Cutting method
The method addresses contamination and leakage risks in medical device disconnections by using elastic deformation under reduced pressure to draw fluids into the line section, ensuring a hygienic and cost-effective disconnection process.
Patent Information
- Application Number
- JP2022574518
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- Priority Date
- 2020-06-05
- Filing Date
- 2021-06-02
- Publication Date
- 2025-11-28
- Estimated Expiration
- 2041-06-02
AI Technical Summary
The challenge in medical devices is to disconnect fluid-conducting line sections while maintaining high hygiene standards to prevent contamination and leakage, especially in systems like extracorporeal blood processing machines, where air or liquid contaminants can enter the patient's bloodstream and require time-consuming disinfection.
A method involving elastic deformation of one line section under reduced pressure to direct fluid away from the connection area, using a pump to generate reduced pressure in the line sections, causing the elastic section to deform and return to its original shape, thereby drawing fluid into it, reducing contamination and leakage risks.
This method effectively minimizes contamination and leakage by directing fluids away from the connection area, ensuring a more hygienic disconnection process without the need for additional components, thus enhancing patient safety and reducing material costs.
Smart Images

Figure 0007777545000001 
Figure 0007777545000002 
Figure 0007777545000003
Abstract
Description
[Technical Field]
[0001] The present invention relates to a method for severing a fluid-conducting line section in a medical device, and to a medical device designed to carry out the method according to the invention. [Background technology]
[0002] When disconnecting fluid-conducting line sections from each other in a medical device, such as a machine-side fluid system from a single-use (disposable) fluid system of an extracorporeal blood processing machine or dialysis machine, high hygiene standards must be maintained to ensure patient safety.
[0003] In fact, when the tubing set is disconnected from the blood processing machine after extracorporeal blood processing, the liquid contained in the tubing set can enter and contaminate the machine fluid circuit or the hydraulic components of the machine, necessitating a time-consuming disinfection process in the blood processing machine.
[0004] Before treatment begins, air, for example in the form of bubbles, or liquid contaminants may be present in the fluid system of a medical device following a priming process (a process in which physiological fluid is filled and flushed into the fluid line system). When the fluid system is disconnected to connect a portion of the fluid system to a patient, it is necessary to ensure that as little air as possible remains in the portion of the fluid system that is connected to the patient. If air or contaminants remain in the portion of the fluid system that is connected to the patient, this air or contaminants may enter the patient's bloodstream.
[0005] Furthermore, particularly in the medical field, it is desirable for hygiene reasons to prevent leakage when any of the fluid conducting lines are disconnected.
[0006] Accordingly, the problem addressed by the present invention is to mitigate or entirely overcome problems from the prior art. In particular, the problem addressed by the present invention is to provide a more hygienic method of disconnecting fluid connections and corresponding medical devices.
[0007] This problem is solved by the subject matter of the independent claims. The dependent claims relate to advantageous developments of the invention. Summary of the Invention [Problem to be solved by the invention]
[0008] A method according to the invention for cutting two fluid-conducting line sections, in particular detachably interconnected, of a medical device, wherein a first of the two line sections has at least partially elastic properties, The method comprises: - enclosing a fluid volume in two line sections; - generating reduced pressure in the two line sections, resulting in an elastic deformation in and / or on the first line section from a starting position to a tensioned position, so that the fluid volume contained in the first line section is lower in the tensioned position than in the starting position; - disconnecting the line sections, in which in a tensioned position the fluid volume contained in the first line section increases and the first line section moves back from the tensioned position towards the starting position; Includes.
[0009] The term "fluid" covers liquids, gases, and mixtures of liquids and gases in dissolved (no interface) or non-dissolved (with interface) form. The teachings described herein can be used, for example, when cutting two line sections that are completely filled with liquid, or completely filled with gas, or liquid and gas, and can be used in particular with liquid-filled systems connected to a gas reservoir, or gas-filled systems that are moist, e.g., still contain liquid droplets.
[0010] The method may include a step in which the line section is filled with a liquid.
[0011] "Fluid volume" means the amount that is enclosed. By applying a vacuum, part of the enclosed amount is removed from the enclosed volume (in the sense of geometric volume), i.e., the fluid volume is reduced. This reaction can involve the geometric volume being reduced, for example, by a reduced tube diameter. This is primarily the case for liquids that cannot be practically compressed or expanded. If the enclosed volume is partially filled with gas, this gas can expand when part of the liquid / gas material is removed from the enclosed volume, especially in the case of a fixed geometric volume. A combination of a reduction in geometric volume and an expansion of the gas with a reduction in fluid volume is also possible.
[0012] "Elastic" or "more elastic" means that the fluid volume contained within the line section increases when the line section breaks a connection without an external force. For example, the line section may contract (henceforth, smaller geometric volume) in response to a reduced pressure, and during the break, it may relax with an increase in volume due to the restoring force inherent in the line section, resulting in the inflow of fluid. In this process, the line section may, but need not, return to its initial volume. In the case of gases, "elastic" can mean that when the reduced pressure is removed, gas or liquid will flow in such a way that the pressure of the gas phase equals the ambient pressure (approximately according to the ideal gas law). Similarly, a gas with a lower pressure is referred to as a "tension position," and expansion or compression is referred to as a "deformation." "More elastic" means that the increase in volume within the line section is greater than that of a comparable line section.
[0013] In other words, the relaxation of the deformed elastic line section, i.e. the reduction in pressure on the line section, can be used to direct fluids, particularly gases or liquids, in a targeted manner away from the connection area of two line sections when the connection is severed.
[0014] For example, creating a reduced pressure creates a deformation of the first line section, causing the inner wall of the section to bend into the lumen, thus narrowing the flow path cross-section. The restoring force of the elastically deformed line section causes the inner wall of the line section to return towards its starting position, meaning that the volume contained by the first line section, e.g., the flow path cross-sectional area, expands again, and fluid is drawn into the previously narrowed region.
