Method and device for carrying out apparatus-assisted washed erythrocyte reinfusion in postoperative period

FIELD: medicine.

SUBSTANCE: method involves using apparatus supporting washed erythrocyte reinfusion as far as the erythrocytes become available. Reinfusion duration is limited with 3-4 h of the nearest postoperative period. The device has valve for preventing excessive rarefaction to occur. The valve is connected to main pipe for taking blood via T-shaped connector. The valve has membrane member which inlet flow nipple is connected to valve nozzle, shutter and upper and lower strap springs connected to each other. Screw for setting zero on the upper strap providing membrane member displacement. Adjusting screw is mounted on the lower strap allowing detaching shutter from the nozzle to make communication to atmosphere.

EFFECT: enhanced effectiveness in compensating postoperative blood losses with full-valued formed blood elements.

2 cl, 2 dwg

 

The present invention relates to medicine, in particular to methods of hardware reinfused washed erythrocytes and devices for its implementation in the treatment of orthopedic patients after surgery on the hip joint. Endoproteinase hip joint is accompanied by blood in the drains in the first day after the conference, and it occurs on the background of existing intraoperative blood loss. The need in erythrocytes as carriers of oxygen is usually compensated donor erythrocyte mass. However, this may be accompanied by intolerance reactions, transfer of viral, bacterial and protozoal infections. One way of compensation for blood loss without the use of donor blood is a way of reinfused blood flowing on drainage. This method, implemented using laundering erythrocytes in physiological solution, is closest to the proposed technical solution (see Borghi C., E. Pignotti, Montebugnoli M. Autotransfusion in major French Brasserie surgery: experience with 1785 patients // Brit. J. Anaesth. - 1997. - V.79, no. 5. - P662-664).

However, this method does not allow to control the vacuum in the line of blood collection.

A device for receiving the drainage of blood washed erythrocytes (see instructions Fresenius C.A.T.S, Continuous AutoTransfusion System), the closest to the proposed technical solution and using the data as a prototype.

Device for reinfused washed erythrocytes is connected to the drainage line for blood sampling, in which the blood is delivered into the tank with the filter, roller pumps, centrifuge, bag for reinfused and the waste container. The use of this device significantly improves the quality of reinfused, as the patient shimmer only suspended in physiological solution erythrocytes, whereas plasma, leukocytes, platelets, free hemoglobin, heparin, fat is removed.

However, the use of this device requires the involvement of qualified personnel, energy and consumables. As the blood loss by drainage continues in varying degrees within 1-2 days after surgery, the question is, how long should continue reinfuse.

The problem to which the invention is directed, is the preservation of red blood cells and the determination of the optimum time of the reinfused in the postoperative period in patients. This problem is solved due to the fact that the duration of reinfused limited to 3-4 hours early postoperative period, and the device for reinfused washed erythrocytes fitted with a valve to prevent excessive vacuum is made in the form of a membrane element, inlet port which is connected to the nozzle, valves and related p the dinners of the upper and lower bars, and on top rod is screw zero.

The essence of the invention is illustrated by drawings, where figure 1 shows a block diagram of the device in figure 2 the valve.

The way reinfused washed red blood cells is carried out as follows. After delivery the patient from the operating room to the intensive care unit in compliance with aseptic drainage from the wound is connected to the intake line of the apparatus for reinfused washed red blood cells, which produce blood collection and processing in the mode of high-quality cleaning. The washed red blood cells transfused to the patient as they arrive. Duration reinfused after the operation limit of 3-4 hours. The choice of this time interval due to the fact that at this time there is the greatest postoperative blood loss, approximately 50% of the total blood loss in the next 16-18 hours after surgery. Therefore, further use of the hardware reinfused becoming less effective, although still requires effort and funds.

Device for reinfused washed erythrocytes contains line 1 for blood sampling, connected to the tank with the filter 2, the roller pump 3, the centrifuge 4 to launder erythrocytes in physiological solution, a reservoir 5 for reinfused and the bag 6 to waste. To highway 1 for a fence to the Ovi through the T-shaped connector connected to the valve 7, to prevent excessive negative pressure. The valve 7 consists of a membrane element 8, the inlet fitting 9 which is connected to the nozzle 10, in the initial state of a closed elastic flap 11. The screw 12 zero through the upper bar 13, the spring 14 and the bottom panel 15 creates the initial displacement of the diaphragm element 8. On the bottom plate 15 has an adjusting screw 16. When creating a vacuum in the diaphragm element 8 is lowered rigidly associated with the lower plate 15. At the moment of reaching the critical dilution adjustment screw 16 mounted on the plate 15 presses the valve 11 from the nozzle 10, the nozzle 10 is connected with the atmosphere and increase the vacuum is terminated.

Duration reinfused after the operation is limited to 3-4 hours. The choice of this time interval due to the fact that at this time there is the greatest postoperative blood loss. It is approximately 50% of the total postoperative blood loss for the first day. Therefore further hardware reinfused blood becomes ineffective, however, still requires effort and funds. Therefore, the hardware reinfusion washed erythrocytes effectively carry out no longer than 3 to 4 p.m. in the nearest postoperative period, which allows you to refuse the transfusion of donor blood.

1. The way the hardware is enfusia washed erythrocytes in the postoperative period, including blood, flowing drainage from the wound, the laundering of erythrocytes in physiological solution, characterized in that in an apparatus for reinfused use the device according to claim 2, providing reinfusion washed red blood cells as they are received, and the duration reinfused limit 3-4 hours nearest postoperative period.

2. Device for reinfused washed erythrocytes containing the artery for blood sampling, connected to the tank with a filter, roller pumps, centrifuge for laundering erythrocytes in physiological solution, the capacity for reinfused and bag waste, characterized in that it is provided with a valve to prevent excessive vacuum is connected to a line for drawing blood through the T-shaped connector, the valve includes a membrane element, inlet port which is connected to the nozzle valve, the valve and connected by springs of the upper and lower bars, the upper limit of set screw zero, providing the displacement of the membrane element, and the lower strap has a regulating screw, configured to push the valve from the nozzle for connecting it with the atmosphere.



 

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