Background
The statements in this section merely provide background information related to the present disclosure and may not constitute prior art.
multiple-Organ Failure (MOF) is a clinical syndrome with a very high mortality rate. The incidence of MOFs is also increasing as the population ages and the surgical treatment modalities become increasingly complex. Artificial organ support is the ultimate therapeutic means for MOF to the uncontrollable stage of conventional drug therapy, and has become a key means for critical care and organ failure treatment in recent years.
The current artificial organ design mainly focuses on single organ support, such as designing an artificial kidney (Continuous Renal Replacement Therapy, CRRT) aiming at Renal failure; artificial Liver (ALS) was designed for hepatic failure; artificial lungs (Extracorporeal Membrane lung Oxygenation, ECMO) were designed for lung function failure; Intra-Aortic Balloon Pump (IABP) or artificial heart, etc. are designed for heart failure.
In the treatment of critically ill patients, more than two organs are frequently in failure, and multiple artificial organs are required to support simultaneously, such as CRRT + ECMO, CRRT + ALS, ECMO + ALS + CRRT, ECMO + IABP and the like. However, since the initial design concept and concept are not uniform, when a plurality of artificial organs are used in combination, the support efficiency is often reduced due to the following problems:
(1) Functional antagonism exists among different artificial organs, so that the best effect is limited;
(2) the artificial organ support needs anticoagulation, multiple anticoagulation standards and repeated anticoagulation, increases the risk of anticoagulation disorder, and is easy to cause hemorrhage and thromboembolism;
(3) each artificial organ needs to be connected with an artificial pipeline through an intubation tube and placed into the autologous blood vessel of a patient, and the multi-position intubation tube greatly increases the incidence of infection and intubation complication;
(4) each artificial organ needs power support to drive blood to flow, and a plurality of sets of driving systems operate simultaneously, so that the occurrence probability of mechanical failure is increased;
(5) multiple artificial organs use simultaneously, and is bulky, inconvenient use operation, and the patient can't get off the bed simultaneously and move about, influences the recovery effect.
It should be noted that the above background description is only for the convenience of clear and complete description of the technical solutions in the present specification and for the understanding of those skilled in the art. Such solutions are not considered to be known to the person skilled in the art merely because they have been set forth in the background section of the present specification.
SUMMERY OF THE UTILITY MODEL
In view of the defects of the prior art, an object of the present specification is to provide a multi-organ in vitro life support system, which integrates and optimizes the functions of multiple artificial organs, can realize power sharing, and improves the support efficiency.
To achieve the above object, embodiments of the present specification provide a multi-organ in vitro life support system, including:
a first conduit having a first inlet and a first outlet for connection to a person;
the artificial lung is positioned at the downstream of the pumping mechanism along the blood flow direction in the first pipeline;
a second conduit having a second inlet and a second outlet, the second inlet being in communication with the first conduit and being located between the pumping mechanism and the artificial lung, the second outlet being in communication with the first conduit and being located between the pumping mechanism and the first inlet;
a third artificial organ disposed on the second conduit.
In a preferred embodiment, the number of the second lines is one or more, and one third artificial organ is provided on each of the second lines.
In a preferred embodiment, the number of the second pipelines is two, wherein the third artificial organ provided on one of the second pipelines is an artificial kidney, and the third artificial organ provided on the other of the second pipelines is an artificial liver.
In a preferred embodiment, the flow rate of the artificial lung is greater than the flow rate of the third artificial organ.
In a preferred embodiment, a first flow control member is disposed on the first conduit between the second inlet and the artificial lung, and the first flow control member is configured to control a flow rate into the artificial lung; and a second flow control piece is arranged on the second pipeline and is positioned between the second inlet and the third artificial organ, and the second flow control piece is used for controlling the flow entering the third artificial organ.
In a preferred embodiment, a second flow control member is provided on one of the second conduits between the second inlet and the artificial kidney, the second flow control member being configured to control flow into the artificial kidney; a third flow control part is arranged between the second inlet and the artificial liver on the other second pipeline, and the third flow control part is used for controlling the flow entering the artificial liver; the first, second and third flow controls are configured to control a flow of the artificial lung to be greater than a flow of the artificial kidney and artificial liver.
