United States Patent [191 Brumfield Oct. 30, 1973 FILTERING CARDIOTOMY RESERVOIR [76] Inventor: Robert C. Brumfield, 73 Emerald Bay, Laguna Beach, Calif. 92657 [22] Filed: Mar. 21, 1972 211 App]. No.: 222,124
[56] References Cited UNITED STATES PATENTS 2,833,279 5/1958 Gollan 23/258.5
Primary ExaminerFrank A. Spear, Jr. Attorney-J. L. Jones [57] ABSTRACT A surgical blood sucker and peristaltic pump combination discharge a three-phase mixed stream of blood, air and surgical tissue debris into a cardiotomy reservoir through a slot shape blood inlet nozzle tangentially disposed on the wall of the blood reservoir volume. The tissue debris is collected internally in the reservoir on the reservoir base filter face and the face of the conical air filter. The air, under slight pressure in the reservoir, exits from the reservoir through the air filter and a relief valve. The defoamed blood flo'ws from the reservoir through multiple base filter plate exit apertures, into a blood oxygenator.
1 FILTERING CARDIOTOMY RESERVOIR CROSS-REFERENCES TO RELATED APPLICATION This application is related to the following applications filed earlier by the same sole inventor:
US. Pat. application, Ser. No. l75,l82 for BLOOD OXYGENATOR AND THERMOREGULATOR AP- PARATUS by Robert C. Brumfield, filed Aug. 26, I971;
US. Pat. application, Ser. No. l96,458, for BLOOD OXYGENATOR GLOW GUIDE, by Robert C. Brumfield, filed Nov. II, 1971;
US. Pat. application Ser. No. 202779 FOR BLOOD OXYGENATOR, by Robert C. Brumfield, filed Nov. 29, 1971; and
US. Pat application Ser. No. 216,649 for LOW PRESSURE HEAT EXCHANGER FOR OXYGEN- ATED BLOOD, by Robert C. Brumfield, filed .Ian. 10, 1972.
BACKGROUND OF THE INVENTION Blood oxygenators useful for oxygenating patients blood during extra-corporeal circulation are classified inClass 23 Subclass 258.3. The cardiotomy reservoir of this invention is taught to be useful in combination with a blood oxygenator, and the invention is so classitied.
Often there is a substantial loss of patient blood during surgical treatment, and surgical blood suckers are useful for processing and returning blood to the patients extra-corporeal circulation. Since the recovered blood can contain surgical tissue debris, the blood can respond to the debris by initiating the clotting mechanism. It is desirable to remove the debris from the recovered blood as quickly as possible prior to returning this blood to the patient. The cardiotomy reservoir of this invention quickly and cleanly processes patient blood, filtering the surgical debris and simultaneously defoaming the blood for rapid return to the patients circulation.
SUMMARY OF THE INVENTION A cardiotomy reservoir for recovering patients blood in a surgical procedure has a uniform tubular case having a base plate and a top plate, together providing an enclosed reservoir volume. A blood inlet conduit is secured in the reservoir providing a slot aperture discharge nozzle directing a flat blood inlet stream flow tangentially onto the inside tubular wall of the reservoir. The small centrifugal force of the blood stream flow tends to deposit the surgical tissue debris on the tubular wall. A reservoir base filter is coextensive with the base plate and has a porosity suitable for filtering whole blood, yet retaining surgical tissue debris on the base filter inside the receptacle. A retaining ring means coplanarly secures the reservoir base filter to the reservoir base plate. An air filter is concentrically coextensive with the tubular case, from the top plate of the reservoir to the base filter, the air filter having a porosity suitable for filtering air, yet blocking blood flow through it. An air exit conduit is normally centrally disposed from the reservoir top plate, discharging filtered air from the reservoir. A plurality of blood exit apertures conductively disposed through the base plate provide for flow of filtered blood from the cardiotomy reservoir. The reservoir base filter and the air filter are both treated with a very thin film of a defoaming composition which is physiologically compatible with patient blood, thereby facilitating the defoaming of the blood, air and surgical tissue debris as it is pumped into the cardiotomy reservoir. A slight internal reservoir positive pressure ranging up to lOO mm Hg maintains a positive flow of blood out of the cardiotomy reservoir through the base plate blood exit apertures. The positive pressure is maintained inside the cardiotomy reservoir by a low pressure release valve secured to the air exit conduit. The air filter can be truncated cone shaped porous filter having a cone apex centrally disposed adjacent the reservoir base filter and a cone base disposed adjacent the top plate of the reservoir. The reservoir base filter and the air filter can be porous reticulated polyurethane foam or a porous silicone foam of selected porosity. The air filter is typically a foam having 10. pores per lineal inch. The reservoir base filter typically passes particle sized to microns.
