Citrate anticoagulation control system suitable for CVVHD process and citrate anticoagulation device and application

Abstract

The invention discloses a citrate anticoagulation control system suitable for the CVVHD process and a citrate anticoagulation device and application. The citrate anticoagulation control system suitable for the CVVHD process comprises a first peristaltic pump velocity calculation module for calculating the infusion speed of citrate and a second peristaltic pump velocity calculation module for calculating the calcium supplement speed; the second peristaltic pump velocity calculation module comprises a second-peristaltic-pump first stage velocity calculation unit for calculating the sum of the calcium amount removed by extracorporeal dialysis and the calcium amount accumulated in the body and a second-peristaltic-pump second stage velocity calculation unit for calculating the calcium amount removed by extracorporeal dialysis. The citrate anticoagulation device comprises the citrate anticoagulation control system suitable for the CVVHD process. According to the citrate anticoagulation control system suitable for the CVVHD process and the citrate anticoagulation device and application, automatic control of a citrate pump and a calcium pump can be achieved, labor is saved, and meanwhilethe more accurate, safer and more stable aim is achieved.

Description

technical field [0001] The invention relates to a citric acid anticoagulation control system suitable for CVVHD process, its device and its application. Background technique [0002] Continuous Renal Replacement Therapy (CRRT) is a commonly used renal replacement therapy method in the intensive care unit, and is now an indispensable means of rescuing critically ill patients. Extracorporeal anticoagulation is an essential part of blood purification therapy (eg, figure 1 ). The principle of regional citrate anticoagulation (RCA) is relatively simple. The use of citric acid can chelate calcium ions, and calcium ions are an indispensable key factor in the process of blood coagulation. The calcium ions chelated into a difficult-to-dissociate soluble complex, calcium citrate, reduce the calcium ions in the blood, thereby blocking the coagulation reaction at multiple levels and achieving the anticoagulant effect. Generally, infusion of citric acid is given at the arterial end of...

AI Technical Summary

Problems solved by technology

[0006] (1) On the basis of the original blood purification device, two additional precision infusion pumps need to be added for the infusion of citrate solution and calcium solution, which is cumbersome to operate;

[0007] (2) The citrate infusion pump and the calcium supplement infusion pump are two independent pumps. When the treatment parameters change or the arterial pump of the dialysis machine stops due to alarms, replacement of replacement fluid / dialysis fluid, etc., the dialysis nurse needs to manually stop the pump. / Start these two pumps, if the operation is not standardized, it may cause excessive iatrogenic citrate infusion or hypercalcemia, resulting in failure of extracorporeal circulation anticoagulation;

[0008] (3) The traditional citrate anticoagulant regimen mainly adopts the "trial and error method" of monitoring-adjustment-remonitoring, that is, an initial calcium supplementation rate is set based on experience, and then adjusted by frequent monitoring of ionized calcium levels in the body and extracorporeal circulation. The speed of calcium supplementation, it was found that the level of ionized calcium in the body fluctuates greatly, and because the change of calcium lags behind the adjustment of calcium, it is difficult to accurately grasp the amount of calcium supplementation;

[0009] (4) The manpower invested in RCA (at least one hemodialysis nurse who has received strict training and a doctor familiar with citrate anticoagulant technology should be present), material resources (ionized calcium needs to be monitored every 2-4 hours, and the cost of each measurement 150 yuan) The cost investment is huge

However, in the previous experiment, it was found that on the one hand, the device is not stable enough, and there is a slight deviation between the actual speed and the theoretical speed of the peristaltic pump used. On the other hand, accidents may occur during the calcium supplementation process, such as The calcium supplement pipeline or the citric acid pipeline may be overpressured or even blocked

Due to the need to be very cautious in the process of CRRT treatment, any unexpected situation may cause harm to the patient

[0011] At the same time, according to the applicant's experience, the previous applicant's "two-stage" calcium supplementation mathematical model has many parameters and cumbersome calculations, and the two-stage models are different in different modes of CRRT. The previous two-stage calcium supplementation is only applicable to CVVH (continuous veno-venous hemorrhage) pretreatment mode

As one of CRRT, CVVHD has not yet reported its calcium supplement model in relevant literature.

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