In a preferred embodiment, the multi-organ in vitro life support system further includes a temperature control unit for adjusting the temperature of blood flowing through the system.
As a preferred embodiment, the temperature control part comprises a heat exchange assembly arranged inside the artificial lung, and the heat exchange assembly adjusts the temperature of a pipeline for blood to flow through a heat exchange mode; or the temperature control part comprises a temperature adjusting device arranged outside the artificial lung, and the temperature adjusting device is used for adjusting the temperature of the blood flowing in the system pipeline.
In a preferred embodiment, a fourth flow control element is disposed on the first tube downstream of the pumping mechanism, and the fourth flow control element is configured to control the flow rate and pressure of blood exiting the pumping mechanism.
In a preferred embodiment, the third artificial organ is connected to a waste liquid recovery container for discharging waste liquid; the third artificial organ is provided with a quick connection interface.
Has the advantages that: the multi-organ in-vitro life support system provided by the embodiment of the specification integrates and optimizes the functions of a plurality of artificial organs together, and can realize power sharing by arranging one pump mechanism, so that the support efficiency is improved.
Specifically, link to each other with the human body through first pipeline, set up the second pipeline on first pipeline to set up pump mechanism, artificial lung and third artificial organ, through optimizing the pipeline design, can make different artificial organs performance function separately, and can unify standard anticoagulation, avoid taking place functional antagonism and anticoagulation disorder. Meanwhile, the multi-organ in-vitro life support system reduces the volume, realizes portable mobile support and can promote postoperative recovery of patients. Only the first inlet and the first outlet are connected with the human body, so that the intubation path is reduced, the occurrence probability of complications such as hemorrhage, thromboembolism, infection and the like is reduced, and the therapeutic effect of each artificial organ is exerted to the maximum extent. In addition, the third artificial organ on the second pipeline can be selected as required, and the installation and the switching are convenient.
In addition, a third artificial organ may generate air bubbles during operation (air bubbles cause air embolism), and the artificial lung may remove the air bubbles. In the multi-organ in-vitro life support system provided by the embodiment, the artificial lung is directly connected with the first outlet, and the extracorporeal circulation blood finally returns to the human body after being defoamed by the artificial lung, so that the adverse effect caused by the bubbles can be avoided to the maximum extent.
Specific embodiments of the present specification are disclosed in detail with reference to the following description and the accompanying drawings, which specify the manner in which the principles of the specification may be employed. It should be understood that the embodiments of the present description are not so limited in scope.
Features that are described and/or illustrated with respect to one embodiment may be used in the same way or in a similar way in one or more other embodiments, in combination with or instead of the features of the other embodiments.
It should be emphasized that the term "comprises/comprising" when used herein, is taken to specify the presence of stated features, integers, steps or components but does not preclude the presence or addition of one or more other features, integers, steps or components.
Detailed Description
In order to make those skilled in the art better understand the technical solutions in the present specification, the technical solutions in the embodiments of the present specification will be clearly and completely described below with reference to the drawings in the embodiments of the present specification, and it is obvious that the described embodiments are only a part of the embodiments of the present specification, and not all of the embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the present specification without any creative effort shall fall within the protection scope of the present specification.
It will be understood that when an element is referred to as being "disposed on" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may be present. The terms "vertical," "horizontal," "left," "right," and the like as used herein are for illustrative purposes only and do not represent the only embodiments.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this specification belongs. The terminology used in the description of the specification herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the specification. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.
Please refer to fig. 1 and fig. 2. Embodiments of the present description provide a multi-organ in vitro life support system that may include afirst circuit 1, apump mechanism 2, anartificial lung 3, asecond circuit 4, and a third artificial organ.
Wherein thefirst pipe 1 has afirst inlet 101 and afirst outlet 102. As shown in fig. 2, thefirst inlet 101 and thefirst outlet 102 are adapted to be connected to thehuman body 100. Thepump mechanism 2 and theartificial lung 3 are provided on thefirst pipeline 1. Theartificial lung 3 is located downstream of the pumping means 2 in the blood flow direction in thefirst line 1. I.e. the pump delivery means 2 is arranged closer to thefirst inlet 101 and theartificial lung 3 is arranged closer to thefirst outlet 102. Thesecond pipe 4 has asecond inlet 401 and asecond outlet 402. Thesecond inlet 401 is communicated with thefirst pipeline 1 and is positioned between thepumping mechanism 2 and theartificial lung 3, and thesecond outlet 402 is communicated with thefirst pipeline 1 and is positioned between thepumping mechanism 2 and thefirst inlet 101. A third artificial organ is arranged on thesecond line 4.
