Apparatus for enteral administration of nutriment

(42) Date of commencement of the patent: 15. 7.1991 (45) Date of issue: 10. 1.92

<td>(30) Priority:</td><td>(73) Patent owner:</td>

<td>25. 9.1981 DE 3138267 claims.</td><td>PFRIWER + CO. CREATE PHARMACEUTICAL WORKS</td>

<td>(56) Documents:</td><td>GMBH D-8520 ERLANGEN (DE).</td>

<td>G &amp; -0S2009453 US-PS4278085 US-PS4184815 US-PS3990444</td><td>(72) Inventor:</td>

<td>U.S. Patent 4,179,249 U.S. Patent 4,087,562</td><td>IWATSCHENKO PETER ING. NINE CHURCHES (DE). GIEBLER FRITZ OSTENDORF (DE).</td>

(54) APPARATUS FOR ADMINISTERING ENTERALER NUTRITION (57) The invention relates to a device for

Administration of enteral nutrition.

It is the object of the invention to provide a device by means of which, according to physiological requirements, substrate can be guided to the point of application. Depending on the use, it should be possible to maintain a constant or quasi-constant Fdr rate. Furthermore, the device according to the invention should have a high degree of operational safety and ease of operation in accordance with their medical significance.

This object is achieved in such a device in that the operating and standstill times of the stepping motor (2) can be preselected by means of an electronic device, comprising independently adjustable timers (17, 19) in the form of oscillators with downstream adjustable dividers (31) CU, wherein the timers (17,19) switching means (21) for adjusting the order of magnitude range between operating and standstill time are assigned and the stepper motor (2) is associated with a counter (23), which is driven by a signal emitted during the running time of the stepping motor (2).

<img file="AT393963B_D0001.tif" />

AT 393,963

AT 393 963 B

The invention relates to a device for administering enteral nutrition with a continuously or intermittently driven by a stepper motor at a constant speed roller pump. This is the most physiologically favorable way to balance the nutritional status of malnourished patients and to ensure a prognostically favorable cure.

In contrast to parenteral nutrition, which requires invasive access to the patient, enteral nutrition uses the natural body cavity of the gastrointestinal tract to deliver nutrients. In this body cavity, a probe is placed and placed so that the liquid humor at the intended location, z. B. in the stomach, duodenum or jejunum can emerge and be resorbed. The probe is coupled to a storage container in which the food, usually industrially manufactured substrate, is located. The application is then usually with the aid of a simple tube clamp that does not allow accurate dosing of the substrate into the gastrointestinal tract. Complications in this type of diet are often observed in the form of diarrhea and other gastrointestinal side effects. These complications are largely due to the unsatisfactory delivery technique in terms of quantity and speed.

Such devices are z. Example, by the US-PS 4,078,562 become known where a distinction is made between an operating time of the motor for the pump and an operating time of another motor for the control of the time interval. Disadvantageously, two motors are required here, whereby the battery is subjected to undue stress during battery operation.

According to GB-PS 2 009 453, a stepping motor is used to drive the peristaltic pump. This stepper motor can be controlled over a very wide speed range to ensure the desired flow rate. Thus, the engine works not only with different speeds, but also with varying efficiency, which is also disadvantageous.

The invention is based on the object, while avoiding all the above-mentioned disadvantages, to provide a device with the aid of which, according to physiological requirements, substrate can be guided to the point of application. Depending on the use, compliance with a constant or quasikonstanten delivery rate, z. B. into the duodenum or jejunum, or a bolus application z. B. in the stomach, be possible. Furthermore, the device according to the invention should have a high degree of reliability and ease of use according to their medical importance. Finally, it is still necessary that such a device be designed so that it can be carried easily and without functional impairment by the patient with.

This object is achieved in a device of the type mentioned, characterized that the operating and standstill times of the stepping motor can be preselected by means of an electronic device, having independently adjustable timers in the form of oscillators with downstream adjustable dividers, wherein switching means for adjusting the order of magnitude range between operating and standstill time are assigned to the timing element and a counting device is associated with the stepping motor, which is driven by a signal emitted during the running time of the stepping motor.

Such a driven and driven pump always runs in the optimal speed range and the engine thus has a particularly favorable efficiency, which is just in terms of a possible battery operation is of particular importance. Due to the adjustability of the addition or Pause intervals, the device can be adapted particularly well to the respective physiological requirements, at the same time a very defined substrate feeding is made possible. By means of said counting device, in a further embodiment of the invention, the counter is assigned a display and alarm device. According to the invention, the device is characterized by the arrangement for switching off the power electronics from the power supply during the cycle breaks. According to a further feature of the invention, the shutdown device is a transistor switch in the power supply branch. By an operation display device according to the invention, the display is pulse-like, preferably in the order of a few hertz. According to another characteristic of the invention, the power supply is either via battery or mains. According to the invention, the operation indicator comprises a light emitting diode. Further, according to the invention, the stepping motor is connected to a pump plate made of glass-fiber-reinforced polyamide, on which sliding bushes are arranged. According to the invention, the pump plate is provided with stub axles on which the sliding bushes acting as rollers are seated. According to the invention, the sliding bushes are made of polyacetal. Further, according to the invention, the sliding bushes are rotatably arranged in a cage guideL Furthermore, according to the invention, the rotating pump part is designed in the manner of a planetary gear with sliding and pressure bushings. According to the invention, a flexible band with a surface having a low coefficient of friction is further arranged between the bushes of the pump and a tube which conveys the nutrient liquid. According to the invention, a rolling body, against which the delivery hose is pressed by the sliding bushes, designed as a pivoting lever. This rolling body is pressed according to the invention by a tab connected to an eccentric in the pumping position Furthermore, a Fedeieinrichtung is provided according to the invention for generating a defined pressure force. Finally, the device according to the invention has a suspension device to a trouble attachment z. B. to allow the patient's bed.

