Simulation training device for vena cava retrograde perfusion

Abstract

The invention provides a vena cava retrograde perfusion simulation training device, and belongs to the field of medical engineering. The simulation training device provided by the invention is provided with the simulation person containing the heart position container, can reproduce the operation situation of vena cava retrograde perfusion in real extracorporeal circulation, and provides real-time feedback. The simulation training device simultaneously comprises a main pump, an inferior vena cava retrograde perfusion pump A, a superior vena cava retrograde perfusion pump B, and a first pressure sensor, a second pressure sensor and a third pressure sensor which are used for measuring the pressure of the inferior vena cava retrograde perfusion pump A and the superior vena cava retrograde perfusion pump B. The vena cava retrograde perfusion simulation training device can simulate a human body circulation system, and can perform simulation training of similar clinical brain retrograde perfusion combined with inferior vena cava retrograde perfusion technology, superior vena cava retrograde perfusion technology and brain priority whole body retrograde perfusion technology on employees.

Description

Technical Field

[0001] The present invention belongs to the field of medical engineering, and particularly relates to a vena cava retrograde perfusion simulation trainer for simulating surgical scenarios. Background Art

[0002] Vena cava retrograde perfusion techniques include superior vena cava retrograde perfusion technique (RCP), inferior vena cava retrograde perfusion technique (RIVP), and brain-first total body retrograde perfusion technique (Bf-TBRP). These techniques are essential perfusion techniques in major vascular surgeries that require deep hypothermic circulatory arrest, and can reduce ischemic injury to vital tissues and organs throughout the body. However, the implementation process is full of various risks. Using a simulation trainer to strictly train practitioners is an important means to reduce these risks.

[0003] The essence of retrograde perfusion is to independently perfuse the superior vena cava and the inferior vena cava respectively. Existing extracorporeal circulation training systems, whether it is the Orpheus in vitro simulation system or the EWCCSIM simulation system, do not have independent circulation of the superior and inferior vena cava, so the simulation training of retrograde perfusion cannot be carried out. That is to say, there is no vena cava retrograde perfusion simulation trainer available for practitioners at home and abroad.

[0004] Extracorporeal circulation refers to draining the patient's venous blood to the outside of the body, oxygenating it into arterial blood using an artificial membrane lung (oxygenator), and then perfusing the blood back into the patient's arterial system in the forward direction by an artificial heart to maintain blood and oxygen supply. However, in a special type of surgery, such as aortic arch replacement and aortic dissection surgery, since the descending aorta needs to be opened and the artificial blood vessel needs to be sutured, normal arterial forward perfusion cannot be used for blood supply. To ensure normal tissue perfusion, vena cava retrograde perfusion is usually adopted clinically at this time, including: superior vena cava retrograde perfusion (RCP): blood perfuses retrograde from the superior vena cava to the microcirculation and returns to the brachiocephalic trunk and common carotid artery to ensure brain perfusion; inferior vena cava retrograde perfusion (RIVP): blood is perfused from the inferior vena cava to the abdominal organs and flows out through the descending aorta to maintain organ blood supply. During the implementation of the inferior vena cava retrograde perfusion technique, selective cerebral antegrade perfusion technique (a part of the blood is perfused into the brain through the common carotid artery, ACP) is often required, that is, ACP + RIVP.

[0005] These two retrograde perfusion techniques are crucial for ensuring the smooth progress of aortic arch replacement surgery and the smooth recovery of patients. However, due to the complex clinical implementation process and full of risks, especially when implementing ACP + RIVP, multiple tubes need to be clamped and opened to divert blood flow. If the operation is incorrect, it will cause poor perfusion, and even gas entry, endangering the patient's life. When performing ACP + RIVP, the close cooperation of two pumps is also required. One pump is the main pump, and a part of the pumped blood enters the common carotid artery to perfuse the brain (ACP), and the other part is driven by another pump (slave pump) and enters the inferior vena cava to perfuse the abdominal organs (RIVP). If the flow rate of the slave pump is greater than that of the main pump, gas will enter the body and endanger the patient's life. If the flow rate of the main pump is too high, it will lead to luxury perfusion of the brain and cause brain injury to the patient.

[0006] Using a simulation trainer to train practitioners is undoubtedly the best choice to enable practitioners to quickly master the technology and reduce patient injuries. However, the inventor reviewed domestic and foreign literature and patents and found that there is no simulation trainer that can help practitioners conduct simulation training for inferior vena cava retrograde perfusion.

[0007] That is to say, in the existing technology, general surgery does not require circulatory arrest, so generally the ascending aorta of the patient is cannulated to deliver its blood to the arteries and all organs of the body. For the current surgical treatment of aortic dissection, since the lower body circulation needs to be temporarily interrupted, the traditional method mainly relies on hypothermia to protect the organs. If it is necessary to ensure the blood supply of organs such as the liver, intestine, and kidney, it must be achieved through retrograde perfusion of the inferior vena cava. For example, West China Hospital clinically uses retrograde perfusion of the inferior vena cava to ensure that the patient's organs are less damaged during the operation.