[0015] By setting or selecting the material and / or shape, e.g., length, diameter, wall thickness, diameter shape, deflection, in at least one region of the first and / or second line section and / or by supplying gas, e.g., in the form of a gas reservoir, in the first and / or second line section, the elastic properties of the first and / or second of the two line sections can be predetermined so that when the line sections are disconnected from each other, a fluid can be directed from the connection region towards one or both line sections, in particular towards the first line section when it has elastic properties. A restoring force can also be generated, for example, by a compressed tube returning to a round shape, or by a more curved tubular line section bending further and then straightening again by applying a reduced pressure, or by an elongated tube returning to its shortened length again.
[0016] The first line section and the second line section have an interior volume for receiving a fluid. Neither of the two line sections is a cover or cap. As intended, the first line section and the second line section are configured to convey a liquid therethrough during use.
[0017] The first line section may be elastic in at least one region, such that contraction occurs when the pressure is reduced, and when the connection to the second line section is opened, liquid may move from the cut point towards the relaxed section of the first line section when the volume of the tube increases due to the elasticity of the line section and the associated restoring force.
[0018] In the context of the present invention, regions of the first and / or second line section or the entire first and / or second line section may have elastic properties.
[0019] The fluid can be increased and moved in the first line section (relatively elastic material or shape in the first line section, relatively rigid material or shape in the second line section) or in the second line section (relatively elastic material or shape in the second line section, relatively rigid material or shape in the first line section).
[0020] The first line section may comprise at least one region that is more elastic than the second line section, such that when a reduced pressure is applied, the first line section experiences a greater decrease in volume than the second line section, and during cutting, the first line section experiences a greater increase in volume, allowing more liquid to be displaced towards the first line section than towards the second line section.
[0021] The first line section and the second line section may each have at least one region made from a more elastic material than the remainder of the first line section and the second line section, the region of the first line section being made from a more elastic material than the region of the second line section, such that when the connection between the line sections is broken, fluid is drawn from the connecting region of the line sections into the first line section to a greater extent than into the second line section.
[0022] In other words, the first line section and optionally the second line section may comprise areas that are more elastic than the second line section or the remainder of the first and second line sections, respectively, however the entire first line section may also be more elastic than the entire second line section.
[0023] From the above, it is clear that longer tube sections (shape and material being otherwise the same) can have greater elasticity than shorter tube sections.
[0024] The first line section may be longer than the second line section.
[0025] A portion of the first and / or second line section can be partially filled with gas, e.g., air, while the remainder of the first and second line sections can be filled with liquid, where the gas-filled region cannot be directly connected to the connection region between the first and / or second line section and / or cannot be transferred from the first and second line sections while a reduced pressure is being generated.
[0026] For example, the pump can pump liquid from the first line section and / or the second line section, and this reduction in fluid volume results in a larger volume being available for gas provided in the gas reservoir and fluidly connected to the first line section and / or the second line section, which then expands and reduces the gas pressure.
[0027] If the connection between the first line section and the second line section is then broken, the gas will contract again (pressure equalization) and the liquid can simultaneously draw liquid from the other line section and / or gas can be drawn towards it from the surroundings through the point of break.
[0028] The cutting method can include closing a blocking element arranged along the second line section, at one end of which another blocking element is already arranged. As a result, the length of the second line section can be shortened. In particular, due to the different elastic properties, the fluid can thus be preferably drawn into the first line section (e.g., a tubing set or another disposable item, or, for example, an internal fluid system of a medical device). The medical device according to the invention can be equipped with such a valve.
[0029] This type of directed movement of the liquid can be used to reduce the risk of unwanted materials in the liquid moving from the first line section to the second line section or from the environment into the second line section, thereby reducing the risk of contamination of the reusable fluid system or reducing the amount of air getting into the tubing set connected to the patient.
[0030] The region having elastic properties can be, for example, a line loop or a pump line section of a pump, particularly a peristaltic pump. During the pumping process, the line loop or pump line section of a peristaltic pump is compressed by one or more actuators, such as rollers or fingers, and is relaxed when the actuator action is removed. In pumps that primarily use rollers as actuators, the line loop may also be subjected to tensile forces, which can result in a reduction in volume. The line loop or pump line section on which this type of pump or its actuator operates typically comprises a softer or more elastic material than the other line sections of the first and / or second line sections. By using the line loop or pump line section as a region having greater elasticity, more elastic line sections specifically provided for the cutting method disclosed herein can be dispensed with, resulting in a more cost-effective, material-saving solution. Furthermore, the actuator of a peristaltic pump can also be utilized as a shutoff member. As a result, a separate component for enclosing a fluid volume is not required, resulting in further cost and material savings.
[0031] Alternatively or additionally, both the first line section and the second line section may also comprise regions with elastic properties, while the remainder of the line sections may be made of a relatively rigid material.
[0032] In this embodiment, the relaxation of the area made of elastic material assists in cutting the fluid column when cutting the line sections, meaning that fluid is transferred from the connection area to both the first and second line sections, preventing leakage and improving hygiene.
[0033] Again, the elastic region of one line section may be more elastic than the elastic region of the other line section, so that fluid will preferably move towards the more elastic region.
[0034] The method according to the invention can be carried out when the patient is not already connected to a device that carries out the method.
[0035] Thus, the method according to the invention can be used to prepare a medical device before treatment, for example during priming of a tubing set to be used or when connecting or coupling necessary lines, and for post-treatment of the medical device after treatment, for example when disconnecting or unconnecting necessary lines, or when disposing of used disposables.
[0036] The method according to the present invention therefore does not act on the patient's body, but rather is performed at the device and on disposables connected to the device or other components fluidly coupled to the device.
[0037] Another aspect of the present invention relates to a medical device.
[0038] The medical device may be designed to perform or may be designed such that the cutting method can be performed on the medical device, the cutting method comprising severing at least two fluid-conducting line sections that are detachably interconnected, a first of the two line sections having at least partially elastic properties.
