The present invention concerns an oxygenator of organic fluids, usable in particular to oxygenate the blood flowing in an extracorporeal circuit.
For some time, oxygenating devices have been known, hereafter oxygenators for short, which are used to oxygenate an organic fluid, in particular blood, which flows in an extracorporeal circuit on which they are mounted and to which a patient is connected, for example subject to a cardiopulmonary support therapy. One example of these oxygenators of a type known in the state of the art is described in WO 00/06357.
Typically, an oxygenator basically consists of a container that can have a cylindrical or parallelepiped shape, which internally defines a gaseous exchange chamber, or oxygenation chamber, in which a mass of hollow fibers is located.
The hollow fibers, which in practice are segments of capillaries, are disposed according to different criteria and have open lumens at the respective opposite ends. The fibers are made with a material that is porous to gases, but impermeable to liquids, so as to be able to be passed through internally only by a gas, in this specific case by oxygen, during the passage of the blood flow that laps the external surface of the fibers in a direction orthogonal to the longitudinal axes of the fibers.
The mass of fibers has all its ends open, which lead into respective chambers for the accumulation of oxygen to be delivered and for the accumulation of the carbon dioxide that is released from the blood during the gaseous exchange step.
The oxygen flows inside each fiber and is released into the blood flow during gas exchange, carrying out the oxygenation process. At the same time, the blood releases carbon dioxide which permeates through the membrane thickness of the hollow fibers which channels the exhausted gas toward the collection compartment from which it is expelled to the outside.
The container that forms the body of the oxygenator comprises at least two apertures for the entry of the oxygen and the exit of the carbon dioxide released in the gaseous exchange, and at least two other apertures for the entry of the blood to be treated and the exit of the blood treated.
The mass of hollow fibers is in turn retained by so-called “pottings” at the ends, that is, by monolithic elements made of polyurethane-based materials that incorporate their ends, blocking them in the fixed position inside the oxygenation chamber.
The mass of hollow fibers is typically made in the form of a bundle which is rolled up on a core or on itself in a direction transverse to the fibers, in such a way as to form a substantially cylindrical and elastically deformable body, in order to be adapted to the size and shape of the oxygenation chamber, defined by a cylindrical container mounted by interference on the rolled bundle. Other known solutions provide to fold a sheet of hollow fibers on itself, for example in bellows fashion, in which the hollow fibers are connected to each other by threads, generally of micrometric thickness, which determine a warp or weft. In any case, once installed, the hollow fibers are always in reciprocal contact with each other.
The disposition and installation of the hollow fibers is a critical aspect of oxygenators, since they are very expensive and very delicate to handle. During their installation there is in fact the risk that, if the fibers are pressed too hard, they will be crushed, causing the closure of one or more fibers, and also compromising the homogeneity of the hydraulic section passed through by the blood flow, consequently reducing the useful contact surface with the blood due to the excessive surface contact of capillary and capillary or layer and layer, or even more serious, they can be damaged and rupture causing a leakage of blood inside the cavities of the capillaries.
Document WO2018173092A1 discloses an oxygenator in which the mass of hollow fibers consists of a sheet of hollow fibers disposed parallel and folded in bellows fashion, and is equipped with one or more spacers located between two consecutive layers, so as to create a space between them with the purpose of allowing a correct outflow of blood. The spacers have flat elements with a central aperture that defines the hydraulic section useful for the outflow of blood. The oxygenator, in correspondence with a pre-chamber for the entry of the blood, also comprises dynamic distribution means, as well as two perforated septa to contain the mass of hollow fibers located upstream and downstream thereof, in relation to the direction of the blood outflow, which also perform a function of distributing the blood flow.
This solution does not fully satisfy the requirements of the sector, since the insertion of the spacers makes the step of assembling the mass of hollow fibers more complex and less fast. Furthermore, the disposition of the fibers is not perfectly controllable and faithfully reproducible according to the ideal hydraulic model, which can lead to irregularities in the network of fibers, entailing uneven blood flow.
Another disadvantage of using spacers is that it is impossible to reduce the overall sizes of the oxygenator, in particular the internal volume of the oxygenation chamber. In fact, the spacers themselves occupy a volume that cannot be reduced.