Other objects and advantages of this invention are taught in the following description and claims.
BRIEF DESCRIPTION OF THE DRAWINGS A description of this invention is to be read in conjunction with the following drawings:
FIG. 1 is an elevational perspective partial sectional view of the cardiotomy reservoir of this invention, disposed in a blood oxygenator.
FIG. 2 is a sectional view through 2-2 of FIG. 1.
FIG. 3 is a sectional view disclosing a further modification of this invention similar to the view of FIG. 2.
FIG. 4 is another sectional view through 44 of FIG. 1.
FIG. 5 is a detailed perspective fragmentary view illustrating thebase plate 13 of FIG. 1.
DESCRIPTION OF THE PREFERRED EMBODIMENT A surgical blood sucker and a peristaltic pump combination are used to suck up blood lost in a surgical procedure or the like. The sucker and pump combination discharge a three-phase mixture of blood, air and surgical tissue debris into the cardiotomy reservoir.
Referring to FIG. 1 in detail, thecardiotomy reservoir 10 of this invention is shown disposed in the top portion of the blood oxygenator 11. Thecardiotomy reservoir 10 has a uniform receptacletubular case 12 closed by abase plate 13 and atop plate 14, providing an enclosedreservoir volume 15. Ablood inlet conduit 16 is normally secured through thetop plate 14, and has a blood inletconduit discharge nozzle 34, whoseslot discharge aperture 17 is permanently positioned, directing a flat blood inlet stream flow tangential to theinner wall 18 of thecase 12. Areservoir base filter 19 is coextensive with thebase plate 13, thefilter 19 providing a porosity suitable for filtering whole blood. Typically thefilter 19 has pore openings sized to pass 100 micron size particles, and retain surgical tissue debris inside thereservoir volume 15 on thebase filter 19. Aretaining ring 20 secures thefilter 19 on thebase plate 13. Thering 20 is sealed to thetubular case ring 30, which is in turn sealed to thebase plate 13. Thetubular case 12 is sealed to thering 30 and thetop plate 14, providing an integral structure.
Anair filter 21 is shown concentrically conextensively disposed in thereservoir 10, coextending from thetop plate 14 to thebase filter 19. Thetruncated cone 21 has a truncatedapex 22 and acone base 23. Theair filter 21 is a plastic sponge having a porosity suitable for filtering air yet blocking blood flow. Anair exit conduit 24 is normally centrally disposed through thetop plate 14 providing an exit conduit discharging filtered air from thereservoir volume 15. Typically, theconduit 24 is sealed to thetop plate 14. Apressure relief valve 25 is shown conductively disposed on theconduit 24, the relief valve being set to relieve at a pressure approximately 100 mm Hg above atmospheric pressure. A plurality ofblood exit apertures 26 are conductively disposed through thebase plate 13, providing for the flow of filtered blood from thecardiotomy reservoir 10. The filter components, theair filter 21 and thereservoir base filter 19 are both coated by well known procedures with physiological compatible compositions which accelerate blood defoaming on contact with the film coating. Typically, a silicone composition is well known and used for this purpose. Plural base filter leaf supports 27 are shown coplanarly integrally secured to thebase plate 13, providing blood exit flow relieving passage means for the blood filtered through thefilter 19.
The reservoir is shown disposed in the top of an oxygenator 11, of the previously cited inventions of this inventor. The blood inlet conduit 16' and theair outlet conduit 24 are sealed through theoxygenator top 35 by the conventional O-ring seal combinations 36 and 37. The oxygen gas exit conduit 38 releases thegas stream 33 from the oxygenator 11.
FIG. 2 illustrates in detail through the cross sectional view through 22 of FIG. 1, that thenozzle 34 having aslot discharge aperture 17 of theblood inlet conduit 16 is tangentially disposed to theinternal wall 18 of the reservoir volume formed by thewall 12. Thus,blood mixture 31 pumped into thecardiotomy reservoir 10 through thenarrow slot aperture 17 is spread in a flat blood inlet stream flow tangentially over thewall 18 tending to distribute the surgical tissue debris pumped into the cardiotomy reservoir over a large wall area. The debris is retained on thereservoir base filter 19 and on theair filter 21, as the foamedblood 28 is defoamed on contact with the twofilters 19 and 21. Thecurved nozzle 34 represents another wall curvature conforming tangential nozzle.