[0039] The medical device may include at least one first blocking element and one second blocking element for enclosing a fluid volume in the two line sections, a pump capable of generating reduced pressure in the two line sections, resulting in elastic deformation of the first line section from a start position to a tensioned position, and a controller for operating the pump, programmed to operate the pump to generate the reduced pressure in a cutting mode.
[0040] The medical device may comprise means for enclosing a fluid volume in the two line sections and means for generating reduced pressure in the two line sections, resulting in elastic deformation of at least a region of the first line section from a starting position to a tensioned position, such that when the connection between the two line sections is severed, at least the region of the first line section returns from the tensioned position to the starting position, resulting in fluid being drawn into the first line section from the connecting region of the line sections.
[0041] The controller can be programmed to close one of the blocking elements before the reduced pressure is generated, meaning that the fluid volume can be closed on one side. Alternatively or additionally, the controller can be programmed to close one of the blocking elements after the reduced pressure is generated, meaning that the fluid volume can be enclosed.
[0042] The controller may activate at least one, some, or all of the active components belonging to the group of means for generating reduced pressure and means for containing, for example, the controller may be programmed to start a pump, thus generating reduced pressure, and / or close a valve or clamp, thus creating a closed system.
[0043] The first line section or the second line section can be part of a device-side fluid system of a medical device.
[0044] The medical device may further comprise a fluid source fluidly connected to the second line section, in particular a physiological fluid source fluidly connected to the second line section, optionally a sterile filter fluidly positioned between the fluid source and the second line section, and a medical device side connector on one end of the second line section for connecting to one end of the first line section.
[0045] In this embodiment, the medical device can be configured to supply physiological fluid to the first line section via the second line section, e.g., by a pump, during a priming process and / or during treatment via a sterile filter capable of retaining contaminants, and the first line section can form part of a tubing system and can be connected to a tubing system that fills with blood during treatment. After treatment, the first line section can be disconnected from the second line system and discarded, e.g., using the method according to the present invention in a disconnection mode. The second line section can remain in the medical device and can be reused in a subsequent treatment.
[0046] The medical device can include an exhaust line, and the first line section can be fluidly connected to or form part of the exhaust line. The medical device can further include a medical device connector at one end of the first line section for connecting to one end of the second line section.
[0047] In this embodiment, the second line section can be part of a line that conducts blood during blood processing. During the priming process, the second line section can be removably connected to the first line section by a medical device connector, and the second line section can conduct fluid that can be transferred from the second line section to the first line section and further to a drain line during a flush step of the priming process. For treatment purposes, the second line section can be disconnected from the connector or the first line section and connected to a patient.
[0048] The pump or means for creating the reduced pressure may be one or more pumps from the group including peristaltic pumps, membrane pumps, centrifugal pumps, impeller pumps and gear pumps.
[0049] The pump or means for creating reduced pressure may be one or more pumps from the group including ultrafiltration pumps, blood pumps, and displacement pumps.
[0050] The pump may be a peristaltic pump, and at least one actuator of the peristaltic pump may be part of the first or second blocking element.
[0051] The blocking element and the containment means may each comprise one or more pumps, valves, check valves or clamps, or a combination thereof.
[0052] The shutoff elements can be manually operated components or can be activated by a controller, and a first shutoff element can be manually activated and a second shutoff element can be activated by a controller, and multiple shutoff elements can be provided.
[0053] The first line section and / or the second line section may be branched. In each case, one blocking element may be provided at each end of the first line section and / or the second line section, except that the detachable connecting ends of the first line section and the second line section may be branched.
[0054] In embodiments with actuatable shutoff elements, the controller can be programmed to activate the actuatable shutoff elements to contain the fluid volume. For example, the controller can be programmed to operate a pump in one direction. The controller can also be programmed to close all upstream-located shutoff elements in a first step, activate the pump in a subsequent step, and then close all downstream-located shutoff elements in a subsequent step. Alternatively, in a first step, one or more or all downstream-located actuatable shutoff elements can also be closed as long as there is an open connection downstream for discharging fluid. This can be, for example, a manually closed check valve or clamp.
[0055] The medical device may include a user interface through which a user inputs commands, and the controller may be programmed to activate the cutting mode in response to the command being input into the user interface.
[0056] When the cut mode is activated, a special mode can be activated in the program code of the controller. When the cut mode is activated, a special sequence of the program code can be executed, which causes the medical device to perform the cut method. The cut mode can also be integrated with other modes. For example, a priming mode can be stored in the program code, and the cut mode can constitute a step, e.g., the last step of the priming mode.
[0057] The user interface can be a display, a screen, a touch screen, a keypad, a control knob, a microphone for recording audio signals, or a camera for detecting user gestures.
[0058] The controller can be programmed to activate multiple modes and automatically switch from one of the modes to the cutting mode.
[0059] For example, in the reinfusion mode, the controller may be connected to a sensor of the medical device, such as an optical sensor, which may detect that there is no longer blood in the tubing set. The controller may process this signal in its program code so that it can activate another mode, which may be a disconnect mode. Alternatively or additionally, the controller's program code may provide an additional mode for emptying the tubing set and / or dialyzer and / or machine-side fluid system after the reinfusion mode is complete, and the controller may be programmed to switch to the disconnect mode after a predetermined period of time, or after a predetermined volume of fluid has been transferred, or after a sensor in the emptied region detects an interface between the reinfusion fluid and the blood that has optical properties different from air or blood, or after a predetermined pressure is detected.
[0060] Alternatively or additionally, the controller's program code can provide a mode for filling the tubing set or cassette with a priming fluid and / or flushing the tubing set or cassette with fluid before therapy begins (a "priming mode"), and the controller can be programmed to switch to a disconnection mode after the priming mode is complete. The controller can be programmed to activate a pump during the priming mode, thereby moving fluid from a fluid source toward the tubing set or cassette. The controller can be programmed to determine the end of priming, for example, when a predetermined time has elapsed, when a predetermined amount of fluid has been moved into the tubing set or cassette, or when an air detector or fluid sensor indicates that there is no longer any air or that there is primarily only fluid.
