JP7725856B2 - Body cavity fluid collection device - Google Patents

Description

The present invention relates to a body cavity fluid collection device used to collect body cavity fluid that has accumulated in the abdominal or pleural cavity from a patient.

In patients with liver cirrhosis and peritonitis carcinomatosis, fluid can leak from blood vessels, causing ascites to accumulate in the abdominal cavity. If a large amount of ascites accumulates, it can put pressure on the surrounding organs, leading to problems such as loss of appetite, decreased kidney function, and difficulty breathing. Ascites also contains plasma components that have leaked from the blood, including useful proteins such as albumin and globulin.

In recent years, a treatment called CART (Cell-free and Concentrated Ascites Reinfusion Therapy) has been proposed, in which ascites fluid removed from a patient is filtered and concentrated, and the useful components are returned to the patient (see, for example, Patent Document 1). More specifically, in CART, ascites fluid removed from a patient is stored in a storage bag, and this storage bag is connected to a CART circuit that includes a filter and concentrator. As the ascites fluid in the storage bag passes through the filter and concentrator, bacteria, cancer cells, and the like are removed, and useful components such as albumin are concentrated. The treated ascites is then returned to the patient via intravenous drip or other means.

Japanese Patent Application Laid-Open No. 2019-134984

When initially collecting body cavity fluids such as ascites from a patient in CART, a collection bag is connected to the outer end of the catheter extending from the patient's body cavity to the outside of the body via a body cavity fluid collection device consisting of a tube and a drip tube. This collection bag is then positioned vertically below the patient, allowing the patient's body cavity fluid to be collected into the collection bag by gravity. When administering infusions to the patient, the timing for completion of the procedure can be determined by visually checking the amount of fluid in the electrolyte bag. However, when collecting body cavity fluids, the remaining amount of fluid within the body cannot be visually confirmed. Therefore, the timing for completion of collection must be determined by observing the rate at which the body cavity fluid drips from the drip tube.

However, if the patient changes position or the storage bag position changes during collection of body cavity fluid, there is a risk that the drip tube will fill with body cavity fluid. For example, unlike known transfusion circuits, when collecting body cavity fluid, the collection storage bag is placed below the patient lying on the bed. Then, to check the amount of body cavity fluid being collected or to replace it with a new bag, the storage bag must be lifted. This poses a unique problem: movement of parts of the circuit other than the drip tube can cause the fluid level to rise, filling the drip tube with body cavity fluid. This makes it impossible to check the drip status of the body cavity fluid, and it becomes difficult to determine when collection is complete.

The purpose of this disclosure is to solve the above-mentioned problems specific to body cavity fluid collection devices.

The body cavity fluid collection device according to the present disclosure is a body cavity fluid collection device for collecting body cavity fluid from a patient's abdominal or thoracic cavity, and includes a collection tube whose upstream end is connected to a catheter extending from the patient, and a drip tube having an inlet to which the downstream end of the collection tube is connected, a storage space for temporarily storing body cavity fluid that has flowed in from the inlet, and a delivery outlet for discharging the body cavity fluid stored in the storage space, with the collection tube or the drip tube being provided with an air inlet for introducing air into the storage space.

As a result, even if the amount of body cavity fluid in the drip tube increases, the amount of body cavity fluid in the drip tube can be reduced by introducing air into the storage space through the air inlet, making it easy to restore the fluid level in the drip tube and adjust the position of the fluid level.

In addition, an air inlet tube through which air passes may be connected to the air inlet port, and the air inlet tube may be provided with an opening/closing device or a hydrophobic filter that limits the flow of body cavity fluid.

This allows air to be introduced into the drip tube while preventing leakage of body cavity fluid from the body cavity fluid collection device.

The air introduction tube may also be provided with a connector for connecting to a syringe or pump.

This allows a syringe or pump to be easily connected to the body cavity fluid collection device, which can then be used to introduce air into the drip tube.

The body cavity fluid collection device disclosed herein allows for the fluid level in the drip tube to be easily restored and adjusted even if the drip tube is filled with body cavity fluid and the fluid level is lost by checking the content of the reservoir bag below the patient or replacing the bag during collection of body fluid.

FIG. 1 is a schematic diagram of a CART circuit for processing body cavity fluid collected by a body cavity fluid collecting device according to the first embodiment. FIG. 2 is a diagram showing a schematic diagram of the collection process. FIG. 3 is a diagram showing a body cavity fluid collection device. 4 is an enlarged cross-sectional view of a portion of the body cavity fluid sampling device of FIG. 3. FIG. FIG. 5 is a diagram showing the configuration of a body cavity fluid collecting device according to the second embodiment.