In surgical procedures thecardiotomy reservoir 10 operates at pressures above atmospheric, resulting from the pump pressurized discharge of blood, air and surgical tissue debris into thereservoir 10. Therelief valve 25 allows escape of theair stream 32 at the set relief pressure of thevalve 25, which can typically be 100 mm Hg.
A further modification of the blood inlet nozzle is shown in FIG. 3, in a cross sectional view similar to 2--2 of FIG. 1. Thecardiotomy reservoir 10" is disposed in a blood oxygenator 11. In thereservoir modification 10, theblood inlet conduit 16 has anozzle 34" integrally tangentially disposed on the exterior wall of thetubular case 12", providing aslot aperture 17" disposed in thecase 12". Thebase 23 of theair filter 21 is shown disposed, as in FIG. 2.
Referring to FIG. 4 in detail, thebase plate 13 is shown in two modifications separated by adiametrical line 41. The plurality ofblood exit apertures 26 are shown conductively disposed through thebase plate 13 providing for the flow of filtered blood from the cardiotomy reservoir under slight pressure. The plural base filter leaf supports 27 are shown coplanarly integrally secured on theplate 13, providing recesses between the leaf supports 27 for the channel flow of filtered blood from the superimposedreservoir base filter 19. On the other half of thefilter plate 13 separated by thediametrical line 41 is shown a plurality of blood exit apertures 26' which also are conductively disposed through the base plate 13'. Acircular recess channel 42 formed in the base plate 13' has a plurality of bloodexit recess channels 40 leading from thecircular recess channel 42 to the blood exit apertures 26'. Thus in principle, thebase plate 13 and the modified base plate 13' can have the blood flow relieving passage means 27, or the means comprising 42 plus 40 disposed in thefilter plate 13. Each blood flow relieving passage means 27, or the like, provides for the flow of blood from the cardiotomy reservoir typically into the defoaming chamber, or the like, of a blood oxygenator.
Typically, thecardiotomy reservoir 10 disposed in the blood oxygenator 11, as shown in FIG. 1, is mounted on the top of atubular array 43 in the recessedaperture 44 providing for the support of thereservoir 10. Thetubular array 43, including its various modifications, are disclosed in the above crossreferenced patent applications of this inventor.
This invention provides a cardiotomy reservoir which quickly processes a three-phase mixture of blood, air and surgical tissue debris providing rapid removal of tissue debris from the blood, together with prompt defoaming of the blood, thus allowing the treated blood to be returned to a patients extra-corporeal circulation. By the prompt treatment and return of the blood to circulation, the potential for initiating blood clotting is reduced, hence the post operative prognosis is en hanced.
Many modifications and variations in the improvement in a cardiotomy reservoir can be made in the light of my teaching. It is therefore understood that within the scope of the appended claims, this invention may be practiced otherwise than as specifically described.
I claim:
1. A cardiotomy reservoir for recovering patient blood in a surgical procedure, comprising in combination: I I
a uniform tubular case having a base plate and a top plate, providing an enclosed reservoir volume;
a blood inlet conduit secured through the reservoir wall adjacent the said top plate, said conduit having a nozzle having an oriented slot discharge aperture providing a flat blood inlet stream flow tangentially on the inner tubular wall of said case;
a reservoir base filter coextensive with said base plate, said filter having a porosity suitable for filtering whole blood, said filter retaining surgical tissue debris inside said receptacle on the filter face;
a retaining ring means coplanarly securing said reservoir base filter to said base plate;
an air filter concentrically coextending in said tubular receptacle from said top plate to said base filter, said air filter having a porosity suitable for filtering air and blocking blood flow;
an air exit conduit normally centrally disposed through said top plate, said exit conduit discharging filtered air from said reservoir;
a plurality of blood exit apertures conductively disposed through said base plate, providing for the flow of filtered blood from said cardiotomy reservoir; and,
all aforesaid components physiologically compatible with patient blood.