[0061] The controller can also be programmed so that switching to disconnect mode is initially automatic, but the pump is only activated after input from the user interface.
[0062] The controller may also be specifically programmed to only allow input via the user interface to start the pump if the cut mode is activated, in other words, the program code of the controller may provide that there are modes or phases other than the cut mode in which the pump will not be started despite corresponding input via the user interface.
[0063] By limiting the cutting methods that can be initiated in this way, it is possible, for example, to prevent such cutting methods from being able to be initiated during treatment.
[0064] As disclosed above, the medical device may not include either the first or second line section, but instead may be connected solely for treatment.
[0065] As disclosed above, a medical device can include one of two line sections and can be solely connected to the second of the two line sections for treatment.
[0066] In another embodiment, a medical device includes both a first line section and a second line section, wherein the first line section can have at least partially elastic properties that allow the first line section to be deformed from a start position to a tensioned position, and wherein a fluid volume contained in the first line section in the tensioned position is less than a fluid volume contained in the start position.
[0067] Optionally, one of the two line sections may be part of a disposable item, in particular a tubing set or cassette system used as part of a blood treatment.
[0068] Optionally, both line sections may be part of one or more disposable items, in particular tubing sets or cassette systems used as part of blood processing, or hydraulic components designed as disposable items that supply dialysate to a dialyzer (machine-side fluid systems through which blood does not flow during processing).
[0069] The first line section may comprise at least one region that is more elastic than the second line section.
[0070] According to one embodiment, the first line section and the second line section comprise at least one region made of a more elastic material than the remainder of the first line section and the second line section, the region of the first line section being made of a more elastic material than the region of the second line section, such that when the connection between the line sections is broken, fluid is drawn from the connecting region of the line sections into the first line section to a greater extent than in the second line section, or vice versa.
[0071] The controller may comprise, for example, a computer system and may be implemented in the form of digital circuitry, computer hardware, firmware, software, or any combination thereof. The present invention may also be implemented in the form of a computer program product, for example, a computer program on a physical information carrier (e.g., a machine-readable storage medium). The controller may comprise a general-purpose processor, a digital signal processor (DSP) for serially processing digital signals, a microprocessor, an application-specific integrated circuit (ASIC), an integrated circuit composed of logic elements (FPGA), or other integrated circuits (ICs) or hardware components to perform the individual method steps. A data processing program (software) may be executed on the hardware components to perform the method steps. A number of different components or combinations thereof that control the operation are possible.
[0072] The controller may further comprise a memory in which the program code is stored, such as a read-only memory (ROM) or a random-access memory (RAM), or both; a magnetic, magneto-optical, optical, or solid-state (SSD) storage medium; a semiconductor memory element (e.g., EPROM, EEPROM); a flash memory element; a magnetic or magneto-optical storage medium; a CD-ROM, a DVD-ROM, or a Blu-ray disc; or a non-volatile storage element. The memory may also be provided on demand or accessible over the Internet (e.g., cloud computing). Suitable data carriers for storing program instructions and data include all forms of non-volatile storage elements, such as a semiconductor memory element (e.g., EPROM, EEPROM); a flash memory element; a magnetic or magneto-optical storage medium; a CD-ROM, a DVD-ROM, or a Blu-ray disc. The processor and the memory element may be supplemented by, or be part of, specialized logic modules.
[0073] Other features and advantages of the present invention will become apparent from the following description of selected embodiments of the invention, taken in conjunction with the accompanying drawings, in which identical or similar components are designated by the same reference numerals. The features described below can be implemented in the above-described embodiments. These above-described embodiments will not be described again in full below. [Brief explanation of the drawings]
[0074] [Figure 1a] 1A-1C show two line sections and a medical device used as part of a method for severing two fluid-conducting line sections. [Figure 1b] FIG. 10 shows a first of two fluid-conducting line sections in a tensioned position in an example of mechanical deformation. [Figure 1c] FIG. 1c shows the first line section of FIG. 1b in a starting / tensioned position. [Figure 2] FIG. 1 shows an embodiment with a pump as a shut-off element. [Figure 3] FIG. 1 shows an embodiment with an anti-reflux valve as the blocking element. [Figure 4] FIG. 1 illustrates an embodiment with hydraulic components as part of the first line section. [Figure 5a] FIG. 1 illustrates an embodiment with an externally located pump. [Figure 5b] FIG. 1 illustrates an embodiment with branched line sections. [Figure 6a] FIG. 1 shows an embodiment with a T-piece or Y-piece connecting two lines. [Figure 6b] FIG. 10 shows an embodiment in which a T-piece or Y-piece is placed at one end of a line section. [Figure 7a] 1 illustrates an embodiment of a medical device. [Figure 7b] 1 illustrates an embodiment of a medical device in another configuration. [Figure 8a] FIG. 1 illustrates an embodiment of a user interface. [Figure 8b] FIG. 1 illustrates an embodiment of a user interface. DETAILED DESCRIPTION OF THE INVENTION
[0075] When using the method according to the invention, the embodiment of the medical device 1 shown schematically in FIG. 1a comprises two fluidly connected line sections 2, 3, which can be fluidly interconnected via two optional connector elements 4, 5 of the two line sections. The medical device 1 further comprises a pump 6. The first and second line sections each comprise a blocking element 7, 8 at one end. The line section 2 at least partially has elastic properties, in particular an elastically deformable region. The elastic properties or the deformable region can be embodied or arranged between the connection point to the second line section 3, i.e., between the connector element 4 and the blocking element 7. By means of the pump 6, a reduced pressure can be generated in the first line section 2, or in the first line section 2 and the second line section 3. The reduced pressure can cause a deformation in and on the first line section 2 from a start position to a tensioned position, such that the fluid volume contained in the first line section 2 in the tensioned position is less than the fluid volume contained in the start position.