The multi-organ in-vitro life support system provided by the embodiment of the specification integrates and optimizes the functions of a plurality of artificial organs together, and can realize power sharing by arranging onepump mechanism 2, so that the support efficiency is improved.
Specifically, link to each other with human 100 throughfirst pipeline 1, set upsecond pipeline 4 onfirst pipeline 1 to set uppump mechanism 2,artificial lung 3 and third artificial organ, through optimizing the pipeline design, can make different artificial organs performance function separately, and can unify standard anticoagulation, avoid taking place functional antagonism and anticoagulation disorder. Meanwhile, the multi-organ in-vitro life support system reduces the volume, realizes portable mobile support and can promote postoperative recovery of patients. Only thefirst inlet 101 and thefirst outlet 102 are connected with thehuman body 100, so that the intubation path is reduced, the occurrence probability of complications such as hemorrhage, thromboembolism and infection is reduced, and the therapeutic effect of each artificial organ is exerted to the maximum extent. In addition, the third artificial organ on thesecond pipeline 4 can be selected as required, and the installation and the switching are convenient.
In addition, a third artificial organ may generate air bubbles during operation (air bubbles cause air embolism), and theartificial lung 3 may remove the air bubbles. In the multi-organ in-vitro life support system provided by the embodiment, theartificial lung 3 is directly connected with thefirst outlet 102, and the extracorporeal blood finally returns to thehuman body 100 after being defoamed by theartificial lung 3, so that adverse effects caused by the bubbles can be avoided to the maximum extent.
In the present embodiment, only onepump mechanism 2 is provided, so that blood can be driven to flow in an extracorporeal circulation manner among a plurality of artificial organs, and damage to blood by the shearing force of thepump mechanism 2 is reduced. In addition, since only onepumping mechanism 2 is provided and the resistance is large when blood flows in the system line and each artificial organ, the pumping power requirement of thepumping mechanism 2 is high. Therefore, thepump mechanism 2 may be selected from, but not limited to, a blood pump or other pump with a large pump output power, which is not limited in this embodiment.
Specifically, the number of thesecond pipelines 4 may be one or more, and eachsecond pipeline 4 is provided with a third artificial organ. The third artificial organ can be provided with a quick-connection interface, so that different artificial organs can be conveniently replaced.
Preferably, the number of thesecond pipelines 4 is two, wherein the third artificial organ arranged on onesecond pipeline 4 is anartificial kidney 5, and the third artificial organ arranged on the othersecond pipeline 4 is anartificial liver 6.
In the present embodiment, the pump mechanism 2 (artificial heart), theartificial lung 3, theartificial kidney 5, and theartificial liver 6 may be any suitable conventional structure, but the present embodiment is not limited thereto.
When the third artificial organs such as theartificial kidney 5, theartificial liver 6 and the like are independently used in the prior art, the requirements of bubble removal, thrombus removal and heat preservation exist, and corresponding functional modules are required to be independently arranged to meet the requirements. In this embodiment, the outlet (i.e., the second outlet 402) of the third artificial organ, such as theartificial kidney 5 and theartificial liver 6, is designed on thefirst pipeline 1 and between thepump mechanism 2 and thefirst inlet 101, so that the blood passing through the third artificial organ flows into thepump mechanism 2 and then flows into theartificial lung 3, that is, theartificial lung 3 is located downstream of the third artificial organ. And theartificial lung 3 has the functions of removing bubbles, removing thrombus and preserving heat, so that corresponding functional modules do not need to be additionally arranged, and meanwhile, the artificial lung can share the driving module (the pump mechanism 2) so as to simplify the structure. The embodiment not only simplifies the structure and reduces the volume, but also has the functions of removing bubbles, removing thrombus and preserving heat under the condition of not additionally arranging a functional module, so that the third artificial organs such as theartificial kidney 5, theartificial liver 6 and the like, theartificial lung 3 and thepump output mechanism 2 have synergistic action.