Further features, advantages and details of the invention will become apparent from the following description of a preferred embodiment and from the drawing. Showing:

Fig. 1 is a perspective view of the device according to the invention; Fig. 2 is a front view in the

-2AT 393 963 B closed state; Fig. 3 is a front view with the rocker open; 4 shows a cross section in the region of the pump plate; 5 shows a longitudinal section in the region of the pump plate; Fig. 6 is a schematic circuit diagram of the electronic control device; Fig. 7 is a schematic representation of the power shut-off device and Fig. 8 is a schematic representation of the display device.

In the housing (1) of the device according to the invention an electric motor (2) is housed. On the drive shaft (3) of the electric motor (2) sits a pump plate (4). The pump plate (4) is provided with a plurality of at its periphery equidistantly arranged pin (5). On each of these pins (5) has a sliding bushing (6) is arranged in polyacetal, while the pump plate (4) consists of polyamide. The direction of rotation of the electric motor (2) is indicated by the arrow (7).

Parallel to the outer edge of the pump plate (4) extends the inner surface of the rolling body (8), which is formed in its entirety as a rocker (9).

The fragmentarily shown in Fig. 5, the substrate feeding hose (10) is pressed by the sliding bushes (6) of the pump plate (4) against the rolling body (8) so that liquid-filled tube sections (11) arise, which according to the rotational movement the pump plate (4) are promoted.

The rocker (9) is pivotally mounted on a on the housing (1) mounted pin (12). The pivoting movement is caused by a controlled by a cam, not shown in detail eccentric (13). The operation of the eccentric is done by a knob (14) in the direction of arrow (14 '). The rotary knob (14) has two defined end positions, wherein the one in FIG. 2 shown state that the rocker (9) is folded down on the hose (10), while the other of the in Fig. 3 corresponds to the situation shown, in which the rocker (9) is opened. In this latter position, the hose (10) can be easily inserted in order to then be fixed by turning the rotary handle (14) under the rocker (9). A spring device not shown in detail ensures a defined contact pressure in this state.

In order to avoid mechanical damage of the hose (10) by the sliding bushings (6) and a force in the direction of forward movement of the hose (10), a flexible band (15) is provided between the sliding bushes (6) and the hose (10) whose surface has a particularly low coefficient of friction. Starting from two fixed points (16) on the housing (1), the band (15) is guided over the sliding bushes (6) of the pump plate (4).

The control electronics of the device according to the invention is designed so that. the pump motor (2) designed as a stepper motor runs in the operating state at a constant, fixed preset speed. The metering of the delivery rate is achieved by correspondingly long activation and deactivation of the motor (2). As shown in FIG. 6 illustrated, an actuator (18) provided by which a timer (17) is switched on. The timer (17) is designed as an oscillator with a downstream frequency divider and specifies the pause length between the working intervals. A second corresponding timer (19) with an actuator (20) controls the length of the operating intervals of the motor (2). Both timers (17) and (19) are additionally umschallbar by a switch (21) with a large factor. The switch (21) is z. B. designed so that in one switching position the duration of the breaks in the range of hours and the running time of the motor in the range of minutes, wherein flow rates of about 100 ml are achieved, while in the second switch position, the operating and service lives of the order of Seconds lie. In the first switch position so that the bolus is controlled, while in the second switch position a quasi-continuous promotion is achieved.

With a switch (22) switchable counter (23) is controlled by one of the running time of the pump motor (2) proportional clock Upon reaching a predetermined count and thus upon reaching a predetermined total delivery of the counter (23) switches off the pump and outputs by means of Signal transmitter (24) audible alarm.

In the operating pauses of the pump motor (2), the entire power electronics (25) is switched off from the supply voltage in order to reduce the power consumption as possible. For this purpose, the transistor (26) is provided, which switches the voltage of the battery to the control and power electronics (25) of the pump motor (2). It is controlled by the timer (19) via the base terminal.

The operating state of the device is indicated by a light-emitting diode, which is turned on in pulses by a transistor (29). The transistor (29) is controlled by an oscillator (30) and a downstream divider (31). The frequency of the pulses is chosen so that a visible flicker arises