[0076] The blocking elements 7, 8 can be closed, so that the fluid volume can be enclosed in the two line sections 2, 3. The blocking elements 7, 8 can be closed sequentially or simultaneously, in particular a first blocking element can be closed, after which a reduced pressure can be generated, and then a second blocking element can be closed.
[0077] The line sections 2, 3 can then be disconnected and the fluid volume contained in the first line section 2 increases compared to the fluid volume in the tensioned position.
[0078] The method will be explained based on elastic mechanical deformation with reference to Figures 1b and 1c. As will be explained, this is only one of several options how the elastic properties can be implemented.
[0079] When the shut-off element 8 is closed at the end of the second line section and the pump 6 pumps the fluid or liquid from the first line section 2 towards the second shut-off element 7, a reduced pressure is generated in at least a part of the first line section 2. In this process, the first line section 2 can, for example, contract inwards (see arrows in FIG. 1b) so that the volume of the first line section 2 is reduced. When the first and second line sections 2, 3 are sealed in this state, for example by closing the shut-off element 7 provided at the end of the first line section 2, a reduced volume of the system remains.
[0080] In other words, the wall of the line section 2 will therefore leave the starting position shown schematically in dashed lines in FIG. 1a and assume a tensioned position reproduced in solid lines in FIG. 1b.
[0081] When the two line sections 2, 3 are disconnected from each other, the elastically deformable region relaxes due to its elastic properties and the first line section 2 moves back from the tensioned position towards the starting position. As shown in Fig. 1c, the wall of the line section 2 thus moves further from the tensioned position (dashed line) towards the starting position or back to the starting position (solid line). In this process, fluid can be drawn from the connection region into the second line section 2, in other words, for example from the disconnection region in the region of the connector element 4, to the right in the embodiment shown in Figs. 1a to 1c.
[0082] Prior to disconnecting the first line section from the second line section, there may be liquid or a liquid column in the connection area. Without the suction effect of relaxation, the liquid column would simply disconnect and the liquid would flow downward from the connection area, at least due to gravity.
[0083] In the case described here, when cutting the first line section from the second line section 2, 3, due to relaxation in the first line section 2, air can be sucked in from the outside to the inside in the cutting area, and the liquid column can likewise at least partially follow the suction effect. As a result, more liquid overall can remain in the first line section 2 during cutting, and a flow of liquid directed into the first line section 2 can also be achieved.
[0084] Therefore, the risk of contamination and / or leakage (external leakage of liquid) of the second line section 2 can be reduced.
[0085] The medical device 1 may comprise a controller 9. The controller 9 may be programmed to activate the pump to generate reduced pressure in the cutting mode. Optionally, the controller 9 may be programmed to activate at least one or both of the shut-off elements 7, 8. For this purpose, the controller may be connected to the respective components to be activated (e.g., pump 6, shut-off elements 7, 8) via signal lines 10, 11, 12 of the medical device 1. The controller 9 may, for example, be programmed to start and / or stop the pump 6.
[0086] For example, the controller can be programmed to start the pump 6 when the first valve 7 is closed or when valve 8 is closed, and close the other valves 7, 8 so that a reduced pressure is applied or a deformable region is deformed to create an enclosed volume.
[0087] The medical device 1 may include a user interface 13. The user interface 13 may be configured for a user to input commands, and the controller 9 may be programmed to activate the cutting mode in response to the command entered into the user interface 13.
[0088] Both line sections 2, 3 are not necessarily part of the medical device 1, or one or both of the line sections 2, 3 may be connected to the pump 6 and the shut-off elements 7, 8 only when the medical device 1 is in use.
[0089] The medical device 1 may comprise a first line section 2 and / or a second line section 3. The first line section 2 and / or the second line section 3 may be part of a device-side fluid system of the medical device 1.
[0090] The first line section 2 and / or the second line section 3 may be part of a disposable item.
[0091] The pump 6 may be located along the first line section 2 and / or the second line section 3, or along a point in the fluid system outside the two line sections 2, 3 that fluidly connects the two line sections 2, 3. For example, the pump 6 may be located to the side of the blocking elements 7, 8 that are located at the back of the connectors 3, 4. The pump 6 only needs to be able to remove liquid from the elastically deformable region.
[0092] The medical apparatus 1 may comprise an automatic cutting device 14. This automatic cutting device 14 may, for example, comprise a motor that moves the first and / or second line sections 2, 3 and thus cuts the connection between the first and second line sections 2, 3. The controller 9 may be programmed to activate the automatic cutting device 14. This may allow the hygienic cutting method to be performed fully automatically, i.e. without human intervention.
[0093] FIG. 2 shows an embodiment in which the pump 6 functions as a shutoff element 7 or a means for enclosing a fluid volume. The view in FIG. 2 is intended to facilitate a comparison of the components of the respective embodiments of the medical device 1 as shown schematically in FIG. 1, rather than at an enlarged scale. Some or all of the controller 9, user interface 13, signal lines 10, 11, 12, and automatic disconnect device 14 may be present in this embodiment; in this regard, reference may be made to the description of FIGS. 1a to 1c. The components of the controller 9, user interface 13, signal lines 10, 11, 12, and automatic disconnect device 14 described below may also be present in the medical device 1, as described in connection with FIGS. 1a to 1c, if technically feasible. The same applies to FIGS. 3 to 8a.
[0094] The pump 6 may be a peristaltic pump and the actuator 15 may engage the first tubing portion 2 in the region of the line loop 16, thereby forming a closed fluid volume.
[0095] In this example, the pump 6 is a roller pump (one embodiment of a peristaltic pump) and the line loop 16 is inserted into the pump 6 .
[0096] Prior to disconnecting line sections 1 and 2, the roller of pump 6 is moved to a predetermined disconnection position so that at least a portion of line loop 16 is within the second section (between the connection point of pump 6 and the fluid cut-off point), and remains in this closed configuration during disconnection. In this embodiment, pump 6 functions as a cut-off element on the side of first line section 2. On the equipment side, valve 8 functions as a cut-off element. Pump 6 is also responsible for generating a reduced pressure in the interconnected line sections 1 and 2.