In the present embodiment, the flow rate of theartificial lung 3 is larger than the flow rate of the third artificial organ, so that the actual blood flow rate of the human organ can be simulated. In particular, thefirst conduit 1 may be provided with a first flow control member 7 located between thesecond inlet 401 and theartificial lung 3. The first flow control member 7 is used to control the flow of blood into theartificial lung 3. In another embodiment, thesecond conduit 4 may be provided with a secondflow control member 8 between thesecond inlet 401 and a third artificial organ. The secondflow control member 8 is used to control the flow of blood into the third artificial organ.
In particular, one of thesecond lines 4 may be provided with a secondflow control member 8 positioned between thesecond inlet 401 and theartificial kidney 5 for controlling the flow of blood into theartificial kidney 5. The othersecond conduit 4 may be provided with a thirdflow control member 9 located between thesecond inlet 401 and theartificial liver 6 for controlling the flow of blood into theartificial liver 6. The first flow control 7, thesecond flow control 8 and thethird flow control 9 are configured to control the flow of theartificial lung 3 to be greater than the flow of theartificial kidney 5 and the flow of theartificial lung 3 to be greater than the flow of theartificial liver 6.
The blood flow rates of theartificial kidney 5 and theartificial liver 6 are preferably not more than 400 ml/min. Preferably, the first flow control member 7, the secondflow control member 8 and the thirdflow control member 9 are configured to control the flow ratio of theartificial lung 3, theartificial kidney 5 and theartificial liver 6 to be 4: 1: 1.
the secondflow control member 8 and the thirdflow control member 9 also have the function of controlling the on-off of thesecond pipeline 4 where the second flow control member is positioned, so that part or all of the third artificial organ can be selectively used. In a specific application scenario, if the patient has only renal failure, the secondflow control element 8 is kept open, the thirdflow control element 9 is closed, so that theartificial kidney 5 works, and theartificial liver 6 does not work; if the patient only suffers from liver failure, the secondflow control part 8 is kept closed, the thirdflow control part 9 is opened, so that theartificial kidney 5 does not work, and theartificial liver 6 works; if the patient is suffering from simultaneous failure of renal and hepatic functions, the secondflow control member 8 and the thirdflow control member 9 are kept open simultaneously, so that both theartificial kidney 5 and theartificial liver 6 are operated.
In this embodiment, thefirst line 1 may be provided with a fourthflow control member 11 downstream of the pumping means 2 for controlling the flow and pressure of the blood exiting the pumping means 2. The flow rate into thepumping mechanism 2 can be adjusted by adjusting the rotational speed of thepumping mechanism 2. The third artificial organ generally has a larger resistance, and after blood flows through the third artificial organ, the pressure is reduced, and the fourthflow control element 11 is arranged at the outlet of thepump mechanism 2 to control the blood flow so as to improve the blood pressure and meet the requirement of thehuman body 100. The fourthflow control element 11 may be a pressure control element, and may be configured to adjust the blood pressure.
In the present embodiment, the types of the first flow rate controller 7, the secondflow rate controller 8, the thirdflow rate controller 9, and the fourthflow rate controller 11 are not particularly limited, and the same or different elements may be used to realize the flow rate control function. For example, the four flow control members may be selected from flow valves, and the blood flow control is realized by controlling the opening degree of the flow valves.
In order to make the temperature of the blood closer to the temperature of the human body during the extracorporeal circulation, the multi-organ extracorporeal life support system of the present embodiment further includes a temperature control portion for performing temperature regulation on the blood flowing in the system. The temperature control part can comprise a temperature measuring module, a heating module and a control module. When the temperature measuring module measures that the temperature of the blood flowing in the system is lower than a target value, the control module controls the heating module to work until the temperature of the blood rises to the target value. The temperature control part can also comprise a temperature reduction module, and when the temperature measurement module measures that the temperature of the blood flowing in the system is higher than a target value, the control module controls the temperature reduction module to work until the temperature of the blood is reduced to the target value.
