRT system) and the intermediate blood return line 320 (or the blood return line 210b) of the intermediate system may be connected to the artificial lung 130 of the ECMO system 100. In this case, in order to prevent recirculation in the artificial lung 130, it is preferable that the intermediate blood return line 320 (or the blood return line 210b) is connected to the downstream side of the intermediate blood removal line 310 (or the blood removal line 210a). From the viewpoint of not having to set a branch in the ECMO blood circuit 110 and removing the bubbles transported from the CRRT system in the artificial lung 130, such a connection method may be used.

[0216] In addition, for example, in the case where the artificial lung is additionally provided with a blood inlet port, Fig. 12B As shown, the intermediate blood return line 320 of the intermediate system (or the blood return line 210b of the CRRT system) may be connected to the inlet port, and a branch may be provided in the connection line 110b to connect the intermediate blood removal line 310 of the intermediate system (or the blood removal line 210a of the CRRT system). Such a connection method may be used from the viewpoint that only one branch may be provided in the connection line 110b of the ECMO blood circuit 110 and from the viewpoint that the bubbles transported from the CRRT system are removed in the artificial lung 130.

[0217] <Example>

[0218] Next, examples of the third and fourth embodiments described above will be described.

[0219] As an example, the circuits of the ECMO system and the CRRT system corresponding to the third embodiment and the fourth embodiment were respectively assembled and connected, and various operation confirmations were performed.

[0220] (Measurement of internal circuit pressure of CRRT system)

[0221] The circuit configuration corresponding to the third embodiment is used as Example 3, and the flow rate of the return blood pump 231 is adjusted so that the measured value (measured by the pressure gauge P10 (Pbo)) of the blood chamber 532 (drip tube) (capacity 10mL) as the storage part is 40-60mmHg. At this time, the experiment of how the circuit internal pressure of the CRRT system changes when the rotation speed of the blood pump (centrifugal pump) of the ECMO system is changed is conducted. The results are shown in Table 3.

[0222] [Table 3]

[0223]

[0224] In Table 3, the speed of the ECMO system represents the speed of the ECMO blood pump (centrifugal pump), the flow rate represents the flow rate of the ECMO blood pump (the measured value of the flowmeter 414), and the post-pump pressure represents the pressure immediately after the ECMO blood pump (measured by the pressure gauge P8 or P11). Qb of the CRRT system represents the set flow rate of the roller pump, Qd represents the set flow rate of the pump of the dialysate line, Qr represents the set flow rate of the pump of the supplementary fluid line, and Qf represents the set flow rate of the pump of the dialysate drainage line. In Example 1, Qb, Qd, Qr, and Qf are respectively set to the same conditions. In addition, the inlet pressure represents the pressure near the upstream end of the CRRT system (measured by the pressure gauge P8). In addition, Pbi represents the inlet pressure of the blood purifier (measured by the pressure gauge P9), Pbo represents the outlet pressure of the blood purifier (measured by the pressure gauge P10), and Pf represents the pressure of the dialysate drainage line (measured by the pressure gauge P12).

[0225] According to the measurement results in Table 3, even if the post-pump pressure rises, the circuit internal pressures of Pbi, Pbo, Pf, etc. from the downstream side of the roller pump to the upstream side of the return blood pump in the CRRT system also show values ​​lower than the inlet pressure. Therefore, it is shown that by using the blood chamber 532 (intravenous drip tube) with a capacity of about 10mL, the pump differential between the roller pump as the flow adjustment unit 511 and the return blood pump 531 can be buffered, and the CRRT system can be operated at a low positive pressure.

[0226] (Measurement of CRRT System Flow Rate When Flow Adjuster 511a (Adjustment Jig) is Fully Opened)

[0227] The circuit configuration corresponding to the fourth embodiment is used as Example 4, and the flow adjustment unit 511a (adjustment fixture) is set to fully open, and the flow of the return blood pump 531 is adjusted to control the measured value of the pressure gauge P10 in a range of 40 mmHg or more and 60 mmHg or less. When the speed of the blood pump (centrifugal pump) of the ECMO system is changed under such conditions, an experiment is conducted to see how the blood delivery volume to the CRRT system changes. The results are shown in Table 4.

