Multiple infusion system.

The invention relates to a device for the dosed, continuous simultaneous infusion of several infusion solutions or medicaments comprising at least one pump with lines radiating from which the infusion or medicament solutions having containers and connected via a transition piece with a common patient line, with valves in each feed line being provided with a flow element and the flow detected with a control unit which is connected in terms of signals to the valves, the pump and the flow element.

The modern intensive care increasingly used infusion pumps for artificial parenteral nutrition, for the continuous and precisely metered application of medications, and more recently for the regulated supply of highly effective drugs as a function of physiological parameters.

Usually three to four different drugs or infusion solutions using multiple pumps or independent control devices are applied via an access to the bloodstream of the patient, usually consisting of a central venous catheter. In exceptional cases, up to twelve pumps can be connected to a patient access.

Usually one uses to pump with the associated disposable tubing products, which are downstream of the pump via three-way valves to a manifold leading to the catheter connected. At the same patient line called gravity infusion devices and equipment are usually in addition also on three-way valves still connected for measuring the central venous pressure.

Such arrangements have the following disadvantages:<ul><li>1. The individual building is cluttered usually, so that there is the danger of confusion.</li><li>2. The individual fitting together of infusion lines, three-way valves and the like leads to the risk of contamination.</li><li>3. In a combination of pumps and gravity infusion devices occurs when laying the patient access to a promotion of infusion solution from the pump into the gravity infusion system because the pressure detection systems of pumps, if at all any, when caused by the gravitational pressure of at most 0, 2 do not respond bar. Therefore, the infusion Stop undetected or is only detected indirectly by means of the patient monitoring.</li><li>4. If the infusion line downstream of the pump is interrupted (eg by an accidentally closed three-way valve), so pumping the pump and operate the pump for as long until due to too high pressure in the line appeals to the pressure detection system of a pump or the pump stops to promote.</li></ul>

Due to the deformability of the infusion lines in the formation of a storage volume that can empty suddenly in the patient when opening the three-way valve or after the elimination of the interruption.

The erroneous closing a three-way stopcock is relatively common, as eg for sampling, but also for measuring the central venous pressure (CVD measurement) connection valves must be closed for a short time to the pumps.

While there are certain rules of conduct and the rules under which the aforementioned hazards are to be avoided, however, require such a large concentration of assets of the user or they are associated with increased costs. So it does not apply, for example, as professionally, to combine a pump infusion with a gravity infusion. This, in turn, that even where an infusion pump must be used, where this is not justified by the accuracy requirement for the promotion of the drug or the infusion solution, which leads to increased costs.

In order to avoid some of the mentioned disadvantages, so-called multiple infusion systems have been developed. From DE-PS 33 29 977 a device for the metered infusion of solutions of a plurality of infusion containers is known. Several gravity infusion means with dropper are flow lines are built into the pinch valves, connected to a collecting line leading to the patient. In this patient line is downstream of first a flow sensor and then a feed pump connected. All valves and the flow sensor and the pump are connected to a control unit.

The to be selected by the physician infusion rate for the individual solutions are converted into the control unit in proportional drop numbers. Each valve remains open until the Channel associated drop number is reached. Thereafter, the valve is closed and the valve of the next channel. It will be determined in each particular drop numbers and supplied to the manifold until a switchover takes place. This device has a number of disadvantages. Infuse sequentially, ie the promotion of individual solutions is not continuous. Nor is it possible to promote a highly effective drug with a lower rate and at the same time, for example, a parenteral nutrient solution at a high rate. A further disadvantage is that the single pump operates at a constant delivery rate and a defect in the pump leads to an uncontrolled infusion.

Object of the present invention is to avoid the disadvantages mentioned and to provide a device for the metered infusion that allows the simultaneous promotion of highly effective drugs with small infusion rates with high accuracy, high infusion rates at medium accuracy and high infusion rates with moderate accuracy, wherein compared to conventional devices not only a simpler and safer application, but also a cost saving is achieved.