In an alternative embodiment, the temperature control part may include a heat exchange assembly integrated inside theartificial lung 3, and the heat exchange assembly adjusts the temperature of the blood flow tube by means of heat exchange. Specifically, heat exchange assembly can include the heat exchange tube, with theartificial lung 3 in be used for supplying the pipeline winding setting that blood flows, circulation heat transfer medium (for example hot water) in the heat exchange tube to give blood with heat transfer through the heat exchange, realize keeping warm and temperature regulation.
In another alternative embodiment, the temperature control part further comprises a temperature control device arranged outside theartificial lung 3 for temperature control of the blood flowing in the system line. Under the guidance of this embodiment, as shown in fig. 1 and 2, a possible solution of the temperature adjusting device is provided on thefirst pipeline 1, the temperature adjusting device may include atemperature adjusting body 10 provided on thefirst pipeline 1 and a temperature adjusting channel provided on thetemperature adjusting body 10 and communicated with thefirst pipeline 1, and a heating module and a cooling module may be provided in thetemperature adjusting body 10, wherein the heating module may be an electric heating module. Thetemperature adjusting body 10 is set to be close to or slightly higher than the normal temperature of the human body, and the blood is adjusted to the target temperature after flowing out of the temperature adjusting channel when flowing into the temperature adjusting channel of the temperature adjusting device from thefirst pipeline 1. This way a contact tempering of the blood can be achieved.
Alternatively, under the guidance of this embodiment, another feasible way of the temperature regulation device is to include a heating or heat preservation chamber, for example, the temperature regulation device is integrally a water bath incubator, and at least the pipelines in the multi-organ in vitro life support system, such as thefirst pipeline 1, thesecond pipeline 4, etc., can be placed in the temperature regulation device; or the multi-organ in-vitro life support system is integrally placed in the temperature regulating device. The mode is also to realize the heating or heat preservation of the blood by a heat exchange mode, and the mode can realize the non-contact temperature regulation of the blood.
In the above embodiment in which the temperature control unit is provided outside theartificial lung 3, the temperature of the blood is adjusted before the blood enters theartificial lung 3, that is, the temperature of the blood before the blood enters theartificial lung 3 is high and close to the temperature of the human body. In this way, the efficiency of oxygenation and degassing (carbon dioxide) of theartificial lung 3 to blood can be greatly improved.
In one embodiment, the temperature control device is a water bath, which allows thefirst line 1 to be immersed in a temperature-controlled liquid, thereby indirectly controlling the temperature of the blood in thefirst line 1. In another embodiment, the temperature regulating means may comprise a temperature regulating material wrapped around thefirst line 1, thereby regulating the temperature of the blood in thefirst line 1. In other embodiments, a temperature regulating device may be provided at the outlet of the pumping means 2, connected in series to thefirst line 1, to regulate the temperature of the blood in thefirst line 1.
In this embodiment, a wasteliquid recovery vessel 12 may be connected to the third artificial organ for discharging waste liquid. A bubble monitoring device may be provided on thefirst conduit 1 between theartificial lung 3 and thefirst outlet 102 to control thepumping mechanism 2 to stop and keep the system in an alarm state once bubbles are detected.
The multi-organ in-vitro life support system provided by the embodiment of the specification focuses on the common problem in the multi-organ cooperative treatment, establishes an integrated power platform, and embodies the design concept of individual and intelligent combined use of multiple organs according to needs.
It should be noted that, in the description of the present specification, the terms "first", "second", and the like are used for descriptive purposes only and for distinguishing similar objects, and no order is present therebetween, and no indication or suggestion of relative importance is to be made. Further, in the description of the present specification, "a plurality" means two or more unless otherwise specified.
It is to be understood that the above description is intended to be illustrative, and not restrictive. Many embodiments and many applications other than the examples provided will be apparent to those of skill in the art upon reading the above description. The scope of the present teachings should, therefore, be determined not with reference to the above description, but should instead be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. The disclosures of all articles and references, including patent applications and publications, are hereby incorporated by reference for all purposes. The omission in the foregoing claims of any aspect of the subject matter that is disclosed herein is not intended to forego such subject matter, nor should the inventors be construed as having contemplated such subject matter as being part of the disclosed inventive subject matter.