[0228] [Table 4]

[0229]

[0230] In Table 4, the speed of the ECMO system indicates the speed of the ECMO blood pump (centrifugal pump), the flow rate indicates the flow rate of the ECMO blood pump (the measured value of the flow meter 414), and the post-pump pressure indicates the pressure immediately after the ECMO blood pump (measured by the pressure gauge P8 or P11). The flow rate of the CRRT system indicates the measured value of the flow meter 512, and the return blood pump set flow rate indicates the set flow rate of the return blood pump 531. In addition, Pbi indicates the inlet pressure of the blood purifier (measured by the pressure gauge P9), Pf indicates the pressure of the dialysate drainage line (measured by the pressure gauge P12), and Pbo indicates the outlet pressure of the blood purifier (measured by the pressure gauge P10).

[0231] In addition, in this embodiment, a dial-type roller pump is used as the return blood pump. Therefore, since the set flow rate of the return blood pump of the CRRT system when the rotation speed of the ECMO blood pump is 5000 rpm and 6000 rpm is unknown, an estimated value is recorded.

[0232] A graph showing the relationship between the post-pump pressure of the ECMO system and the maximum flow rate of the CRRT system obtained from the experimental results in Table 4 is shown in FIG. Fig.17 As shown in FIG. , an approximate curve is calculated.

[0233] In the CRRT system, a blood flow rate of at least 0.1 L / min is required. From the approximate curve, it can be seen that the post-pump pressure of the ECMO system that can achieve a flow rate of more than 0.1 L / min is more than 141 mmHg.

[0234] The above results confirm that even if the CRRT system does not have a pump in the blood removal circuit 510, blood can flow into the blood purifier of the CRRT system at a specified flow rate by utilizing the pressure of the blood transported by the ECMO blood pump 420 of the ECMO system 400.

[0235] (Measurement of CRRT System Flow Rate When Opening and Closing of Flow Rate Adjustment Unit 511a (Adjustment Jig) are Adjusted)

[0236] Next, the circuit configuration corresponding to the fourth embodiment is used as Example 5, and an experiment is conducted to confirm whether the CRRT flow rate can be controlled to a specified flow rate by adjusting the opening and closing of the flow adjustment unit 511a (adjustment fixture). At this time, the flow rate of the return blood pump 531 is adjusted and controlled in a manner so that the measured value of the pressure gauge P10 is within the range of 40 mmHg or more and 60 mmHg or less. In addition, the circuit internal pressure of the CRRT system is measured when the CRRT flow rate is changed. The results are shown in Table 3. In addition, regarding the set flow rates of each pump of the CRRT system, the dialysate pump 541 is set to 350 mL / h, the drainage pump 551 is set to 1050 mL / h, and the replenishing fluid pump 561 is set to 750 mL / h.

[0237] [Table 5]

[0238]

[0239] In Table 5, the speed of the ECMO system indicates the speed of the ECMO blood pump (centrifugal pump), the flow rate indicates the flow rate of the ECMO blood pump (the measured value of the flow meter 414), and the post-pump pressure indicates the pressure immediately after the ECMO blood pump (measured by the pressure gauge P8 or P11). The flow rate of the CRRT system indicates the measured value of the flow meter 512, and the return blood pump set flow rate indicates the set flow rate of the return blood pump 531. In addition, Pbi indicates the inlet pressure of the blood purifier (measured by the pressure gauge P9), Pf indicates the pressure of the dialysate drainage line (measured by the pressure gauge P12), and Pbo indicates the outlet pressure of the blood purifier (measured by the pressure gauge P10).