(Embodiment 1)
First, a CART circuit will be described as an example of a body cavity fluid processing circuit that processes body cavity fluid collected using a body cavity fluid collecting device according to the present invention.

[CART circuit]
FIG. 1 is a schematic diagram of a CART circuit for treating ascites, which is body cavity fluid collected by a body cavity fluid collection device according to an embodiment of the present disclosure. As shown in FIG. 1 , this CART circuit 10 includes a flexible tubing line through which ascites flows, extending from a body cavity fluid storage bag 1, a filter 2, a concentrator 3, and a collection bag 4. Specifically, a line L1 through which ascites flows extends from the body cavity fluid storage bag 1, which is suspended from a hanging bracket F attached to the top of a stand or the like, to the bottom of the filter 2, via a first pump P1. A line extending from a bag 5 containing physiological saline solution joins this line L1, between the body cavity fluid storage bag 1 and the first pump P1. A line extending from a pressure gauge 6, which measures the pressure of the ascites flowing through line L1, joins this line L1, between the first pump P1 and the filter 2.

Line L2, through which ascites fluid from which foreign matter has been removed by filter 2 flows, extends from the side of filter 2 via second pump P2 to the bottom of concentrator 3. Line L3, through which ascites fluid that has been dehydrated and concentrated by concentrator 3 flows, extends from the top of concentrator 3 to the inlet port of collection bag 4. Line L4, which circulates the concentrated ascites fluid to further concentrate it, extends from the outlet port of collection bag 4, and merges with line L2 between filter 2 and second pump P2.

Meanwhile, a line L5 extends from the top of the filter 2 for appropriately discharging foreign matter removed from the ascites by the filter 2. Furthermore, a line L6 extends from the side of the concentrator 3 for appropriately discharging water removed from the ascites by the concentrator 3.

In the case of this CART circuit 10, ascites collected from a patient and stored in a body cavity fluid storage bag 1 has unnecessary components removed by a filter 2 and is concentrated to an appropriate concentration by a concentrator 3, becoming filtered and concentrated ascites, which is then collected in a collection bag 4. The filtered and concentrated ascites produced in this way is returned to the patient via intravenous drip injection.

[Body cavity fluid collection device]
Next, a body cavity fluid collection device for collecting body cavity fluid from a patient to be treated in the CART circuit 10 as described above will be described. Figure 2 is a diagram schematically illustrating the collection process. As shown in Figure 2, the body cavity fluid collection device 30 has a collection tube 31, a drip tube 32, an air introduction tube 33, and a delivery tube 34. This body cavity fluid collection device 30 is interposed between the patient 20 and the reservoir bag 1, and guides body cavity fluid in the abdominal cavity or thoracic cavity of the patient 20 into the reservoir bag 1.

More specifically, one end 21a of the catheter 21 is placed in the patient's abdominal or thoracic cavity. The upstream end 31a of the collection tube 31 is connected to the other end 21b of the catheter 21 via a connector 40. The downstream end 31b of the collection tube 31 is connected to a drip tube 32, which is also connected to the upstream end 34a of a delivery tube 34. Furthermore, the downstream end 34b of the delivery tube 34 is connected to the inlet tube 12 of the storage bag 1 via a connector 41. As a result, the patient's body cavity fluid is guided into the storage bag 1 via the catheter 21 and the body cavity fluid collection device 30. The catheter 21 may be a plastic or metal needle.

The storage bag 1 comprises a transparent and flexible bag body 11, as well as an inlet tube 12, an injection tube 13, and an outlet tube 14 that connect the inside and outside of the bag body 11. The inlet tube 12 is a port that guides body cavity fluid into the bag body 11 when the fluid is collected. The injection tube 13 is a port that injects a medicinal solution into the body cavity fluid collected in the bag body 11. The outlet tube 14 is a port that draws the body cavity fluid out of the bag body 11 during CART treatment.

Next, the body cavity fluid collection device 30 will be described in more detail. Figure 3 is a diagram showing the body cavity fluid collection device 30, and Figure 4 is an enlarged cross-sectional view of a portion of the body cavity fluid collection device 30 in Figure 3. As shown in Figure 3, the collection tube 31 is a long tube made of a transparent and flexible synthetic resin. A connector 40 is attached to the upstream end 31a of the collection tube 31, allowing connection to the end 21b of the catheter 21. A roller clamp 42 is attached midway along the collection tube 31 as a flow rate regulator for the body cavity fluid. Note that clamps other than the roller clamp 42 may also be attached as flow rate regulators.

The drip tube 32 is roughly cylindrical and includes a cylindrical body 50, an upstream cap 51 that closes one end of the cylindrical body 50, and a downstream cap 52 that closes the other end of the cylindrical body 50. Of these, the cylindrical body 50 is made of a transparent, relatively hard synthetic resin and is cylindrical in shape.