There is therefore a need to perfect an oxygenator which can overcome at least one of the disadvantages of the state of the art.
In particular, one purpose of the present invention is to provide an oxygenator which allows easier, faster and more controllable assembly of the mass of hollow fibers, and which at the same time guarantees its integrity.
Another purpose of the present invention is to provide an oxygenator which allows to reduce the risks of allergic reactions which blood can have in contact with extraneous surfaces.
Yet another purpose is to provide an oxygenator whose sizes and therefore the volume that has to be filled can be reduced compared with known oxygenators.
Yet another purpose is to provide an oxygenator whose total exchange surface of the capillaries in contact with the blood is as low as possible, given the same performances required, compared with known oxygenators.
Another purpose is to perfect a method to make a mass of capillary fibers which is easier, faster and more controllable than known methods.
The Applicant has devised, tested and embodied the present invention to overcome the shortcomings of the state of the art and to obtain these and other purposes and advantages.
The present invention is set forth and characterized in the independent claims. The dependent claims describe other characteristics of the present invention or variants to the main inventive idea.
In accordance with the above purposes, an oxygenator of organic fluids is described below which overcomes the limits of the state of the art and eliminates the defects present therein.
In accordance with some embodiments, an oxygenator of organic fluids is provided comprising a container body inside which an oxygenation chamber is defined. The container body comprises a first aperture for the entry of a gas and a second aperture for the exit of an exhausted gas. Favorably, the gas is oxygen and the exhausted gas also contains carbon dioxide.
The container body also comprises a third aperture for the entry of an organic fluid, and a fourth aperture for the exit of the organic fluid. Advantageously, the organic fluid is blood. The third and fourth apertures are preferably located upstream and downstream of the oxygenation chamber with respect to the outflow of the organic fluid.
The oxygenator also comprises a plurality or mass of capillary fibers contained inside the oxygenation chamber. The capillary fibers are made of a material porous to gases and impermeable to liquids, so as to allow only the exchange of gas with the organic fluid to be treated. The capillary fibers are oriented parallel to each other in a first direction, and disposed in such a way as to be externally lapped by the organic fluid.
The mass of capillary fibers comprises at least two sheets of capillary fibers located in reciprocal contact along a respective surface thereof. In each sheet, the capillary fibers are connected and kept equidistant from each other by means of at least two connection threads oriented in a second direction. This second direction is orthogonal or inclined with respect to the first direction, in which the capillary fibers are oriented. Favorably, the connection threads are intertwined, or knotted, around each individual capillary fiber. The two sheets are disposed reciprocally offset in the first direction.
Preferably, each sheet of fibers is monolayer, that is, it comprises a single layer of capillary fibers.
Preferably, the two sheets are also offset in the second direction. In this way, the capillary fibers of each of the sheets are not located in correspondence with a capillary fiber of the other sheet, allowing the two sheets to be more homogeneously distanced.
In accordance with some embodiments, the oxygenator comprises a chamber for the entry of the organic fluid disposed between the third entry aperture of the organic fluid and the oxygenation chamber. Preferably, the entry chamber comprises static distribution means, configured to homogeneously distribute the flow of organic fluid.
In a preferred way, the oxygenator also comprises a chamber for the exit of the organic fluid located between the oxygenation chamber and the fourth exit aperture of the organic fluid. More preferably, the exit chamber comprises second static distribution means, configured to distribute the flow of blood homogeneously and direct it toward the fourth exit aperture of the organic fluid.
According to one aspect, there is also provided a method to form a mass of capillary fibers to be inserted in an oxygenation chamber of an oxygenator. The method provides to make available at least two sheets of capillary fibers each comprising a plurality of capillary fibers disposed parallel in a first direction, and at least two connection threads for connecting the capillary fibers, the connection threads being oriented in a second direction perpendicular, or inclined, with respect to the first direction. The at least two sheets are then disposed in reciprocal contact in correspondence with a respective face thereof, and offset in the first direction in such a way that the threads of one sheet are offset with respect to the threads of the other sheet. In this way, the threads that create the external weave on the various capillary fibers come into contact with the capillary fibers of the other sheet.