[0240] According to Table 5, it can be confirmed that the target flow rates of 0.10 L / min, 0.20 L / min, and 0.25 L / min can be set by adjusting the opening and closing of the flow regulator 511a (adjustment fixture). It can also be confirmed that the circuit internal pressure when the CRRT system is operated at these flow rates is maintained at a low positive pressure.

[0241] The above results indicate that, when the adjustment jig is used as the flow rate adjustment unit 511 a , the flow rate of the CRRT system can be controlled and the circuit internal pressure can be made a low positive pressure.

[0242] As mentioned above, each preferred embodiment of the CRRT system of the present invention has been described, but the present invention is not limited to the above-mentioned embodiments and can be modified appropriately.

[0243] For example, in each of the above-mentioned embodiments, the pressure on the upstream side of the blood return pump is measured by measuring the pressure of the storage section provided on the upstream side of the blood return pump, but the present invention is not limited thereto. For example, the pressure on the upstream side of the blood return pump may be measured by measuring the pressure of the blood return line on the upstream side of the blood return pump without providing a storage section. In addition, for example, the pressure may be measured by branching the pipes constituting the blood return line by a branch section such as a T-tube, or by providing a unit for measuring pressure in the blood return line and connecting a pressure gauge to the unit.

[0244] In addition, in the above-mentioned embodiments, an example of connecting the blood removal line and the blood return line of the CRRT system to the connection line of the ECMO system is shown, but it is not limited to this. From the viewpoint of removing bubbles mixed in the blood in the artificial lung, it is desirable to connect the blood removal line and the blood return line of the CRRT system to the upstream side of the artificial lung, but the blood removal line and the blood return line may also be connected to the downstream side of the artificial lung of the ECMO system.

[0245] In addition, in each of the above-mentioned embodiments, the downstream end of the blood return line is connected to the ECMO system downstream of the connection point with the blood removal line so that recirculation is not performed, but the present invention is not limited thereto. That is, the downstream end of the blood return line may be connected to the ECMO system upstream of the connection point with the blood removal line so that recirculation is performed.

[0246] In addition, in each of the above-mentioned embodiments, the ECMO blood circuit 410 includes the blood removal line 410a, the connection line 410b, and the blood return line 410c, but the invention is not limited thereto. For example, the connection line 410b may not be provided, and a part of the blood removal line 410a may be used to form the connection line, and a part of the blood return line 410c may be used to form the connection line.

[0247] In addition, in the above-mentioned embodiments, as an example of connecting the blood return line of the CRRT system to the upstream side of the artificial lung, the case of connecting to the branch part on the downstream side of the ECMO blood pump 420 in the connection line of the ECMO system is shown, but it is not limited to this.

[0248] For example, Fig.18 As shown, both the blood removal line 510 and the blood return line 530 of the CRRT system may be connected to the artificial lung 430 of the ECMO system 400. However, in order to prevent recirculation in the artificial lung 430, the blood return line 530 needs to be connected to the downstream side of the blood removal line 510. From the viewpoint of not requiring a branch to be provided in the ECMO blood circuit 410 and removing bubbles transported from the CRRT system in the artificial lung 430, such a connection method may be used.

[0249] In addition, for example, in the case where the artificial lung is additionally provided with a blood inlet port, Fig.19 As shown, the blood return line 530 of the CRRT system may be connected to the inlet port, and a branch may be provided in the connection line 410b to connect the blood removal line 510 of the CRRT system. According to such a connection method, it is possible to set a branch at only one position in the connection line 410b of the ECMO blood circuit 410 and to remove the bubbles transported from the CRRT system in the artificial lung 430.

