Apparatus for enteral administration of nutriment

(54) Name Device for dispensing enteral nutrient solution (56) Publications cited:

(57) Summary: [jppf i_nnin_ng_{one of}sees a device for dispensing or administering enteral nutrient solution.

The object of the invention is to provide such a device, by means of which substrates can be supplied to the application site according to the physiological requirements. In this way, a constant or quasi-constant transport speed should be maintained as required. Furthermore, the device, in accordance with its medical significance, should have a high operational reliability and it should be easy to earn.

This object is achieved with such a device, in which there is an electrically driven pump controlled by means of an electronic device, that the pump can be operated at a fixed speed continuously or intermittently at a fixed speed, and the operating and rest times are selectable in advance by the electronic device. .

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The present invention relates to a device for dispensing or administering enteral nutrition. This includes understanding the most physiologically favorable way of leveling the nutritional status of 5 malnourished patients and ensuring a prognostically favorable recovery.

In contrast to parenteral nutrition, which requires an invasive entrance to patients, in the case of enteral nutrition, the natural body cavity of the gastrointestinal tract is used for the supply of nutrients.

In this body cavity, a probe is inserted which is positioned so that the nutrient fluid can exit at the predetermined location, for example in the stomach, duodenum (duodenum) or jejunum (empty intestine) and is resorbed there. The probe is coupled to a storage container in which the nutrient, mostly industrially produced substrate, is located. The application is then usually done with the aid of a simple tube clamp, which does not allow for accurate dosing of the substrate in the gastrointestinal tract. Often, 20 complications are noted in this type of nutritional administration in the form of diarrhea and other gastrointestinal side effects. These complications can mostly be attributed to the unsatisfactory delivery technique in terms of quantity and speed.

It is already known (DE-OS 28 51 656, DE-OS 26 51 962,

DE-OS 31 12 902), for enteral nutritional supplies, use roller pumps driven by DC stepper motors, whereby in a known case the roller pump operates on the conveyor hose via an elastic band.

3θ in all known cases, however, the amount of transport is regulated by the control of the engine speed. This, of course, requires a complicated device design and requires that the drive does not always take place with optimum efficiency, which makes it difficult to control the ring. In the device according to DE-OS 28 51 656, the drive motor has a speed control and possibly a reduction gear, to allow control of the amount of transport in accordance with predetermined data. According to DE-OS 26 51 962, an angular or speed controlled drive motor is arranged at the roller pump for controlling the amount of transport. The device according to DE-OS 31 12 902 has the specificity that the amount of transport is given by the inner diameter of the hose and by the rotor speed of the pump. In this case, special arrangements are made to counteract the extensive variations in the torque of the rotor carrying the rollers. Between the rollers of the rotor and the hose wall there is a liner, arranged to compensate for dimensional changes between the rollers and changes of the contact surface and the hoses. In addition, the claim serves as a hose support.

US-PS 39 90 444 discloses a blood transmission device with a roller pump to be operated with interval control and is actuated by an electronic control device and runs for as long as an electro-optically monitored drip chamber reports a drop corresponding to the amount of transport up to this point. The roller pump is then switched off and reconnected only after a time interval, which is determined on the basis of the preselected number of drops per unit of time. This game is repeated cyclically. In this way, the drip chamber serves as a measuring device, for precise control of the small amounts of transport occurring here.

In accordance with this known technique, the invention aims at providing a device for dispensing enteral nutritional solution, which device has an electrically controlled roller pump driven by a DC motor whose equidistantly arranged rollers roll on an elastic band and a hose arranged therebetween. The object of the invention is to design a device of this kind that it operates continuously at full optimum efficiency.

8204800-0 of the pump motor, thus having a particularly favorable efficiency, which is of particular importance especially with regard to possible battery operation. This is especially required when the device is to be carried around by patients without disturbing its function. By means of an improved adjustability, the device should be particularly well adapted to the prevailing physiological requirements and at the same time enable a very precisely defined substrate supply.