In accordance with some embodiments, the sheets are supplied by respective reels. Such reels are preferably disposed offset in the first direction.
In accordance with some embodiments, the method provides to dispose the sheets in such a way that the reciprocal contact between them occurs only between the threads of each sheet and the capillary fibers of the other sheet.
These and other aspects, characteristics and advantages of the present invention will become apparent from the following description of some embodiments, given as a non-restrictive example with reference to the attached drawings wherein:
To facilitate comprehension, the same reference numbers have been used, where possible, to identify identical common elements in the drawings. It is understood that elements and characteristics of one embodiment can conveniently be combined or incorporated into other embodiments without further clarifications.
We will now refer in detail to the possible embodiments of the invention, of which one or more examples are shown in the attached drawings, by way of a non-limiting example. The phraseology and terminology used here is also for the purposes of providing non-limiting examples.
Advantageously, the container body 20 defines a longitudinal axis A and is preferably parallelepiped in shape, that is, it comprises an upper wall 20A and a lower wall 20B which are opposite and perpendicular to the longitudinal axis A, as well as four lateral walls 20C connected to the upper and lower walls 20A, 20B, and preferably extended along their own axis parallel to the longitudinal axis A.
The container body 20 comprises a first aperture 21 for the entry of a gas, and a second aperture 22 for the exit of the same gas, in an exhausted condition. In the specific case of an oxygenator, the gas is oxygen, and the exhausted gas can comprise oxygen and contains carbon dioxide.
In the example shown, the first aperture 21 and the second aperture 22 are located in correspondence with two lateral walls 20C opposite each other, in such a way that the flow of gas passes through the oxygenation chamber 30 (
The container body 20 also comprises a third aperture 23 for the entry of the organic fluid and a fourth aperture 24 for the exit of the organic fluid (
It should be noted that each of the apertures 21, 22, 23, 24 is provided with a corresponding connection duct 21A, 22A, 23A, 24A to allow the connection to corresponding systems for supplying gas or organic fluid (
In an advantageous way, it can be provided that the connection duct 24A of the fourth aperture 24 is provided with one or more connection elements 24B, 24C (
It is preferable that the third aperture 23 and the fourth aperture 24 are positioned respectively upstream and downstream of the oxygenation chamber 30, with respect to the sense in which the organic fluid flows out, which is advantageously parallel or longitudinal to the longitudinal axis A.
Specifically, and in a preferential way, the third aperture 23 is positioned in the upper wall 20A of the container body 20, and the fourth aperture 24 is positioned in the lower wall 20B (
It can be observed that the fourth aperture 24 is preferably in a central position with respect to the lower wall 20B, that is, it is centered with respect to the longitudinal axis A (
The third aperture 23 opens into the container body 20, advantageously into an entry chamber 40 located between the third aperture 23 and the oxygenation chamber 30. In the example shown in the drawings, the entry chamber 40 is made in the upper wall 20A of the container body 20, which forms a dome 40A extending toward the outside of the container body 20. Preferably, the dome is coaxial with respect to the container body 20, that is, their longitudinal axes coincide.
Favorably, the entry chamber 40 is equipped with static distribution means 41. In accordance with some embodiments, the distribution means 41 are made in a single piece in the upper wall 20A of the container body 20 and protrude from its internal surface (
More advantageously, the fins 41 are configured to have a flat lower surface 42, so that the flat lower surfaces 42 of all the fins 41 are disposed on the same plane, which delimits at the lower part the entry chamber 40 of the organic fluid (
The dome 40A allows to accumulate air potentially present in the organic fluid, in such a way as to prevent the air from accumulating in the oxygenation chamber 30 and possible emboli from being created in the event that the organic fluid is blood. To allow the evacuation of the air, it is possible to provide an upper aperture 43 at the top of the dome 40A, preferably of a tubular shape extending toward the outside of the container body 20, and possibly equipped with connection means 44 so as to connect it to an external system (
Similarly, the lower wall 20B preferentially defines an exit chamber 50 of the organic fluid, located between the oxygenation chamber 30 and the fourth aperture 24 (
Favorably, the fins 51 are straight and oriented radially with respect to the fourth aperture 24, that is, with respect to the longitudinal axis A (
The fins 51 have a flat upper surface 52 preferably oriented perpendicular to the longitudinal axis A. Preferably, the fins 51 are configured in such a way that their upper surfaces 52 are disposed on a same plane, advantageously perpendicular to the longitudinal axis A, which delimits the exit chamber 50 at the top.