[0250] Description of Reference Numerals

[0251] 100, 400 Extracorporeal membrane oxygenation (ECMO) system

[0252] 110, 410ECMO blood circuit

[0253] 110b, 410b connection lines

[0254] 120ECMO blood pump

[0255] 130, 430 artificial lung

[0256] 200, 200A, 200B, 200C, 500, 500A Continuous Renal Replacement Therapy (CRRT) Systems

[0257] 210CRRT blood circuit

[0258] 210a, 510 blood removal line

[0259] 210b blood return line

[0260] 220CRRT blood pump (liquid delivery unit)

[0261] 230, 520 blood purifier

[0262] 280 height adjustment unit

[0263] 300, 300A intermediate system

[0264] 310 Intermediate blood removal line

[0265] 311 Flow Control Unit

[0266] 312 Blood removal side pressure buffer

[0267] 320 Middle Blood Return Line

[0268] 321, 531 blood return pump

[0269] 322 Blood return side pressure buffer

[0270] 3121 Blood removal detection unit

[0271] 3221 Blood return detection unit

[0272] 420ECMO blood pump (blood pump)

[0273] 511 Flow adjustment unit (roller pump, finger pump)

[0274] 511a Flow adjustment unit (adjustment fixture)

[0275] 530 blood return line

[0276] 532 blood chamber (storage part)

[0277] 570 Control Unit.

Claims

1. An intermediate system is an intermediate system provided at a connection portion between an extracorporeal membrane artificial lung system and a blood purification system, wherein the extracorporeal membrane artificial lung system comprises an ECMO blood pump and an artificial lung arranged on the downstream side of the ECMO blood pump, and the blood purification system comprises a blood purification pump and a blood purifier arranged on the downstream side of the blood purification pump, wherein the intermediate system is characterized in that: The upstream end of the blood purification system is connected to the extracorporeal membrane artificial lung system at a downstream side of the ECMO blood pump, The intermediate system comprises: An intermediate blood return line, the upstream end of which is connected to the downstream end of the blood purification system, and the downstream end is connected to the extracorporeal membrane artificial lung system; A blood return pump, which is arranged on the intermediate blood return line; a blood return side pressure buffer, which is provided on the upstream side of the blood return pump in the intermediate blood return line and can store a predetermined amount of liquid; a blood return side detection unit configured to detect a storage state of a liquid in the blood return side pressure buffer unit; and The control unit adjusts the flow rate of the blood return pump according to the storage state of the blood return side pressure buffer unit detected by the blood return side detection unit so as to control the storage amount of the liquid in the blood return side pressure buffer unit to be within a predetermined range.

2. The intermediate system according to claim 1, wherein: Also available: An intermediate blood removal line, whose upstream end is connected to the extracorporeal membrane artificial lung system at a downstream side of the ECMO blood pump, and whose downstream end is connected to the upstream end of the blood purification system; A flow adjustment unit, which is arranged on the intermediate blood removal line and adjusts the flow of the intermediate blood removal line; a blood removal side pressure buffering unit, which is provided on the downstream side of the flow rate adjusting unit in the intermediate blood removal line and can store a predetermined amount of liquid; and a blood removal side detection unit for detecting a storage state of the blood removal side pressure buffer unit, The control unit adjusts the flow rate of the flow rate adjustment unit based on the storage state of the blood removal-side pressure buffer unit detected by the blood removal-side detection unit so that the storage amount of the liquid in the blood removal-side pressure buffer unit is within a predetermined range.

3. The intermediate system according to claim 1 or 2, wherein: The downstream end of the intermediate blood return line is connected to the artificial lung or the artificial lung in the extracorporeal membrane artificial lung system, which is upstream of the artificial lung.