2. The combination ofclaim 1 wherein the blood inlet conduit comprises:
a blood inlet conduit normally secured through said top plate adjacent the top plate perimeter and the receptacle wall, said conduit having a nozzle having an oriented slot discharge aperture providing a fiat inlet stream flow tangentially on the inner tubular wall of said receptacle.
3. The combination ofclaim 1 wherein the base plate comprises:
a plurality of blood flow relieving passage means disposed in the face of base plate adjacent said reservoir base filter.
4. The combination ofclaim 1 wherein said reservoir base filter comprises:
a porous reticulated polyurethane foam having a porosity passing blood elements ranging up to 100 microns diameter, said foam coated with a film composition collapsing blood-air foam.
5. The combination ofclaim 1 wherein said reservoir base filter comprises:
a porous silicone foam having a porosity ranging up to 100 micron diameter, said silicone foam collapsing blood-air foam.
6. The combination ofclaim 1 wherein said reservoir air outlet conduit has a pressure relief valve secured thereon, said valve relieving at a pressure not exceeding 100 mm Hg above atmospheric.
7. The combination ofClaim 1 wherein said air filter comprises:
a truncated cone shape porous filter having a truncated cone apex centrally disposed adjacent said reservoir base filter and a cone base disposed adjacent said top plate.
8. The combination ofclaim 7 wherein said truncated cone shape porous filter comprises:
a porous reticulated polyurethane foam having a porosity ranging up from 10 pores per lineal inch, said foam coated with an air-blood foam collapsing composition.
9. The combination ofclaim 7 wherein said truncated cone shape porous filter comprises:
a porous silicone foam structure having a porosity ranging up from 10 pores per lineal inch.
10. In a cardiotomy reservoir whose internal reservoir volume is enclosed by a reservoir case having a case top and case base, the combination comprising:
a blood inlet conduit secured through the reservoir wall adjacent said case top, said conduit having a nozzle having an oriented discharge aperture providing a blood inlet stream flow tangentially on the inner wall of said case;
a reservoir base filter coextensive with said case base, said filter having a porosity suitable for filtering whole blood, said filter retaining surgical tissue debris inside said case on the filter face;
a means coplanarly securing said reservoir base filter to said case base;
an air filter concentrically coextending in said reservoir case from said case top to said base filter, said air filter having a porosity suitable for filtering air and blocking blood flow;
an air exit conduit normally centrally disposed through said case top, said exit conduit discharging filtered air from said reservoir volume;
a plurality of blood exit apertures conductively disposed through said case base, providing for the flow of filtered blood from said cardiotomy reservoir;
and,
all aforesaid components physiologically compatible with patient blood.
11. The combination ofclaim 10 wherein the nozzle of the blood inlet conduit has a slot aperture providing a flat oriented blood inlet flow tangentially on the inner wall of said case.
12. The combination ofclaim 10 wherein the blood inlet conduit comprises: I
a blood inlet conduit normally secured through said case top adjacent the case top perimeter and the case wall, said conduit having a nozzle having an oriented slot discharge aperture providing a flat inlet stream flow tangentially on the inner tubular wall of said receptacle.
13. The combination ofclaim 10 wherein the case base comprises:
a plurality of blood flow relieving passage means disposed in the face of case base adjacent said reservoir base filter.
14. The combination ofclaim 10 wherein said reservoir base filter comprises:
a porous reticulated polyurethane foam having a porosity passing blood elements ranging up to microns diameter, said foam coated with a film composition collapsing blood-air foam.
15. The combination ofclaim 10 wherein said reservoir base filter comprises:
a porous silicone foam having a porosity ranging up to 100 micron diameter, said silicone foam collapsing blood-air foam.
16. The combination ofclaim 10 wherein said reservoir air outlet conduit has a pressure relief valve secured thereon, said valve relieving at a pressure not exceeding 100 mm Hg above atmospheric.
17. The combination ofclaim 10 wherein saidair filter comprises:
a truncated cone shape porous filter having a truncated cone apex centrally disposed adjacent said reservoir base filter and a cone base disposed adjacent said top plate.
18. The combination ofclaim 17 wherein said truncated cone shape porous filter comprises:
a porous reticulated polyurethane foam having a porosity ranging up from 10 pores per lineal inch, said foam coated with an air-blood foam collapsing composition.
19. The combination ofclaim 17 wherein said truncated cone shape porous filter comprises:
a porous silicone foam structure having a porosity ranging up from 10 pores per lineal inch.