It can be surmised that the oxygenation chamber 30 is contained between the lower surfaces 42 of the fins 41 of the upper wall 20A and the upper surfaces 52 of the fins 52 of the lower wall 20B (
It should be noted that the lower surface 20B can define an internal zone 50A with a shape and sizes equal to those of the dome 40A (
Inside the oxygenation chamber 30 there is disposed a mass 31 of capillary fibers 32 made of a material porous to gases and impermeable to liquids. The capillary fibers 32 are all oriented in a same first direction X, preferably perpendicular to the longitudinal axis A (
For this purpose, the oxygenator 10 can comprise a support element 25 to support the capillary fibers 32 which is conformed to only engage their ends (
The capillary fibers 32 thus disposed put in fluidic communication a first lateral chamber 60, located laterally with respect to the oxygenation chamber 30, and a second lateral chamber 70, also located laterally with respect to the oxygenation chamber 30, but on the opposite side to the first lateral chamber 60.
Advantageously, the first lateral chamber 60 is delimited externally by the lateral wall 20C where the first aperture 21 is located, while the second lateral chamber 70 is delimited externally by the lateral wall 20C where the second aperture 22 is located (
This configuration of the lateral chambers 60, 70 can be achieved by providing that they are made in two respective half-bodies which are able to be reciprocally coupled in a hermetic way and which combine to form the container body 20. The half-bodies can for example have a substantially semi-annular shape, so as to delimit the hydraulic section when they are coupled to each other.
The mass of fibers 31 is obtained by using two sheets 33A, 33B of capillary fibers 32. Each sheet 33A, 33B consist of a plurality of capillary fibers 32 disposed parallel to each other in a first direction X, and connected to each other by means of at least two threads 34A, 34B intertwined on the external surface of the capillary fibers 32 and oriented in a second direction Y inclined with respect to the first direction X, preferably perpendicular to the first direction X (
It should be noted that in each sheet 33A, 33B the capillary fibers 32 preferentially form a single layer. The capillary fibers 32 can have a diameter of the order of a few hundred microns, for example 380 μm, and the threads 34A, 34B can have a thickness of the order of 10 μm.
Each sheet 33A, 33B preferably comprises a plurality of threads 34A, 34B which are regularly distributed along the length of the capillary fibers 32 according to a predefined pitch P1. The pitch P1 can be of the order of a few millimeters, for example 10 mm.
The two sheets 33A, 33B are placed in reciprocal contact along a respective surface defined by the capillary fibers 32 (
In this way, the contact between the two sheets 33A, 33B only actually occurs between the threads 34A, 34B of one of the sheets and the fibers 32 of the other sheet. Furthermore, instead of having a predetermined pitch, for example of 10 mm between the threads 34A, 34B, there is obtained an alternation of threads 34A, 34B between the capillary fibers 32 of the two sheets, wherein the threads 34A, 34B are distanced by a smaller pitch, for example smaller than 10 mm. This alternation of threads 34A, 34B creates a layer of threads which is interposed between the capillary fibers 32 of the two sheets 33A, 33B.
By doing so, the installation of the capillary fibers 32 in the oxygenation chamber 30 is easier, faster and more controllable than in the state of the art. The capillary fibers 32 are regularly distanced from each other, creating a homogeneous and repeatable three-dimensional matrix which defines a hydraulic section useful for the passage of the organic fluid such as to prevent the capillary fibers 32 from touching each other. Furthermore, a contact surface for the organic fluid is freed which, the number of capillary fibers 32 being equal, is higher and therefore allows to reduce the useful contact surface between the fibers and the organic fluid. In the case of blood, this is an advantage since it reduces the risk of allergic reactions of the blood with the material of the fibers.
All this also allows to reduce the sizes of the oxygenator 10, in particular of its internal volume.