[0008] Given that junior extracorporeal circulation technicians and novice surgeons cannot directly complete such high-risk operations in patients, simulation trainers are urgently needed in postgraduate continuing education and standardized training to assist in mastering the techniques related to inferior vena cava retrograde perfusion. During clinical surgery, the control of retrograde perfusion blood flow is crucial: too large a flow rate may lead to excessive load on the venous system and increase the risk of complications; too small a flow rate may not effectively protect the target organs. Therefore, it is of great significance to develop a training device that can dynamically reflect the changes in the process of inferior vena cava retrograde perfusion in a simulated environment. Generally, inferior vena cava retrograde perfusion mainly maintains the microcirculation perfusion of abdominal organs (such as the intestine, liver, kidney, etc.), while superior vena cava retrograde perfusion is mainly used to ensure the microcirculation blood supply to the brain.

[0009] One of the inventors of the present invention has previously applied for a patent CN201810162115.9 as the first inventor and obtained authorization. A vena cava retrograde perfusion tube is disclosed in this patent, which includes an arterial perfusion tube. Arterial perfusion branch tube A and arterial perfusion branch tube B are connected to the arterial perfusion tube. The free end of arterial perfusion branch tube A is connected to one end of vena cava drainage tube A, and the free end of arterial perfusion branch tube B is connected to one end of vena cava drainage tube B. The arterial perfusion branch tube A and the vena cava drainage tube A, and the arterial perfusion branch tube B and the vena cava drainage tube B are integrally formed. The vena cava drainage tube A or the vena cava drainage tube B is connected to the arterial perfusion tube through a retrograde perfusion tube. The arterial perfusion branch tube A, the arterial perfusion branch tube B, the vena cava drainage tube A, and the vena cava drainage tube B are all flexible tubes. This invention is convenient to operate, has a short preparation time, and has the advantage of rapid conversion between various perfusion methods. For example, this product can be directly used for selective cerebral perfusion combined with inferior vena cava retrograde perfusion (ACP + RIVP) of the human body, as shown in Figures 4 and 6 of this patent; this product can be used for normal arterial perfusion of the human body, as shown in Figure 3 Figure 5 of this patent; this product can also be used for superior vena cava retrograde perfusion combined with inferior vena cava retrograde perfusion of the human body, as shown in Figure 7 of this patent; this product can also be used for separate superior vena cava retrograde perfusion of the human body, as shown in Figure 8 of this patent.

[0010] When this product is used for vena cava retrograde perfusion of patients, it can shorten the preparation time, shorten the operation time, and improve the prognosis of patients. However, this product is not suitable for simulation training of vena cava retrograde perfusion of a mannequin by junior extracorporeal circulation technicians and novice surgeons.

[0011] Therefore, there is still a need in the art for a vena cava retrograde perfusion simulator. Summary of the Invention

[0012] Therefore, the present invention provides a simulator for retrograde perfusion of the vena cava, which includes a retrograde perfusion pump A (6) for the inferior vena cava, a retrograde perfusion pump B (7) for the superior vena cava, and a mannequin (102) containing a heart-position container (101) for accommodating a certain amount of liquid. The simulator includes a superior vena cava cannula (1) and an inferior vena cava cannula (2) respectively connected to the mannequin. The other free ends of the superior vena cava cannula (1) and the inferior vena cava cannula (2) are respectively connected to a blood storage tank (3), or the two merge at point P (22) into a common venous return tube (31) and then are connected to the blood storage tank (3). The outlet of the blood storage tank (3) is connected to a main pump (4) through a pipeline. The outlet of the main pump (4) is connected to an oxygenator (5) through a pipeline. The outlet of the oxygenator (5) is connected to the inlet tube of a four-way tube. The four-way tube is a communicating pipeline integrally formed with one inlet tube and at least four outlet tubes. The first outlet tube (91) of the four-way tube serves as a femoral artery cannula for connecting to the femoral artery tube access point on the mannequin. The second outlet tube (92) of the four-way tube serves as an axillary artery cannula for connecting to the axillary artery tube access point on the mannequin. The third outlet tube (93) of the four-way tube serves as the pump front end of the retrograde perfusion tube for the inferior vena cava and is connected to the retrograde perfusion pump A (6) for the inferior vena cava. The fourth outlet tube (94) of the four-way tube serves as the pump front end of the retrograde perfusion tube for the superior vena cava and is connected to the retrograde perfusion pump B (7) for the superior vena cava. The outlet of the retrograde perfusion pump A (6) for the inferior vena cava is connected to the pump rear end (61) of the retrograde perfusion tube for the inferior vena cava. The outlet of the retrograde perfusion pump B (7) for the superior vena cava is connected to the pump rear end (71) of the retrograde perfusion tube for the superior vena cava. The pump rear end (61) of the retrograde perfusion tube for the inferior vena cava and the inferior vena cava cannula (2) are a communicating pipeline integrally formed and intersect at point M (21). The pump rear end (71) of the retrograde perfusion tube for the superior vena cava and the superior vena cava cannula (1) are a communicating pipeline integrally formed and intersect at point N (11). The simulator further includes at least three pipeline clamps and at least three pressure sensors. Among them, a pressure sensor one (41) is arranged on the inlet tube and is used to monitor the pressure of the main pump (4). A pressure sensor two (62) is arranged on the pipeline where the retrograde perfusion pump A (6) for the inferior vena cava retrogradely returns to the heart-position container (101) and is used to monitor the pressure of the retrograde perfusion pump A (6) for the inferior vena cava. A pressure sensor three (72) is arranged on the pipeline where the retrograde perfusion pump B (7) for the superior vena cava retrogradely returns to the heart-position container (101) and is used to monitor the pressure of the retrograde perfusion pump B (7) for the superior vena cava.