This object is achieved by a device according to the characterizing features of claim 1st

With multiple infusion device according to the invention a plurality of pumps and gravity means may be combined. Thus, syringe infusion pumps, which ensure high accuracy at low infusion rates, be combined with linear peristaltic infusion pumps, which ensure an average accuracy at high infusion rates. For high infusion rates with moderate accuracy gravity infusion means are provided. Both the pump and the gravity infusion means are connected downstream to conveyor lines which open into a common patient line. In these delivery lines each clamp valves are installed, which are connected to a computing unit which also has a control unit. The processing unit is also connected to the pump so that the predetermined infusion rates that have been entered into the computer unit, can be passed on to the pump. The processing unit may also be equipped with a barcode reader, which allows to detect infusion containers, in turn, are marked with a bar code in terms of data. The computing unit then has both information on the composition of the connected infusion solution and to the rate with which these are applied. Thus, the arithmetic unit, both the total amount of the at any time the patient applied amount of liquid as well as the amount of energy and specific amount of substance (sodium, potassium, other electrolytes, amino acids, fats, glucose and the like) calculated and displayed on a screen or on a printer. Instead of a bar code reader, other reading devices, which allow automatic detection may be used. Such devices are not provided on the infusion solution container, it may also be a manual input. In the patient conduit a valve is also arranged.

Important in the device of the invention is that the flow element is arranged downstream of the pump and that the control unit deactivates the apparatus on detection of a fluid stop by the flow element by closing the valves and switching off the pump.

Preferably, the flow element is arranged in the patient conduit.

The flow element in the common patient conduit downstream of the pump or downstream of the union of all infusion lines has the purpose to detect the interruption of the infusion, for example by a blockage of the catheter. A closure of the catheter, it by bending the lead or for other reasons, may have far-reaching and serious consequences for the patient is. Initially, the patient is not receiving the infusion solutions present in the medicines. Since including drugs with half-lives may be a few minutes (for example, sodium nitroprusside, which is used for blood pressure control), this may very soon lead to a dangerous increase in blood pressure in patients. There may be an increase of the pressure in the infusion lines in front of the closing position but also by the pumping action. Since these are elastic, a certain amount of infusion solution is stored. If, finally, to a stop infusion, because usually detects this pressure increase in infusion pumps existing pressure detector and the sealing point is eliminated thereafter, the stored volume is suddenly infused into the patient, which leads to more infusion.

The flow element downstream of the pump can detect an interruption of flow, even before a pressure build-up has occurred. While also located downstream of the flow element nor a piece of hose with a certain elasticity, but the fact storable volume is substantially less than the entire system. Add to this that in the event of the closure and the pressure build-up above a much larger part funded by the pump flow in the larger volume of the tubing system, ie upstream of the flow element, stored, and thus the flow through the flow element in the location downstream of the flow element hosepiece strong returns. Although the river does not go to zero at this moment, it is still to a large value, more than 50% decrease. This change is readily detectable. As a result of such a detection, not only the valves are stopped, but also the pumps. The pumps may work against the valves under any circumstances, unless for any test and inspection purposes, since otherwise a storage volume is established before the valves.

Preferably, the flow element consists of a drop detector. In addition, may be connected to this patient line nor a CVP measuring means.

According to a further embodiment, in the patient conduit additionally an air detector may be arranged, which is also connected to the computing unit.

Advantageously, said pinch valves are actuated mechanically and electrically monitored or electrically operated by the computing unit and redundantly monitored.

Preferably, the pinch valves and the sensors are combined in a so-called sensor and valve block.

At least one gravity infusion means is connected, the flow element can instead be arranged in the patient conduit in the respective connection line to the gravity infusion means. Since the gravity infusion means usually have a drop regulator with manual or automatic operating terminal, it can take over the task of the flow element. The signal from the associated drop sensor is used to detect an occlusion of the patient line.

The detection is possible as follows:

Normally, the pumps feed and parallel to the gravity infusion means for infusion to the patient. If the patient line, for example, interrupted by a blockage of the catheter, so the pressure is due to the pumping action increases in the system, whereby the flow rate using the gravity-driven system goes back and finally becomes zero: The pumps back into the gravity infusion system. This is a dangerous condition in itself, since thereby the interruption of the infusion is not detected. In the embodiment according to the invention, however, this state is detected by the drop sensor, so that the device can be deactivated.

The inventive device allows the safe combination of pumps with the connected gravity infusion means as a disruption of the flow to the patient is detected by the flow element. The prevent the computer unit electrically controlled and monitored valves in that a valve is unintentionally closed, although the pumps were put into operation. If a CVP measuring means is connected to the patient line, an automatic performing this measurement is also possible. The central venous pressure can be detected by means of a manual or automatic lockable water column. A device for automatically detecting the water column may be advantageously embodied as an ultrasonic level sensor, which is provided as a reference path in the riser an ultrasound reflective point.