The object is achieved according to the invention in that the nutritional quantity transported by the pump per unit time is selectable in advance by means of an electronic control device which controls the stepper motor operating times and rest times, the roller pump being operated at a constant speed during the operating times.

Such a device can operate with continuous or intermittently operated pumps, and the operating and rest times are selectable in advance by the electronic control unit. This provides an excellent opportunity for dosing the currently desired nutritional amount. In this way, it should be possible to maintain a constant or quasi-constant flow rate as needed, for example to the duodenum or jejuneum or a bolus application, for example in the stomach. The device according to the invention has high reliability and is easy to operate.

It is advantageous to arrange the power supply optionally over battery or mains. During battery operation, mobility of the patient is ensured and in a stationary supply situation with mains operation, the batteries can be spared and charged at the same time.

The electronic control device may comprise within the scope of the invention as independently adjustable timing mechanisms, oscillators with post-coupled adjustable dividers. The interval lengths of the rest and operating times are preselected by means of these timing devices. Due to the design chosen according to the invention, there is a problem-free adjustment possibility over a wide size range. The independent adjustability of the delivery and respite times enables the advancement of physiologically particularly favorable conditions.

The timing mechanisms can, with particular advantage, be assigned to switching devices for changing the order of magnitude. In this way and with the help of clear scales, an accurate adjustment is possible in such different order of magnitude as on the one hand seconds and on the other several hours.

The pump motor is preferably assigned a counter, which is controlled by a signal delivered during the pump motor's run time. By means of this counter, the total running time of the motor is determined, which is directly proportional to the amount of substrate supplied.

Advantageously, the counter is assigned an indicator and alarm device. Thus, the service personnel can read the total amount of fluid already supplied, and it is possible to adjust the amount intended for supply, so that either an automatic switch-off of the motor occurs after the preset value is reached or triggered by an acoustic and / or optical alarm signal.

According to the invention there is also a device for switching off the power electronics during the clock breaks. This measure reduces the inventive device's power requirements.

As a switch-off device, a transistor switch can be used in the power supply branch.

Advantageously, an operating indication device is designed so that the indication is pulsed, preferably in the order of a few Hz. Such an impulse-like indication has a lower power consumption as well as it creates a greater attention and is clearly highlighted · also in bright rooms at not too high brightness levels. As an operating indication device, a light-emitting diode can be used.

Preferably, the plate supporting the roll pump rollers and which is driven by an electric motor is made of fiberglass reinforced polyamide. This results in a high strength and deformation resistance, while at the same time the material is also hygienically untouchable.

The plate may be provided with eight pins, on which are mounted sliding bushes, which serve as rollers. These sliding bushes are preferably made of polyacetal.

However, it may also prove advantageous to arrange the sliding bushes pivotally in a cage guide. The very small rolling friction thus obtained lowers the driving torque to be created by the motor, and thereby the motor's energy consumption.

Under circumstances, it may be advantageous to perform the rotary pump portion with slide and pressure bushings as is the case with a planetary gear.

Preferably, between the bushings of the roller pump and the nutrient transporting hose, a flexible belt is provided whose upper surface has a low coefficient of friction. This avoids that the rotating bushings act immediately mechanically on the hose and damage it, and at the same time avoids any possibly exerted transport effect on the hose, through which the hose would be entirely affected by movement in the device.

According to the invention, the roller body against which the conveyor hose is pressed by means of the sliding bushes is formed as a rocker arm. It is therefore without difficulty possible to insert the transport hose into the device at the beginning and at the end of the supply process or remove the transport hose from the device.

Advantageously, the roller body is pushed to the pump position by means of a link connected to an eccentric. Thereby the roller body can be brought to the working position by means of a pushbutton with precisely defined end positions.

In this case, it proves to be advantageous to provide a spring device for generating a defined compressive force.

Finally, for practical use, it is also advantageous to provide the device according to the invention with a suspension device which enables a problem-free application, for example, at the patient's bed.