[0013] In a specific embodiment, the pipe wrench (8) includes a first pipe wrench (81) configured to be disposed between point M (21) and point P (22) or between point M (21) and the blood storage tank (3), a second pipe wrench (82) configured to be disposed between point N (11) and point P (22) or between point N (11) and the blood storage tank (3), and a third pipe wrench (83) configured to be disposed on the first outlet pipe (91).

[0014] In a specific embodiment, the pipe wrench (8) further includes a fourth pipe wrench (84) configured to be disposed on the second outlet pipe (92).

[0015] In a specific embodiment, there is a first artificial artery connection between the femoral artery access point and the heart position container, and a second artificial artery connection between the axillary artery access point and the heart position container. The superior vena cava cannula (1) is connected to the simulator at the superior vena cava access point, and there is a first artificial vein connection between the superior vena cava access point and the heart position container. The inferior vena cava cannula (2) is connected to the simulator at the inferior vena cava access point, and there is a second artificial vein connection between the inferior vena cava access point and the heart position container.

[0016] In a specific embodiment, the second pressure sensor (62) is disposed on the pump rear end (61) of the inferior vena cava retrograde perfusion tube, and the third pressure sensor (72) is disposed on the pump rear end (71) of the superior vena cava retrograde perfusion tube.

[0017] In a specific embodiment, the main pump (4), the inferior vena cava retrograde perfusion pump A (6), the superior vena cava retrograde perfusion pump B (7), and the first pressure sensor (41), the second pressure sensor (62), and the third pressure sensor (72) are all electrically connected to a controller for control. Preferably, the controller further includes a reader for inputting radial artery blood pressure data.

[0018] In a specific embodiment, the simulation trainer further includes a first return pipe (103) connecting from the descending aorta of the simulator to the blood storage tank (3) to return blood to the blood storage tank (3), and a return pump C (104) is disposed on the first return pipe (103).

[0019] In the present invention, the descending aorta of the simulator mainly includes the first artificial artery and the second artificial artery as described above.

[0020] In a specific embodiment, the simulation trainer further includes a second return pipe (105) connecting from the heart position container (101) of the simulator to the blood storage tank (3) to return blood to the blood storage tank (3), and a return pump D (106) is disposed on the second return pipe (105).

[0021] In a specific embodiment, the superior vena cava cannula (1), inferior vena cava cannula (2), total venous return tube (31), the pump rear end of the inferior vena cava retrograde perfusion tube (61), and the pump rear end of the superior vena cava retrograde perfusion tube (71) are integrally provided.

[0022] The present invention has at least the following beneficial effects: The vena cava retrograde perfusion simulation trainer of the present invention can simulate the human circulatory system, as well as operations such as open ascending aorta vascular suture and vena cava occlusion during surgery, and is provided with pressure monitoring. Cooperating with the extracorporeal circulation machine and circulation pipeline used clinically, it can conduct approximate clinical ACP+RIVP, RCP, Bf-TBRP simulation training for practitioners. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] Figure 1 Schematic diagram of the simulation trainer for the cerebral antegrade perfusion combined with inferior vena cava retrograde perfusion technique (ACP+RIVP) of Example 1.

[0024] Figure 2 Schematic diagram of the simulation trainer for the superior vena cava retrograde perfusion technique (RCP) of Example 2.

[0025] Figure 3 Schematic diagram of the simulation trainer for the brain-first total body retrograde perfusion technique (Bf-TBRP) of Example 3. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0026] The present invention provides a vena cava retrograde perfusion simulation trainer, which is used for the training of extracorporeal circulation perfusionists to improve the perfusionists' understanding of extracorporeal circulation perfusion techniques and their ability to handle clinical emergencies.

[0027] In the present invention, when a pressure sensor is set in the pipeline, the pipeline is cut open and the pressure sensor is connected to the pipeline.

[0028] In the prior art, neither the Orpheus in vitro simulation system nor the EWCCSIM simulation system can simulate the retrograde perfusion operation. The reasons are as follows: 1) These systems do not separate the superior and inferior vena cava; 2) They do not divide the arterial system into the upper and lower body; 3) They do not have an electronic clamp to simulate arterial clamping; 4) They do not have a pressure monitoring system; 5) They do not set up an open artificial heart or heart position container.