As shown in Figure 4, the upstream cap 51 is roughly cylindrical, and is provided with a first connection part 60 and a second connection part 61 at one end in the axial direction (upstream in the direction of collection of body cavity fluid). The collection tube 31 is connected to the first connection part 60. Therefore, the first connection part 60 is cylindrical with an inner diameter roughly the same as the outer diameter of the collection tube 31. The opening of the first connection part 60 forms an inlet 62 to which the downstream end 31b of the collection tube 31 is connected. The open end of the inlet 62 facing the cylindrical body 50 forms an opening surface 62a that is inclined relative to the axial direction of the inlet 62.

The air inlet tube 33 is connected to the second connection part 61. To this end, the second connection part 61 is cylindrical with an inner diameter approximately the same as the outer diameter of the air inlet tube 33. The opening of the second connection part 61 forms an air inlet port 63 to which the downstream end 33b of the air inlet tube 33 is connected. The open end of the air inlet port 63 on the cylindrical body 50 side forms an opening surface 63a that is approximately perpendicular to the axial direction of the air inlet port 63.

The other axial end of the upstream cap 51 forms an external fitting portion 65 that fits onto one end of the cylindrical body 50. In other words, the inner diameter of the external fitting portion 65 is approximately the same as the outer diameter of one end of the cylindrical body 50, and the two are connected by fitting onto one end of the cylindrical body 50.

The downstream cap 52, which closes the other end of the cylindrical body 50, is a cone-shaped cylinder with a smaller diameter at one end than at the other end. One end of the downstream cap 52 forms an outer fitting portion 66 that fits onto the other end of the cylindrical body 50. In other words, the inner diameter of the outer fitting portion 66 is approximately the same as the outer diameter of the other end of the cylindrical body 50, and the two are connected by fitting onto the other end of the cylindrical body 50.

A third connector 67 is provided at the other end of the downstream cap 52. The delivery tube 34 is connected to this third connector 67. For this purpose, the third connector 67 is cylindrical with an inner diameter approximately equal to the outer diameter of the delivery tube 34. The opening of the third connector 67 forms a delivery port 68 to which the upstream end 34a of the delivery tube 34 is connected. The downstream cap 52 has a reduced diameter section 69 between the outer fitting section 66 at one end and the third connector 67 at the other end, where both the outer and inner diameters are gradually reduced. When the upstream cap 51 is fitted onto one end of the tube 50 and the downstream cap 52 is fitted onto the other end as described above, the internal space forms a storage space 50a in which body cavity fluid is temporarily stored in the drip tube 32.

The air inlet tube 33, whose downstream end 33b is connected to the second connecting portion 61 of the upstream cap 51, is a long tube made of transparent, flexible synthetic resin. A connector 43 is provided at the upstream end 33a of the air inlet tube 33, allowing connection to an air syringe, air pump, or the like. A tube clamp 44, which is an open/close device, is attached midway along the air inlet tube 33 as an air flow rate regulator. Note that clamps other than the tube clamp 44 may also be attached as flow rate regulators.

[How to use the body cavity fluid sampling device]
The method of using the body cavity fluid collection device described above will now be described. First, the delivery tube 34 of the body cavity fluid collection device 30 is connected to the inlet tube 12 of the empty storage bag 1 via the connector 41. Next, with the roller clamp 42 and tube clamp 44 closed, the collection tube 31 of the body cavity fluid collection device 30 is connected to the end 21b of the catheter 21 extending from the patient's abdominal or thoracic cavity via the connector 40. The body cavity fluid collection device 30 and the storage bag 1 are then placed vertically below the patient. In this state, the roller of the roller clamp 42 is operated to adjust the opening of the collection tube 31, thereby starting the collection of body cavity fluid.

During collection of body cavity fluid, the collection pace and timing of completion of the collection process are determined based on the body cavity fluid dripping into the storage space 50a of the drip tube 32 via the collection tube 31. However, if the patient changes their posture or the position of the body cavity fluid collection device 30 or storage bag 1 shifts while collecting body cavity fluid, the storage space 50a of the drip tube 32 may become filled with body cavity fluid. This makes it difficult to determine the collection pace and completion timing.

In the body cavity fluid collection device 30 according to this embodiment, if the storage space 50a becomes filled with body cavity fluid, the tube clamp 44 is opened and air is introduced into the drip tube 32 via the air introduction tube 33. Air can be introduced, for example, using a syringe or air pump connected to the upstream end 33a of the air introduction tube 33. By introducing an appropriate amount of air into the drip tube 32 in this way, the level of the body cavity fluid in the storage space 50a can be lowered, making it possible to once again visually check the dripping status of the body cavity fluid from the collection tube 31. As a result, the collection pace and completion timing can be determined.