[0097] The rollers of pump 6 make at least one revolution through the predetermined angle to create a vacuum. If the starting position of the rollers is such that the angle is no longer large enough, the two rollers can be rotated another full or half revolution. Rotation can also occur until the predetermined vacuum is reached.
[0098] A pressure sensor 17 may be provided within the medical device 1, which measures the pressure within the enclosed volume and, if necessary, cooperates with the user interface 13 to display the pressure or whether the pressure reduction is sufficient and / or the controller 9 indicates that the pump 6 needs to be rotated further.
[0099] The controller can be programmed to operate the pump accordingly.
[0100] When the first line section is disconnected from the second line section 1, 2, the second line section 2 or region 16 thereof returns to the starting position and fluid is drawn into the second line section 2 or region 16 thereof.
[0101] As shown in Figure 3, the pump 6 can be used in combination with a shut-off member 8 in the form of a check valve. The first line section 2 is therefore fluidly closed by the check valve, its forward direction extending away from the connector or second line section 3.
[0102] By means of the pump 6, a fluid, in particular a liquid, is transmitted through the non-return valve 8, so that the first line section 2, in particular its region 16, is put into a tensioned position. In this embodiment, the trapped volume can already be present before the pump is started. When the pump is activated, the fluid is removed from the region of the first and / or second line sections 2, 3.
[0103] For example, because occlusion is not required to contain the fluid volume in this example, various types of pumps can be used in this embodiment, such as peristaltic pumps 6 with reversible actuators, gear pumps, impeller pumps, centrifugal pumps, and membrane pumps.
[0104] However, a check valve can also be present in the embodiment described in connection with Figure 2. As a result, an additional protection is provided to prevent liquid from entering the connection area between the two line sections, since both the blocking effect of the check valve and the blocking effect of the actuator must be overcome. This type of additional measure can be particularly useful in peristaltic pumps, because by design the rollers are regularly spring-loaded and must lift when subjected to excessive force, which can result in the loss of their closing function.
[0105] The level of reduced pressure produced can be set by a predetermined number of pump revolutions / actuation of the fingers of a finger pump or by a predetermined reduced pressure, which can be controlled or monitored by the controller 9.
[0106] When the first line section 1 and the second line section 2 are cut, the second line section 2 or a region 16 thereof returns to the starting position and fluid is drawn into the second line section 2 or a region 16 thereof.
[0107] As shown schematically in FIG. 4 , the medical device 1 can include a machine-side hydraulic component 18, which can be fluidly connected to or form part of the first line section 2. The machine-side hydraulic component 18 can be fluidly closed by one or more shutoff elements. The machine-side hydraulic component 18 can include a gas reservoir 20. Upon activation of the medical device 1, the first and second line sections 2, 3 and the hydraulic component 18 can be filled with liquid, except for the gas reservoir 19. A pump 6 can be provided to generate reduced pressure. The pump 6 can be a pump that pumps liquid during blood therapy, for example, a pump that pumps dialysate during dialysis therapy. The pump 6 can be an ultrafiltration pump or a balancing pump.
[0108] In this type of arrangement, fluid can be drawn toward the first line section 2 as part of one of the machine-side hydraulic components 18. This arrangement can be used, for example, when, after priming, a liquid-filled tubing set formed at least in part by the second line section 3 is intended to be disconnected from the first line section 1 and then connected to a patient. As a result, the second line section 3 can potentially be kept in a more hygienic condition.
[0109] The medical device 1 can comprise a shut-off means 20. The shut-off means 20 can be opened before the reduced pressure is generated, or the controller 9 can be programmed to open said means. As a result, the volume on which the reduced pressure acts can be increased (by an additional volume of the hydraulic component 18), or the fluid volume of the first line section 2 can be increased, and / or a gas reservoir can be part of the first line section 2. This can give the first line section 2 more elastic properties than when the shut-off element 20 is closed. Thus, the relaxation effect from the tensioned position can be enhanced.
[0110] The machine-side hydraulic component 18 may comprise an area made of elastic material, which can be moved into a tensioned position by the generated reduced pressure.
[0111] Figures 5a and 5b show a further embodiment of the medical device 1. This embodiment differs from the embodiment as described in Figures 2 and 3 in that the pump 6 is arranged outside the first line section 2. The shut-off element 8 may be a non-return valve, but may also be another shut-off element as described herein.
[0112] The pump 6 may be a blood pump of a blood processing machine. The blood pump may be configured to pump blood in the blood line 21 during blood processing. The first line section 2 may be a liquid supply line. During treatment, liquid may be transferred from the first line section 2 to the blood line 21.
[0113] The line section 2, or at least a region thereof, can be put into a tensioned position by a reduced pressure created by an externally located pump 6 so that fluid is drawn into the second line section 2 when the line sections 2 and 3 are cut.
[0114] 5b shows a variant of the embodiment of FIG. 5a, in which a branch to a pump 6, e.g., a substitute pump for a hemofiltration process, is further provided in the first line section 2. In this embodiment, the pump 6 also assumes the function of a blocking element 7 for this branch of the first line section 2. Here, a reduced pressure can be generated in the first line section 2 by the pump 6.
[0115] 6a and 6b illustrate an embodiment of the medical device 1 described in connection with FIG. 4. In this embodiment, the second line section 3 is disposable and comprises at least a portion of an arterial line 22 and a venous line 23 interconnected by a T-piece 24. As shown in FIG. 6a, the T-piece 24 can be directly connected to the first line section 2, for example, via an outlet of a blood processing machine. In the embodiment shown in FIG. 6b, the T-piece 24 is not directly connected to the first line section 2, for example, the outlet of a blood processing machine, but instead is connected via another line section 25. The T-piece 24 can also be in the form of a Y-piece. The outlet can also be known as a flushing port, allowing flushing fluid to be transferred from the second line section 3 to the first line section 2 when flushing the arterial line 22 and / or the venous line 23.