[0029] In the present invention, the artificial heart is connected to the blood storage tank (3) through the superior vena cava cannula (1) and the inferior vena cava cannula (2), and after being pumped by the main pump (4), it is transported to the oxygenator (5). The venous blood is oxygenated and becomes arterial blood. The arterial blood returns to the inferior vena cava cannula (2) and the superior vena cava cannula (1) respectively through the inferior vena cava retrograde perfusion pump A (6) and the superior vena cava retrograde perfusion pump B (7) via point M (21) and point N (11), and then flows back to the heart.

[0030] As Figure 1 shown, when the inferior vena cava retrograde perfusion pump A is opened, a pipe clamp 1 (81) is installed on the distal side of the inferior vena cava cannula (2) near point M (21), so that a part of the inferior vena cava cannula (2) is clamped. The arterial blood flows back to the heart from the inferior vena cava retrograde perfusion pump A, point M, and the unclamped part of the inferior vena cava cannula (2). Figure 1 In, the inferior vena cava retrograde perfusion pump A is opened, and the superior vena cava retrograde perfusion pump B is closed. The blood flows at the inferior vena cava retrograde perfusion pump A and the second outlet tube (i.e., the axillary artery cannula), corresponding to the inferior vena cava retrograde perfusion and the cerebral antegrade perfusion respectively.

[0031] As Figure 2 shown, when the superior vena cava retrograde perfusion pump B is opened, a pipe clamp 2 (82) is installed on the distal side of the superior vena cava cannula (1) near point N (11), so that a part of the superior vena cava cannula (1) is clamped. The arterial blood flows back to the heart from the superior vena cava retrograde perfusion pump B, point N (11), and the unclamped part of the superior vena cava cannula (1). Figure 2 In, the superior vena cava retrograde perfusion pump B is opened, and the inferior vena cava retrograde perfusion pump A is closed. The blood flows at the superior vena cava retrograde perfusion pump B, corresponding to the superior vena cava retrograde perfusion.

[0032] As Figure 3 shown, when the inferior vena cava retrograde perfusion pump A is opened, a pipe clamp 1 (81) is installed on the distal side of the inferior vena cava cannula (2) near point M (21), so that a part of the inferior vena cava cannula (2) is clamped. The arterial blood flows back to the heart from the inferior vena cava retrograde perfusion pump A, point M, and the unclamped part of the inferior vena cava cannula (2); and when the superior vena cava retrograde perfusion pump B is also opened, a pipe clamp 2 (82) is installed on the distal side of the superior vena cava cannula (1) near point N (11), so that a part of the superior vena cava cannula (1) is clamped. The arterial blood flows back to the heart from the superior vena cava retrograde perfusion pump B, point N (11), and the unclamped part of the superior vena cava cannula (1). Figure 3 In, the superior vena cava retrograde perfusion pump B and the inferior vena cava retrograde perfusion pump A are opened. The blood flows at the inferior vena cava retrograde perfusion pump A and the superior vena cava retrograde perfusion pump B, which is the whole body retrograde perfusion with priority for the brain.

[0033] In the above figure, the first outlet tube (91) is generally in a state of being clamped by the third pipe wrench (83) (simulating the arrest of blood circulation in the lower body of a patient). In the present invention, although the first outlet tube (91), i.e., the femoral artery cannula, is generally clamped, this passage must exist in the simulation trainer; because when the arterial dissection involves the axillary artery, only the femoral artery can be used for antegrade perfusion.

[0034] In the present invention, the first outlet tube (i.e., the femoral artery cannula) and the second outlet tube (i.e., the axillary artery cannula) are both arterial cannulas, so they are all in the antegrade direction; the third outlet tube (i.e., the inferior vena cava retrograde perfusion tube) and the fourth outlet tube (the superior vena cava retrograde perfusion tube) are both venous cannulas, and the venous cannulas are all in the retrograde direction.

[0035] The simulation trainer of the present invention trains primary extracorporeal circulation technicians and novice surgeons at least in the following aspects:

[0036] 1) Training novice surgeons to install pipe wrenches on the superior vena cava cannula (1) and / or the inferior vena cava cannula (2) to clamp the corresponding pipes;

[0037] 2) Training primary extracorporeal circulation technicians to pay attention to the height of the liquid level in the reservoir (3) in a timely manner;

[0038] 3) Training primary extracorporeal circulation technicians to pay attention to the pressure and blood flow of the main pump (4), and generally need to reduce the blood flow of the main pump when installing pipe wrenches to clamp the superior vena cava cannula and / or the inferior vena cava cannula.

[0039] 4) Training extracorporeal circulation technicians to control the blood flow of the inferior vena cava retrograde perfusion pump A (6) and the superior vena cava retrograde perfusion pump B (7);

[0040] 5) Training novice surgeons to correctly connect each pipeline to ensure that they are not connected reversely or wrongly.