The invention is described in more detail below with reference to the accompanying drawings. Fig. 1 is a perspective view of the device according to the invention. Fig. 2 is a front view in the closed condition. Fig. 3 is a front view of opened rocker arm. Fig. 4 is a cross-sectional view of the pump plate area. Fig. 5 is 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 illustration of the power disconnection device. Fig. 8 is a schematic illustration of the indicating device.

In the housing 1 of the device according to the invention there is an electric motor 2. On the drive shaft 3 of the electric motor 2 is a pump plate 4. This is provided with a plurality of pins arranged equidistantly at its periphery.

5th On each pin 5 is provided a polyacetal slide bush 6, while the pump disc 4 consists of polyamide. The direction of rotation of the electric motor is indicated by arrow 7.

Parallel to the outer edge of the pumping disc 4, the inner surface of the roller body 8 extends, which in its entirety is formed as a rocker arm 9.

The tube 10 shown in the cut-out, shown in Fig. 5, is pressed by means of the sliding bushes 6 on the pump plate 4 against the roller body 8, so that it is formed with liquid-filled hose sections 11 which are advanced in accordance with the rotational movement of the pump plate 4.

The rocker arm 9 is pivotally mounted on a pin 12, which is arranged on the housing 1. The pivoting movement is created by means of a link 13, which is controlled by an eccentric not shown in detail. The eccentric maneuver is done model st a steering wheel 14 in the direction of arrow 14 '. The steering wheel 14 has two defined end positions, one of which corresponds to that shown in Fig. 2

8204800-0 state, wherein the rocker arm 9 is folded down on the hose 10, while the other corresponds to the situation shown in Fig. 3, in which the rocker arm 9 is folded up. In this latter position, the hose 10 can be inserted in a simple manner, and then after the steering wheel 14 has been re-fixed under the rocker arm 9. A spring arrangement not shown in detail provides a defined compression pressure in this state.

In order to avoid mechanical damage to the hose 10 by means of the sliding bushes 6 and a force effect in the direction of a forward movement of the hose 10, there is a flexible belt 15 between the sliding bushes 6 and the hose 10, the upper surface of which has a particularly low coefficient of friction. The belt 15 is based on two fixed points 16 on the housing 1 and is laid over the slide bushes 6 of the pump disc 4.

The control electronics of the device according to the invention are designed in such a way that the pump motor 2 operating as a stepper motor runs at constant preselected speed. The dosage of the feed quantity is obtained by correspondingly long switching on and off of the motor 2. For this purpose, see Figure 6, one. setting means 18, by means of which a timing device 17 can be engaged. This is designed as an oscillator with a switched frequency divider and determines the pause length between the working intervals. A second corresponding timing mechanism 19 with an adjusting means 20 determines the length of the operating interval of the motor 2. In addition, both timing mechanisms 17 and 19 are switchable by a large factor by means of a switch 21. The switch 21 is, for example, designed such that in one switching position the operating pauses are in the order of hours and the running time of the order of minutes, in which transport volumes of about 100 ml can be achieved, while in the other switching positions the operating and downtime times are in the order of seconds. Thus, in the first coupling position, the bolus feed is controlled, while in the second coupling mode, single-phase continuous transport is achieved.

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The counter switchable with a switch 22 is controlled by a rate proportional to the running time of the pump motor 2. Upon reaching a predetermined counter state and thus a predetermined total feed rate, counter 23 turns off the pump and provides an audible alarm via a signal transducer.

In the operating breaks of the pump motor 2, the power electronics 25 are disconnected from the supply voltage, whereby the power consumption can be lowered. In addition, there is a transistor

26, which connects the battery voltage to the control and power electronics 25 of the pump motor 2. It is controlled by the timing mechanism 19 via the base connection.

The state of operation of the device is indicated by an LED which is pulsed on by a transistor 29. This is controlled by an oscillator 30 and an after-coupled divider.

31st The frequency of the impulse is thereby chosen so that a visible flicker occurs.

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