[0116] 6a and 6b can be used in particular for priming / filling tubing sets / disposables before treatment begins. When disconnecting the first and second line sections 2, 3, fluid is preferably intended to be drawn towards the first line section (to the machine-side hydraulic component 18).
[0117] 7a and 7b show a schematic representation of an embodiment of a medical device 1 in the form of a dialysis machine. Some components in the figures are optional. In particular, some components can be designed as disposable and do not necessarily constitute fixed components of the medical device 1. Dialysis machines differ solely in the disposable items and / or the configuration of the line routing. The medical device 1 may have two disconnection points (referenced 2, 3, 4, and 5 on the one hand, and 2', 3', 4', and 5' on the other hand) or only one of the two disconnection points. Two embodiments are shown by way of example. The disconnection points can be the connection points for the inflow of a liquid into the extracorporeal blood circuit system, e.g., the connection point of the first line section 2 with the second line section 3, or the connectors 4 and 5 located at their respective ends. The disconnection points can also be the connection points for the discharge of a liquid from the extracorporeal blood circuit system, e.g., the connection point of the first line section 2' with the second line section 3', or the connectors 4' and 5' located at both ends thereof. The embodiments or configurations herein may also be provided in place of the components and configurations explicitly described herein.
[0118] The dialysis machine in the form of a medical device 1 comprises the following components: a fluid source 26, a priming system with a pump 27, a first sterile filter 28 (optional), a second sterile filter 29 (optional), a dialyzer 30 (optional), a vent chamber 19 (optional), an ultrafiltration pump 6' (optional), a priming or substitution port 5, a priming or substitution pump 6 (optional). The blood pump 31 may comprise or be comprised of an exhaust port 4', a blood pump 31, a controller 9, a user interface 13, signal lines 10, 11, 12 (only selected portions shown), a venous clamp 8', an arterial clamp 32 (optional), a pre-dialyzer shut-off element 36 (optional), a post-dialyzer shut-off element 37 (optional), a first exhaust line shut-off element 7' (optional), a first exhaust line shut-off element 7' (optional), a first exhaust line shut-off element 7' (optional), a first exhaust line shut-off element 7' (optional), a first exhaust line shut-off element 8' (optional), a first exhaust line shut-off element 8' (optional), a first exhaust line shut-off element 8' (optional), a first exhaust line shut-off element 8' (optional).
[0119] The components can be connected to the fluid transmission lines as follows: A fluid, typically a physiological fluid or dialysate, is pumped from a fluid source 26 through a balancing system 27 into a dialysate line 33, optionally through a first sterile filter 28, to the dialyzer 30, and then from the dialyzer 30 in a drain line 34, optionally through the ventilation chamber 19, again through the balancing system 27, and to a drain 35 (not part of the medical device 1). The dialysate line 33 can, for example, optionally be provided with a branch line in the form of a second line section 3, optionally via a second sterile filter 29, which can lead via a priming or substitution port 5 to a priming or substitution line in the form of a second line section 2. This priming or substitution line 2 can be connected to an arterial blood line 22 or a venous blood line 23. A fluid, for example blood during treatment, or a priming or washing solution during the priming phase, can be pumped by a blood pump 31 in the blood lines 22, 23. The balancing system ensures that only a predetermined amount of fluid is removed from the patient. Various balancing systems are known; for example, the amount of fluid pumped to the patient and the amount pumped away from the patient can be determined by flow measurement, and a predetermined delta can be set to achieve the desired ultrafiltration rate, or net balance rate, as prescribed. Another balancing system is shown in Figures 7a and 7b. In these figures, the same volume is pumped to the patient as is pumped away from the patient, for example, by a volume balance system 26. An ultrafiltration pump 6' connected in parallel further pumps fluid away from the patient, thereby producing a net balance rate or ultrafiltration rate.
[0120] Furthermore, the medical device 1 can include a series of cutoff elements. For example, the device 1 can include a venous cutoff element 8′ (venous clamp), an arterial cutoff element 32 (arterial clamp), a pre-dialysis cutoff element 36, a post-dialysis cutoff element 37, a first drain line cutoff element 7′, and first and second priming line cutoff elements 7, 8.
[0121] The difference between the embodiment shown in Figure 7a and the embodiment shown in Figure 7b is that in the embodiment shown in Figure 7a, priming or substitution line 2 is connected to one end of arterial blood line 22 (typically the end connected to the patient during treatment), and only venous blood line 23 is connected to the end with drain port 4' (typically the patient end). In the embodiment shown in Figure 7b, priming or substitution line 2 is connected to a port located along venous blood line 23, and further, the end of arterial blood line 22, typically located on the patient side, is connected to drain or rinse port 4'. In another embodiment, the priming or substitution line is connected to a port located along the arterial blood line.
[0122] In particular, the following components or lines may be designed as disposable items: dialyzer 30, arterial blood line 22, venous blood line 23, or priming or substitution line 2. These lines may together form a tubing set or cassette system, meaning that at least two of these lines are detachably interconnected and / or the lines are at least partially formed by flexible tubing or otherwise dimensionally stable flow paths.