[0041] In the present invention, the main pump plays the role of the power of the artificial heart, and the oxygenator plays the role of the artificial lung. In the present invention, all the tubes are flexible tubes.

[0042] In the present invention, the superior vena cava cannula (1) and the inferior vena cava cannula (2) can both achieve normal venous drainage and the retrograde perfusion function of the vena cava.

[0043] Example 1

[0044] This example is a simulation training of cerebral antegrade perfusion combined with inferior vena cava retrograde perfusion technology (ACP + RIVP).

[0045] Figure 1 It is a schematic diagram of the simulation training of ACP + RIVP, which is applicable to the total aortic arch replacement surgery.

[0046] Its operation process includes: 1) clamping the femoral artery cannula; 2) starting the main pump; 3) clamping the proximal end of the inferior vena cava cannula near the reservoir; 4) starting the inferior vena cava retrograde perfusion pump A. And the reflux pump C (104) and / or the reflux pump D (106) can be started in time according to the blood volume in the reservoir (3).

[0047] Precautions during operation: First, when performing unilateral or bilateral cerebral antegrade perfusion, the following situations should reduce the flow rate of the main pump to reduce the pressure: 1) the right radial artery pressure rises > 30 mmHg; 2) the left radial artery pressure rises > 20 mmHg; 3) the pump pressure of the main pump rises > 90 mmHg; Second, the following situations should reduce the flow rate of the inferior vena cava retrograde perfusion pump A to reduce the pressure, and at the same time reduce the flow rate of the main pump to reduce the pressure: 1) the pressure of the inferior vena cava retrograde perfusion pump A > 25 mmHg; 2) when the blood return in the descending aorta affects the surgical operation, the flow rate should be gradually reduced so as not to affect the surgical operation.

[0048] The operation scenarios for trainees include: clamping the femoral artery cannula, clamping the proximal end of the inferior vena cava cannula near the reservoir, starting the main pump, starting the inferior vena cava retrograde perfusion pump A, and establishing a model of combined cerebral antegrade perfusion and inferior vena cava retrograde perfusion; First, if the pressure sensors of the left or right radial artery indicate that the pressure rise amplitude exceeds 20 mmHg or 30 mmHg respectively, or the pressure sensor of the main pump (pressure sensor one) indicates that the pressure rise amplitude exceeds 90 mmHg, then reduce the flow rate of the main pump. Second, if the pressure sensor of the inferior vena cava retrograde perfusion pump A (pressure sensor two) indicates that the pressure > 25 mmHg, then reduce the flow rates of both the main pump and the inferior vena cava retrograde perfusion pump A simultaneously.

[0049] The left or right radial artery is located at the left or right wrist of a person. Regarding the monitoring of radial artery blood pressure, the training instructor can provide simulated blood pressure data or adjust the blood pressure setting in the simulator according to teaching needs. Generally speaking, the instructor may adjust certain variables according to the trainee's operation performance to help the trainee understand how to adjust the flow rate of extracorporeal circulation under different blood pressure conditions so as to perform simulated clinical interventions.

[0050] Embodiment 2

[0051] This embodiment is a simulation training of the superior vena cava retrograde perfusion technique (RCP).

[0052] Figure 2 It is a schematic diagram of the simulation training of RCP, which is applicable to right hemiarch replacement surgery.

[0053] Its operation process includes: 1) Clamp the femoral artery cannula and the axillary artery cannula; 2) Clamp the proximal end of the superior vena cava cannula near the blood storage tank; 3) Start the main pump perfusion; 4) Start the superior vena cava retrograde perfusion pump B. And the reflux pump C (104) and / or the reflux pump D (106) can be started in a timely manner according to the blood volume in the blood storage tank (3).

[0054] Precautions: When the central venous pressure (CVP) > 25 mmHg, the main pump flow rate should be reduced to lower the pressure.

[0055] Scenario of the trainee's operation: Clamp the femoral artery cannula, the axillary artery cannula, and the proximal end of the superior vena cava cannula near the blood storage tank, start the main pump perfusion, start the superior vena cava retrograde perfusion pump B, and establish a superior vena cava retrograde perfusion model; when the central venous pressure sensor (pressure sensor three) indicates that the pressure > 25 mmHg, reduce the main pump flow rate.

[0056] Example 3

[0057] This example is a simulation training of the brain-first total body retrograde perfusion technique (Bf-TBRP).

[0058] Figure 3 It is a schematic diagram of the simulation training of Bf-TBRP, which is applicable to the right hemiarch replacement surgery.

[0059] Its operation process includes: 1) Clamp the femoral artery cannula and the axillary artery cannula; 2) Clamp the proximal end of the superior vena cava cannula near the blood storage tank; 3) Clamp the proximal end of the inferior vena cava cannula near the blood storage tank; 4) Start the main pump perfusion; 5) Start the inferior vena cava retrograde perfusion pump A and the superior vena cava retrograde perfusion pump B; where steps 2) and 3) can be in any order. And the reflux pump C (104) and / or the reflux pump D (106) are started in a timely manner according to the blood volume in the blood storage tank (3).