The air detector may be a known ultrasonic air detector. This air detector is advantageously connected to the valve in the patient line, so that it will be closed in response of the air sensor.

To vent the lines advantageously a venting device is connected to the patient line. Initially, all the valves are closed in the delivery lines, which is done by the computer and control unit. If the patient line is equipped with a combination of hydrophobic filter and non-return valve, also the ventilation valve of the venting device may remain closed. Otherwise, this is opened by the control unit.

Then the valve is opened in the first feed line and put the pump located in this branch in operation, while a high rate promotes until the air sensor signaled air freedom. Then, this valve in the delivery line and the vent valve are closed and the pump stopped.

Subsequently, the valve in the patient line and the valve can be opened in the second feed line and put the pump in this tree in operation. This initially promotes air, with the existing from the previous filling residual amount of liquid is pumped out and discarded in the patient line from this. In this way, the same is done to flush the tubing. Once the air sensor responds, the valve is closed in the patient line and the vent valve opened. The delivery of the pump is continued until the air sensor air freedom indicates. The pump is stopped and the valve closed again in this Tube. In this way also the other conveyor lines are vented.

After completion of this action, the patient line is connected to the patient and the infusion can begin.

If according to a further embodiment, a CVP measuring means connected to the patient line, it will be put into operation characterized in that the valve in the supply line to the patient line and the valve is opened in a conveyor line and all other valves remain closed. The component connected to this delivery pipe pump is started, which then as long as liquid promotes until the CVP measuring means is vented or responsive. Gravity infusion device is made in an analogous manner in operation. For this purpose, the valve in the delivery line of the gravity infusion means and the vent valve are opened. Due to gravity infusion solution penetrates into the conveying line and displaced from the air. As soon as the air sensor indicates air freedom, these valves, that the valve in the delivery line to the infusion device and the vent valve is closed again.

Become a gravity infusion means connected with a drop sensor on the feed line and the mentioned drop sensor with the computer and control unit signally connected, the latter may be open as in a known manner, the valve in the supply line and conclude that a predetermined drop rate is achieved on average. This means that the system works as drip infusion controller.

Hereinafter, an exemplary embodiment will be explained with reference to the drawing.

In the figure, a multiple infusion device is shown, the two linearperistaltische infusion pumps 1 and 2, two syringe infusion pumps 3 and 4, a gravity infusion means 16 and a CVP measuring means 15 has. The linear peristaltic infusion pumps 1 and 2 are each connected to the infusion solution container 25 and 26th Each infusion pump as well as the gravity infusion means is connected to a conveying line, indicated with 18, 19, 20, 21 and 36th In each delivery line is a pinch valve 5, 6, 7, 8, 11, which are signally connected to a processing and control unit 17th This arithmetic and control unit is also connected to the infusion pumps 1, 2, 3 and 4. FIG. The delivery rate of infusion pumps is controlled by the arithmetic and control unit according to a predetermined program.

The feed lines 18, 19, 20, 21 and 36 and the lead 35 to the CVP measuring means 15 are connected via a transition piece 27 in common to the patient line 23rd In this patient line 23 an air sensor 13, a flow element 14 and a further valve 12 are arranged. The air sensor, the flow sensor and this valve 12 are also connected to the arithmetic and control unit 17th

To the transition piece 27. In addition, a venting device 22 is still connected in the form of a connecting piece with the valve 9, which is also connected to the arithmetic and control unit 17th Instead of the valve 9 can also be a hydrophobic filter 28, optionally 22 closed sterile with a not shown check valve, said vent means relative to the environment.

These multiple infusion device is thus composed of different infusion devices with which different amounts can be administered at infusion solutions or medications with varying degrees of accuracy. Through the arrangement of air sensor 13 and flow sensor 14 in the patient line may be dispensed usually arranged in the feed pipes and air pressure sensors. This arrangement of the invention ensures a high level of safety for the patient, as a disruption of the flow of patients through the flow sensor 14 is detected and the arithmetic and control unit then the corresponding valves in the feed lines or the safety valve 12 may be closed immediately. In addition, the multiple infusion device offers the possibility of a CVP measuring means 15 also be connected to the patient line 23rd