4. A blood purification system connected to an extracorporeal membrane artificial lung system, the extracorporeal membrane artificial lung system comprising an ECMO blood pump and an artificial lung arranged downstream of the ECMO blood pump, the blood purification system comprising: A blood removal circuit, the upstream end of which is connected to the extracorporeal membrane artificial lung system at a downstream side of the ECMO blood pump; a blood purifier connected to the downstream end of the blood removal circuit; a liquid delivery unit, which delivers liquid to the blood purifier; A blood return line, the upstream end of which is connected to the blood purifier, and the downstream end of which is connected to the extracorporeal membrane artificial lung system; A blood return pump, which is arranged on the blood return line; a blood return side pressure buffer, which is provided on the blood return line at an upstream side of the blood return pump and can store a predetermined amount of liquid; a return-blood-side detection unit configured to detect a storage state of the return-blood-side pressure buffer unit; and The control unit adjusts the flow rate of the blood return pump according to the storage state of the blood return side pressure buffer unit detected by the blood return side detection unit so as to control the storage amount of the liquid in the blood return side pressure buffer unit to be within a predetermined range.

5. The blood purification system according to claim 4, wherein: Also available: A flow adjustment unit, which is arranged at the upstream side of the blood removal line and adjusts the flow of the blood removal line; a blood removal side pressure buffer, which is provided on the downstream side of the blood removal line and can store a prescribed amount of liquid; and a blood removal side detection unit for detecting a storage state of the blood removal side pressure buffer unit, The control unit adjusts the flow rate of the flow rate adjustment unit based on the storage state of the blood removal-side pressure buffer unit detected by the blood removal-side detection unit so that the storage amount of the liquid in the blood removal-side pressure buffer unit is within a predetermined range.

6. The blood purification system according to claim 5, wherein: The liquid delivery unit is a blood purification pump provided on the blood removal line at a downstream side of the blood removal side pressure buffer section.

7. The blood purification system according to claim 5, wherein: The liquid supply unit includes a height difference adjustment unit capable of relatively changing the position of the blood removal-side pressure buffer section in the height direction and the position of the blood return-side pressure buffer section in the height direction.

8. The blood purification system according to any one of claims 4 to 7, wherein: The downstream end of the blood return line is connected to the artificial lung or to the artificial lung in the extracorporeal membrane artificial lung system, which is upstream of the artificial lung.

9. A blood purification system connected to an extracorporeal membrane artificial lung system, the extracorporeal membrane artificial lung system comprising a blood pump and an artificial lung arranged downstream of the blood pump, the blood purification system comprising: A blood removal circuit, the upstream end of which is connected to the extracorporeal membrane artificial lung system at a downstream side of the blood pump; a blood purifier connected to the downstream end of the blood removal circuit; A flow adjustment unit, which is arranged on the blood removal circuit and adjusts the flow of the blood removal circuit; A blood return line, the upstream end of which is connected to the blood purifier, and the downstream end of which is connected to the extracorporeal membrane artificial lung system; A blood return pump, which is arranged on the blood return line; a pressure gauge for measuring the pressure on the upstream side of the blood return pump in the blood return line; as well as A control unit adjusts the flow rate of the flow rate adjustment unit and the blood return pump so that the measured value of the pressure gauge falls within a predetermined range.

10. The blood purification system according to claim 9, wherein: The device further comprises a storage unit, the storage unit being provided on the upstream side of the blood return pump in the blood return line and capable of storing a predetermined amount of liquid. The pressure gauge measures the pressure of the storage section.

11. The blood purification system according to claim 9 or 10, wherein: The flow rate adjustment unit is a roller pump or a finger pump, The control unit adjusts the flow rate of the roller pump or the finger pump to control the inflow amount of the blood purifier, and adjusts the flow rate of the return blood pump to control so that the measured value of the pressure gauge falls within a predetermined range.

12. The blood purification system according to claim 9 or 10, wherein: The flow rate adjustment part is an adjustment fixture capable of adjusting the opening. The control unit adjusts the flow rate of the blood return pump to control the inflow amount of the blood purifier, and adjusts the opening of the adjustment jig to perform control so that the measured value of the pressure gauge falls within a predetermined range.

13. The blood purification system according to claim 9 or 10, wherein: The downstream end of the blood return line is connected to the artificial lung or to the artificial lung in the extracorporeal membrane artificial lung system, which is upstream of the artificial lung.

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