[0060] In this simulation trainer, because both the superior vena cava cannula (1) and the inferior vena cava cannula (2) are clamped, during the simulated operation, the blood in the blood storage tank (3) mainly comes from the blood refluxed from the reflux pump C (104) and / or the reflux pump D (106) to the blood storage tank (3). Further, in this example, the blood in the blood storage tank (3) mainly comes from the blood refluxed from the reflux pump C (104) to the blood storage tank (3), while the reflux pump D (106) only provides an auxiliary function.

[0061] Precautions: When the central venous pressure (CVP) > 25 mmHg, the main pump flow rate should be reduced to lower the pressure.

[0062] Trainee operation scenario: Clamp the femoral artery cannula and axillary artery cannula, clamp the end of the superior vena cava cannula near the blood reservoir, and clamp the end of the inferior vena cava cannula near the blood reservoir, start the main pump perfusion, and establish a brain-first systemic retrograde perfusion model; the central venous pressure sensor indicates that the pressure is >25mmHg, and reduce the main pump flow.

[0063] exist Figure 2 and Figure 3 In the figure, the femoral artery cannula and the axillary artery cannula are both in a clamped state, but there are three different situations. The first situation is that the femoral artery cannula is connected to the simulator, while the axillary artery cannula is not connected to the simulator; the second situation is that the axillary artery cannula is connected to the simulator, while the femoral artery cannula is not connected to the simulator; the third situation is that both the femoral artery cannula and the axillary artery cannula are connected to the simulator.

[0064] In the present invention, the heart position container is a separate container for simulating the human heart and having the blood storage function. The advantages of setting a separate heart position container in the present invention include at least the following points.

[0065] 1) Enhanced control and management of liquids: Setting up a separate center-position container can provide more precise liquid storage and flow control, improving the accuracy of liquid management and operation.

[0066] 2) Higher visualization and feedback: The separate heart-position container provides a more intuitive display of liquid flow and pressure monitoring, which can help the training instructor understand the liquid capacity status of the "simulator" in real time and help the trainees intuitively feel the "simulator" capacity status and liquid flow rules.

[0067] 3) Improve flexibility and adaptability: Setting up a separate heart container can flexibly respond to various liquid distribution strategies and fault simulations, replenish or reduce the liquid capacity of the "simulator" at any time, translate changes in heart capacity, and improve the trainees' emergency response capabilities.

[0068] 4) Better fault simulation and operation training: It can simulate specific faults in liquid storage and flow process to help trainees identify and solve problems in actual operation in time.

[0069] In the present invention, the oxygenator is arranged at the rear end of the main pump. The method of arranging the oxygenator in front of the main pump has been abandoned for the following reasons: 1) Low efficiency: the blood flow rate and pressure before the pump fluctuate greatly, and the oxygenation effect is unstable; 2) High bubble risk: bubbles are easily sucked into the pump, resulting in bubble embolism; 3) Blood damage: the contact time between blood and oxygenator is too long, increasing the risk of blood coagulation and damage; 4) Complex system: this method will increase the complexity and operation difficulty of the extracorporeal circulation system.

[0070] Compared with the inventor's prior patent CN201810162115.9, "A Retrograde Venous Perfusion Tube and Its Usage Method", the present invention has at least the following features.

[0071] 1) The simulation trainer provided by the present invention is equipped with a mannequin, which can reproduce the operation scenario of retrograde venous perfusion in real extracorporeal circulation and provide real-time feedback. The simulation trainer also includes a main pump, a retrograde inferior vena cava perfusion pump A, a retrograde superior vena cava perfusion pump B, and pressure sensors one, two, and three for measuring their pressures. The design of the mannequin covers the dynamic changes of physiological and mechanical parameters such as arterial blood pressure, venous return, and blood flow resistance (pump pressure). Through the pipeline system built into the mannequin, the blood flow situation in the real body can be simulated, and the blood flow velocity, blood pressure, flow rate, and other parameters of the mannequin system can be adjusted according to different training requirements set in the course. The mannequin contains a heart position container, and trainees can intuitively perceive the changes in blood flow in the perfusion pipeline in real time, and then adjust the operation strategy. Trainees can adjust the venous return system of the mannequin by physical means (such as adjusting pipeline clamps, etc.). The blood flow, blood pressure, venous return, and other parameters of the mannequin can be accurately adjusted according to different trainings as required by the training instructor, and the relevant data changes can be displayed in real time on the computer screen of the simulation training.