In the above explanation, an example was described in which a clamp such as the tube clamp 44 was provided midway along the air introduction tube 33. However, instead of a clamp, a known hydrophobic filter may be provided at the upstream end 33a of the air introduction tube 33. Alternatively, a clamp and a hydrophobic filter may be provided alongside the air introduction tube 33. In this way, even if the clamp is forgotten to be closed (or is unintentionally not closed completely), leakage of body cavity fluid through the air introduction tube 33 can be prevented.

(Embodiment 2)
5 is a diagram showing another configuration of the body cavity fluid collection device. This body cavity fluid collection device 30A differs from the body cavity fluid collection device 30 of the first embodiment in that the air introduction tube 33 is connected to the middle of the collection tube 31, rather than to the drip tube 32. However, the other configurations are essentially the same. Therefore, the following will specifically explain these differences, and the same reference numerals will be used to designate components common to both embodiments, and detailed explanations thereof will be omitted.

As shown in Figure 5, the drip tube 32A of this body cavity fluid collection device 30A has an upstream cap 51A that has only the first connection portion 60, and does not have the second connection portion 61 as in embodiment 1. Therefore, only the collection tube 31A is connected to the upstream cap 51A. It should be noted that there is no restriction on using an upstream cap 51 with the second connection portion 61 closed in place of the upstream cap 51A in the drip tube 32A.

On the other hand, the collection tube 31A has an upstream tube 311 and a downstream tube 312, and the two tubes 311, 312 are connected by a three-way branch joint 313. That is, for example, of the three joints 313a to 313c of the T-shaped three-way branch joint 313, the downstream end of the upstream tube 311 and the upstream end of the downstream tube 312 are connected to two of the linearly arranged joints 313a, 313b. The roller clamp 42 is provided midway along the upstream tube 311.

The downstream end 33b of the air inlet tube 33 is connected to the remaining joint 313c of the three-way branch joint 313. A tube clamp 44 is provided midway along this air inlet tube 33, as in embodiment 1. That is, in the body cavity fluid collection device 30A of this embodiment, air introduced from the air inlet tube 33 is sent to the storage space 50a of the drip tube 32A via the collection tube 31A (downstream tube 312). Therefore, an air inlet port is provided midway along the collection tube 31A. Note that the tube clamp 44 may be replaced with another clamp, and a hydrophobic filter may be provided in place of or in addition to the clamp, as in embodiment 1.

The method of use for the body cavity fluid collection device 30A according to this second embodiment is the same as that described for the first embodiment. Therefore, if the patient changes their posture or the position of the body cavity fluid collection device 30 or the collection bag 1 shifts and the collection space 50a becomes filled with body cavity fluid, the level of the body cavity fluid in the collection space 50a can be lowered by introducing air into the drip tube 32A via the air introduction tube 33, making it possible to once again visually check the dripping status of the body cavity fluid from the collection tube 31A. As a result, the collection pace and completion timing can be grasped.

The present invention can be suitably applied to body cavity fluid collection devices used to collect body cavity fluid that has accumulated in the abdominal or thoracic cavity from a patient.

30, 30A Body cavity fluid sampling device 31, 31A Sampling tube 32, 32A Drip tube 33 Air introduction tube 34 Delivery tube 43 Connector 44 Tube clamp (opening and closing tool)
62 inlet 63 air inlet 68 outlet

Claims (3)

A body cavity fluid collection device that is placed vertically below a patient lying on a bed and that collects body cavity fluid from the patient's abdominal cavity or thoracic cavity and stores the fluid in a collection bag,
a collection tube having an upstream end connected to a catheter extending from the patient;
a drip tube having an inlet to which the downstream end of the collection tube is connected, a storage space for temporarily storing the body cavity fluid that has flowed in from the inlet, and a delivery outlet for delivering the body cavity fluid stored in the storage space to the storage bag;
The collection tube or the drip tube is provided with an air inlet for introducing air into the storage space and a connector for connecting to a syringe or a pump ,
The air introduced from the syringe or the pump is introduced into the storage space through the air inlet, thereby adjusting the liquid level of the body cavity fluid.
Body cavity fluid collection device. An air inlet tube through which air passes is connected to the air inlet port, and the air inlet tube is provided with an opening/closing device or a hydrophobic filter that restricts the flow of body cavity fluid.
The body cavity fluid collection device according to claim 1 . The air introduction tube is provided with the connector for connecting to the syringe or the pump.
The body cavity fluid collection device according to claim 2 .