[0123] The medical device 1 can be configured to prime the tubing set or cassette system with physiological fluid, for example, prior to treatment. To this end, the controller 9 can be programmed, for example, in a fill mode, which may also be referred to as a priming mode, to transfer fluid from the fluid source 26 into the tubing set or cassette system via the priming or substitution port 4 by a pump of the balancing system 27. In another method step, for example, a flush mode, the tubing set or cassette system can be flushed after filling, with fluid being pumped through the tubing set or cassette system and into the drain line 34 via the drain port 4'. For treatment, the venous line 23 needs to be connected to the patient. For this purpose, for example, in the embodiment of FIG. 7a, the end of the venous line connected to the drain port 4' by the optional transition piece 5' is disconnected from the drain port 4'. However, before this disconnection, which can be performed manually or automatically, the controller 9 closes at least the first line section 2' connected to the drain port 4' and a portion of the venous line as the second line section 3', at least on the side of the venous line 23. The controller can, for example, activate the ultrafiltration pump 6', which can pump liquid so that a reduced pressure is generated. Due to the elastic properties of the first line section 2', at least a portion of the first line section 2' is deformed into a tensioned position. The first line section 2' can also be more elastic than the second line section 3'. The controller can then activate at least one blocking element 7', optionally multiple blocking elements, to maintain the system in this tensioned position. The first line section 2' can then be relaxed when the second line section 3' is disconnected from the drain port or rinse port 4', optionally manually or automatically.
[0124] At this point, it should be noted that the medical device 1 described in relation to Figures 7a and 7b may also comprise one or more of the following components having the functions described herein: a gas reservoir 19, a valve 20 that increases the elastic properties of the first line section 2', or a pressure sensor (not shown).
[0125] The medical device 1 can also be configured for a post-treatment disconnection step. To this end, the controller 9 can close the blocking element 8 and operate the pump 6. The pump 6 can be a peristaltic pump in the form of a substitution pump. Alternatively, the blood pump 31 can also be used to generate a vacuum in the line section 2 or to pump liquid from the line section. The blocking element 7 can be a check valve or part of the transition piece or the arterial tube 22, so that active closure of this blocking element is not necessary. In other configurations of the blocking element 7, the controller can be programmed to close the blocking element 7 after activation of the pump 6. Due to the elastic properties of the first line section 2, at least a portion of the first line section 2 is deformed into a tensioned position. The first line section 2' can also be more elastic than the second line section 3'. The first line section 2 can then be relaxed when the second line section 3' is disconnected from the priming port or substitution port 5, optionally manually or automatically.
[0126] 8a and 8b schematically illustrate the user interface 13. The user interface 13 may comprise a screen 38 and at least one button 39. The screen 38 may be a touchscreen, and the button 39 may be designed as a softkey, i.e., a button that is pressed on the touchscreen, as shown in FIG. 7a. The button 39 may also be designed as a hardkey, i.e., a button provided separately from the screen, as shown in FIG. 7b. The controller 9 may be configured to send commands to the user interface 13 via a data line or to receive such commands therefrom. For example, the user interface 13 may be programmed such that pressing the button 39 causes the controller to switch to or activate a cutting mode. The controller 9 can be programmed to execute the method sequence and, for example, send a message 40 for display on the user interface 13 when one or more or all of the following situations occur, or when the controller reaches this point in its program execution: the disconnect mode can be activated by the program sequence, the disconnect mode can be initiated, the connection can be broken when the method steps to be performed by the machine are completed, a disinfection process needs to be performed, for example because the controller has detected that a treatment is to be prepared or performed, or a sensor, for example a pin indicating the presence of a disposable, indicates to the controller that a disposable has been removed from the machine even though the method steps to be performed by the machine have not been completed.
[0127] When reference is made herein to an embodiment, it should be understood that this is a purely exemplary embodiment in accordance with the present invention.
[0128] An embodiment according to the invention may have one or more of the above-mentioned features in any combination, unless a particular embodiment is deemed technically impossible for a person skilled in the art.
Claims
1. 1. A medical device configured to receive at least two fluid-conducting line sections that are detachable from one another, the medical device comprising a first line section and a second line section, the first line section of the two fluid-conducting line sections having at least partially elastic properties; at least first and second blocking elements enclosing fluid volumes in the two line sections; a pump for generating reduced pressure in the two line sections, resulting in elastic deformation in and / or on the first line section from a start position to a tensioned position; a controller for operating the pump, the controller being programmed to operate the pump to generate the reduced pressure in a cutting mode; A medical device characterized by:
2. the controller is programmed to close one of the blocking elements to enclose the fluid volume on one side before generating the reduced pressure, and / or to close one of the blocking elements to enclose the fluid volume after generating the reduced pressure. The medical device of claim 1 .
3. the first line section or the second line section is part of a device-side fluid system of the medical device; 3. The medical device according to claim 1 or 2.
4. a fluid source for physiological fluid fluidly connected to the second line section; a sterile filter fluidly disposed between and connected to the fluid source and the second line section; a medical device connector on one end of the second line section for connection to one end of the first line section. The medical device of claim 3 .
5. a discharge line to which the first line section is fluidly connected or which is a part of the first line section; a medical device connector on one end of the first line section for connection to one end of the second line section. The medical device of claim 3 .
6. the pump is a peristaltic pump, and at least one actuator of the peristaltic pump is part of or is the first or second blocking element; A medical device according to any one of claims 1 to 5.
7. The pump is an ultrafiltration pump and / or a blood pump and / or a displacement pump of a dialysis machine, A medical device according to any one of claims 1 to 6.
8. a user interface for a user to input instructions; the controller is programmed to activate the cutting mode or start the pump in response to the command being entered on the user interface, and / or the controller is programmed to activate a plurality of modes and to automatically switch from one of the modes to the cutting mode. A medical device according to any one of claims 1 to 7.
9. a fluid volume contained in the first line section in the tensioned position is less than a fluid volume contained in the first line section in the start position; One of the two line sections is a tubing set or cassette system that is part of a disposable item and is used as part of a blood process, or both the first section and the second section are tubing sets or cassette systems that are part of one or more disposable items and are used as part of a blood process. A medical device according to any one of claims 1 to 8.
10. the first line section includes at least one region that is more elastic than the second line section; The medical device of claim 9.
11. the first line section and the second line section include at least one region that is more elastic than the remainder of the first line section and the second line section; 11. The medical device according to claim 9 or 10.
Citation Information
Patent Citations
Apparatus for carring out sludge
JP1978056853A
Embedded fluid management device for removing excess fluid
JP2010527247A
Connector for dialyzer
US20160243347A1