[0072] 2) The present invention adopts pressure sensing technology to monitor the blood pressure changes in various important parts of the simulation system in real time. By setting multiple pressure sensors, the system can detect and feedback the pressure changes in key parts such as the venous perfusion tube, arterial perfusion tube, and blood return channel. The pressure data is not only displayed in real time on the control panel, but also can remind the operator of possible problems such as poor perfusion and insufficient blood return in the form of sound or visual alarms. In the present invention, multi-point pressure sensors are integrated, and the sensing accuracy can be automatically adjusted according to different training stages during the simulation process to provide more accurate pressure data. This multi-point pressure monitoring can help trainees accurately judge the perfusion state, so as to adjust the operation strategy and avoid misoperation or delay. The system can also be designed with a multi-level alarm mechanism. When an abnormality occurs during perfusion (such as too high or too low pressure or flow interruption), it can automatically trigger an emergency warning to timely remind the operator to adjust the operation and reduce the risk caused by improper operation.

[0073] 3) To ensure that trainees can receive sufficient training for coping in various clinical scenarios, the system of the present invention integrates multiple functions such as flow monitoring, pressure feedback, and venous return monitoring into the controller, achieving a deep integration of operation and feedback. During the operation of the system, trainees can not only judge the accuracy of the current operation through the feedback of pressure and flow, but also adjust the operation strategy in real time according to the changes in blood flow in the simulation system. This design greatly improves the flexibility and adaptability of the simulation training. Different from traditional simulation training devices, the present invention not only focuses on blood flow and pressure, but also can integrate multiple physiological parameters such as blood return and radial artery changes, enabling the simulation system to more accurately reflect the multi-dimensional changes in actual operations. For example, when there are fluctuations in the blood flow in the simulation system, trainees can adjust the pipe clamp, regulate the perfusion parameters or take other intervention measures according to the blood flow state. Generally speaking, this system can be set to an intelligent system that can intelligently sense every change in the operation and feed the data back to the controller. This not only provides trainees with real-time training data, but also can provide personalized training suggestions through automatic system adjustment to help trainees better master the operation of retrograde perfusion of the vena cava.

[0074] 4) Diversity and flexibility of training modes. The device of the present invention has multiple adjustable training modes, which can meet different training needs. Trainees can select a suitable mode for operation according to the complexity of the training content. Each training mode is equipped with a simulation feedback system and can be adjusted according to the trainees' operations. The training modes include, for example, but are not limited to: ① Basic mode: Simulate simple retrograde perfusion of the vena cava operations to help trainees familiarize themselves with the basic usage methods of the device. ② Challenge mode: Test the trainees' emergency response capabilities by simulating complex blood flow obstacles (such as poor drainage, gas entry, etc.). ③ Clinical mode: Simulate various complex situations that may occur during actual surgeries for comprehensive operation training. Conventional simulation training devices can only complete basic extracorporeal circulation accident scenarios. The device of the present invention can simulate blood perfusion situations under different surgical environments, including multiple scenarios such as retrograde perfusion of the vena cava, acute volume loss, and air entry into the pipeline, to help trainees train and cope with complex situations in actual surgeries under different simulation conditions.

[0075] Generally speaking, the present invention provides a simulator for retrograde perfusion of the vena cava. The simulator provided by the present invention is equipped with a mannequin containing a heart position container, which can reproduce the operation scenario of retrograde perfusion of the vena cava in real extracorporeal circulation and provide real-time feedback. The simulator also includes a main pump, a retrograde perfusion pump A for the inferior vena cava, a retrograde perfusion pump B for the superior vena cava, and pressure sensors one, two, and three for measuring their pressures. The simulator for retrograde perfusion of the vena cava according to the present invention can simulate the human circulatory system and can conduct simulation training for practitioners on techniques such as antegrade cerebral perfusion combined with retrograde perfusion of the inferior vena cava, retrograde perfusion of the superior vena cava, and brain-priority total retrograde perfusion techniques that are approximate to clinical situations.