One way of achieving the offset of the threads 34A, 34B is simply to offset the two sheets 33A, 33B in the first direction X. It can for example be provided to resort to two reels 330A, 330B of sheets 33A, 33B of capillary fibers 32, and dispose them reciprocally offset in the first direction X in such a way as to be able to supply the sheets already offset with respect to each other (
The offset between the threads 34A, 34B of the two sheets 33A, 33B is advantageously smaller than the pitch P1 between the threads 34A, 34B of a same sheet 33A, 33B, so that the threads are separated from each other by a distance smaller than the pitch P1. Advantageously, the threads 34A, 34B are offset by a half pitch P1, in such a way as to be regularly distanced from each other by a distance equal to half the pitch P. In the case of a pitch P1 equal to 10 mm, the threads 34A, 34B are distanced by 5 mm in the sheet with a double layer (
In accordance with some embodiments, the sheets 33A, 33B are offset with respect to each other also in the second direction Y.
In each sheet 33A, 33B, the capillary fibers 32 are suitably separated, in the second direction Y, by a second pitch P2. It is particularly advantageous to provide that the sheets 33A, 33B are offset by half of the second pitch P2, so that the capillary fibers 32 of a first sheet 33A are located between two capillary fibers 32 of the second sheet 33B (
In the embodiment shown in
Favorably, the support element 311 has a substantially annular shape, with an internal aperture with a shape and sizes larger than those of the dome 40A, so as to not interfere with the useful hydraulic section of the oxygenator 10.
Below a mode of assembly of the oxygenator, and a functioning mode thereof are described.
It is first provided to make available the container body 20, of the type that can be dismantled or opened, so as to make the oxygenation chamber inside it accessible.
Subsequently, the mass 31 of capillary fibers 32 is prepared, by supplying two sheets 33A, 33B placed in reciprocal contact in correspondence with a surface thereof and disposed in such a way that the threads 34A of the first sheet 33A are offset with respect to the threads 34B of the second sheet 33B (
Preferably, the two sheets 33A, 33B are fed by respective reels 330A, 330B, which can be disposed offset, in such a way that the sheets 33A, 33B are already offset when they are supplied.
It is advantageous to provide that the two sheets 33A, 33B are also offset in the second direction Y, so that each capillary fiber 32 of one sheet 33A is positioned resting on the respective threads between two capillary fibers 32 of the other sheet 33B (
The two sheets 33A, 33B taken together (in such a way as to form a single sheet with a double layer of capillary fibers 32) are then shaped in order to enter the oxygenation chamber 30 in order to fill it. According to one embodiment, the sheets 33A, 33B are folded in bellows fashion, in order to obtain different double layers of capillary fibers 32 accumulated on each other. The mass 31 thus obtained is then inserted into the oxygenation chamber 30.
Alternatively, it can also be provided to prepare sub-groups 310 by preparing a support element 311 on a pair of sheets 33A, 33B, and to repeatedly wrap the latter around the support element 311 until a sub-group 310 with a predetermined thickness is obtained. The thickness can be any thickness whatsoever, according to the requirements or sizes of the oxygenation chamber 30 to be filled, or also the number of sub-groups 310 to be used.
The sub-groups 310 are then disposed stacked in the oxygenation chamber 30, as shown in
Once the mass 31 of capillary fibers 32 has been installed, the container body 20 is hermetically closed.
The oxygenator is subsequently connected, by means of the connection ducts 21A, 22A, 23A, 24A and possibly also by means of the upper aperture 43, if provided, to a suitable circuit, for example an extracorporeal circuit for blood circulation, or the circulation of another organic fluid.
The functioning of the oxygenator 10 is similar to that of known oxygenators 10.
It is clear that modifications and/or additions of parts or steps may be made to the oxygenator and to the method as described heretofore, without departing from the field and scope of the present invention as defined by the claims.
In the following claims, the sole purpose of the references in brackets is to facilitate reading: they must not be considered as restrictive factors with regard to the field of protection claimed in the specific claims.
Number | Date | Country | Kind |
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102020000025762 | Oct 2020 | IT | national |
Filing Document | Filing Date | Country | Kind |
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PCT/IT2021/050357 | 10/28/2021 | WO |