[0076] It is easy for those skilled in the art to understand that the above are only preferred embodiments of the present invention and are not used to limit the present invention. Any modifications, equivalent replacements, and improvements made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A vena cava retrograde perfusion simulation trainer, characterized in that: The invention comprises an inferior vena cava retrograde perfusion pump A (6), a superior vena cava retrograde perfusion pump B (7), and a manikin (102) having a heart position container (101), wherein the heart position container is used to contain a certain amount of liquid. The simulation trainer comprises a superior vena cava cannula (1) and an inferior vena cava cannula (2) respectively connected to the manikin. The other free ends of the superior vena cava cannula (1) and the inferior vena cava cannula (2) are respectively connected to a blood storage tank (3) or the two are connected to a common venous return pipe (31) after merging at a point P (22) and then connected to the blood storage tank (3). The outlet of the blood storage tank (3) is connected to a main pump (4) through a pipeline. The main pump ( The outlet of the oxygenator (4) is connected to the oxygenator (5) through a pipeline, and the outlet of the oxygenator (5) is connected to the inlet pipe of the four-branch pipe, and the four-branch pipe is a connecting pipe including an inlet pipe and at least four outlet pipes and is integrally formed. The first outlet pipe (91) of the four-branch pipe is used as a femoral artery cannula for connecting to a femoral artery tube access point on the simulated person, the second outlet pipe (92) of the four-branch pipe is used as an axillary artery cannula for connecting to an axillary artery tube access point on the simulated person, the third outlet pipe (93) of the four-branch pipe is used as a pump front end of the inferior vena cava retrograde perfusion pipe for connecting to the inferior vena cava retrograde perfusion pump A (6), and the fourth outlet pipe (94) of the four-branch pipe is used as a pump front end of the inferior vena cava retrograde perfusion pipe for connecting to the inferior vena cava retrograde perfusion pump A (6). 4) as the pump front end of the superior vena cava retrograde perfusion tube, used to be connected to the superior vena cava retrograde perfusion pump B (7), the outlet of the inferior vena cava retrograde perfusion pump A (6) is connected to the pump rear end (61) of the inferior vena cava retrograde perfusion tube, the outlet of the superior vena cava retrograde perfusion pump B (7) is connected to the pump rear end (71) of the superior vena cava retrograde perfusion tube, and the pump rear end (61) of the inferior vena cava retrograde perfusion tube and the inferior vena cava cannula (2) are integrally formed as a connecting pipe, and the two intersect at point M (21), and the pump rear end (71) of the superior vena cava retrograde perfusion tube and the superior vena cava cannula (1) are integrally formed as a connecting pipe, and the two intersect at point N (11); the simulation trainer also includes at least three pipe clamps and at least three pressure sensors, wherein pressure sensor one (41) is arranged on the inlet pipe and is used to monitor the pressure of the main pump (4), pressure sensor two (62) is arranged on the pipeline from the inferior vena cava retrograde perfusion pump A (6) to the heart container (101) and is used to monitor the pressure of the inferior vena cava retrograde perfusion pump A (6), and pressure sensor three (72) is arranged on the pipeline from the superior vena cava retrograde perfusion pump B (7) to the heart container (101) and is used to monitor the pressure of the superior vena cava retrograde perfusion pump B (7).

2. The vena cava retrograde perfusion simulation trainer according to claim 1, characterized in that: The pipeline clamp (8) comprises a pipeline clamp 1 (81) for being arranged between point M (21) and point P (22) or between point M (21) and the blood storage tank (3), a pipeline clamp 2 (82) for being arranged between point N (11) and point P (22) or between point N (11) and the blood storage tank (3), and a pipeline clamp 3 (83) for being arranged on the first outlet pipe (91).

3. The vena cava retrograde perfusion simulation trainer according to claim 2, characterized in that: The pipe clamp (8) further comprises a pipe clamp four (84) for being arranged on the second outlet pipe (92).

4. The vena cava retrograde perfusion simulation trainer according to claim 1, characterized in that: A first artificial artery is connected between the femoral artery tube access point and the heart container, a second artificial artery is connected between the axillary artery tube access point and the heart container, the superior vena cava catheter (1) is connected to the simulated person at the superior vena cava tube access point, and a first artificial vein is connected between the superior vena cava tube access point and the heart container, the inferior vena cava catheter (2) is connected to the simulated person at the inferior vena cava tube access point, and a second artificial vein is connected between the inferior vena cava tube access point and the heart container.

5. The vena cava retrograde perfusion simulation trainer according to any one of claims 1 to 4, characterized in that: The second pressure sensor (62) is arranged on the rear end (61) of the pump of the inferior vena cava retrograde perfusion tube, and the third pressure sensor (72) is arranged on the rear end (71) of the pump of the superior vena cava retrograde perfusion tube.

6. The vena cava retrograde perfusion simulation trainer according to any one of claims 1 to 4, characterized in that: The main pump (4), the inferior vena cava retrograde perfusion pump A (6), the superior vena cava retrograde perfusion pump B (7), and the pressure sensor 1 (41), the pressure sensor 2 (62), and the pressure sensor 3 (72) are all electrically connected to the controller for control. Preferably, the controller also includes a reader for inputting radial artery blood pressure data.

7. The vena cava retrograde perfusion simulation trainer according to any one of claims 1 to 4, characterized in that: The simulation trainer also includes a return pipe 1 (103) connected from the simulated human descending aorta to the blood storage tank (3) so that blood returns to the blood storage tank (3), and a return pump C (104) is arranged on the return pipe 1 (103).

8. The vena cava retrograde perfusion simulation trainer according to claim 7, characterized in that: The simulation trainer also includes a reflux tube 2 (105) connected from the simulated person's heart position container (101) to the blood storage tank (3) so that blood returns to the blood storage tank (3), and a reflux pump D (106) is arranged on the reflux tube 2 (105).

9. The vena cava retrograde perfusion simulation trainer according to any one of claims 1 to 4, characterized in that: The superior vena cava cannula (1), the inferior vena cava cannula (2), the common venous return tube (31), the pump rear end (61) of the inferior vena cava retrograde perfusion tube, and the pump rear end (71) of the superior vena cava retrograde perfusion tube are integrated.

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