U.S. patent number 3,655,123 [Application Number 04/869,418] was granted by the patent office on 1972-04-11 for continuous flow blood separator.
Invention is credited to Emil J. Freireich, George T. Judson.
United States Patent |
3,655,123 |
Judson , et al. |
April 11, 1972 |
CONTINUOUS FLOW BLOOD SEPARATOR
Abstract
Apparatus for separating whole blood into at least two
fractional components and continuously returning at least one
component thereof to the source of the blood. The apparatus
includes supply means establishing continuous communication between
the source and the separating means, the separating means including
a high speed centrifuge with a rotating seal means permitting entry
of the whole blood through a stationary portion and separation of
the blood in the centrifuge with the various components of the
blood being returned to the stationary portion of the seal
means.
Inventors: |
Judson; George T. (Whitney
Point, NY), Freireich; Emil J. (Houston, TX) |
Assignee: |
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Family
ID: |
27075407 |
Appl.
No.: |
04/869,418 |
Filed: |
July 30, 1969 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
|
570792 |
Aug 8, 1966 |
3489145 |
Jan 13, 1970 |
|
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Current U.S.
Class: |
422/44; 494/41;
494/84; 494/10; 494/60; 604/67; 604/6.07; 604/6.11; 604/6.01 |
Current CPC
Class: |
A61M
1/3696 (20140204); B04B 5/0442 (20130101); A61M
1/3693 (20130101); A61M 1/0209 (20130101); B04B
2005/045 (20130101); A61M 2205/3393 (20130101); B04B
2005/0464 (20130101) |
Current International
Class: |
B04B
5/00 (20060101); B04B 5/04 (20060101); A61M
1/36 (20060101); B04b 011/00 () |
Field of
Search: |
;233/21,16,1A,2,22,19,3,4,11,32,27,28 ;128/214,2.05 ;23/258.5 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Franklin; Jordan
Assistant Examiner: Krizmanich; George H.
Parent Case Text
This application is a divisional application of copending
application Ser. No. 570,792, filed Aug. 8, 1966, now U.S. Pat. No.
3,489,145, granted Jan. 13, 1970.
Claims
What is claimed is:
1. A continuous flow blood separator comprising:
means for separating whole blood into at least two fractional
components;
a source of whole blood;
supply means establishing continuous communication between said
source of whole blood and said separating means to thereby provide
whole blood to be separated, said supply means including receptacle
means having an inlet means for receiving old blood from said
source and an outlet means for discharging said blood to said
separating means;
first pump means for conveying said whole blood from said source to
said inlet means;
weight sensing means coupled with said receptacle means, a signal
means initiated by said weight sensing means and responsive to
predetermined weight conditions of said receptacle means, said
weight sensing means being controllably coupled with said first
pump means whereby said signal means controls the operation of said
pump means, whereby said first pump means may be operated
intermittently or continuously; and
return means establishing continuous communication between said
separating means and the source of whole blood to return at least
one of said separated fractional components from said separating
means to said source of whole blood.
2. A continuous flow blood separator as defined in claim 1 wherein
said supply means further includes means for admixing an
anti-coagulant with said whole blood before the same is supplied to
said separating means.
3. A continuous flow blood separator as defined in claim 2 wherein
said admixing means is a second pump means.
4. A continuous flow blood separator as defined in claim 3 wherein
said first and second pump means operate at a preselected ratio to
thereby control the respective whole blood and anti-coagulant flow
rates.
5. A continuous flow blood separator as defined in claim 1 wherein
said return means includes a bubble detecting and removing means to
assure that any fractional component returned to said source is
free of air bubbles.
6. A continuous flow blood separator as defined in claim 1 wherein
said return means includes reheating means for heating a returning
fractional component to substantially the same temperature as that
of the whole blood at said source.
7. A continuous flow blood separator as defined in claim 1 wherein
said separating means separates said whole blood into three
fractions including red cells, white cells and plasma, and wherein
said return means returns said red cells and at least a portion of
said plasma to said source.
8. A continuous flow blood separator comprising:
means for separating whole blood into at least the fractional
components;
a source of whole blood;
supply means establishing continuous communication between said
source of whole blood and said separating means to thereby provide
whole blood to be separated; and return means establishing
continuous communication between said separating means and the
source of whole blood to return at least one of said separated
fractional components from said separating means to said source of
whole blood;
said separating means including a centrifuge means and means for
driving said centrifuge means;
said centrifuge means including an outer casing means engaged with
said driving means, an inner member disposed within said outer
casing means in spaced relation thereto, said outer casing means
and said inner member thereby forming a confined chamber radially
displaced from the axis of rotation of said centrifuge means into
which whole blood can be introduced, said confined chamber being
formed by the space between said inner member and said outer casing
means;
passage means in said inner member communicating between said
supply means and said confined chamber to supply whole blood to
said confined chamber, said passage means being coaxial with said
axis of rotation; and
a cover means engaged with said outer casing means and said inner
member, said cover means including inlet aperture means in
communication with said passage means to admit whole blood, and
outlet port means communicating with said confined chamber and said
return means to permit at least one of said separated fractions to
be returned to said source, said outlet port means communicating
with said confined chamber at least at two different separation
levels therewithin whereby one of said outlet port means is adapted
to receive one separated fraction and another outlet port means is
adapted to receive a different separated fraction; said separating
means further includes seal means having a fixed portion and a
rotating portion, said rotating portion being coupled with said
cover means, said seal means further including a plurality of
apertures therein, at least one of said aperture communicating
between said supply means and said inlet aperture means, and at
least two other apertures communicating between said return means
and said outlet port means, said fixed portion and said rotating
portion each having a planar face, said planar faces being in
abutting contact with one another to form an interface, at least
one of said planar faces having at least two groove means therein,
each of said groove means forming a channel at said interface, said
channels communicating with said outlet port means and said other
apertures, said channels being concentrically arranged about said
axis of rotation, and pressure applying means engaged with said
fixed portion to maintain said fixed portion pressed against said
rotating portion.
9. A continuous flow blood separator comprising:
means for separating whole blood into at least two fractional
components;
a source of whole blood;
supply means establishing continuous communication between said
source of whole blood and said separating means to thereby provide
whole blood to be separated;
return means establishing continuous communication between said
separating means and the source of whole blood to return at least
one of said separated fractional components from said separating
means to said source of whole blood;
said return means including at least two pump means to permit
individual pumping of said fractional components from said
separating means;
said return means further including a pair of counteracting valves,
which, in one position recombine one fractional component with
another, and which, in an opposite position return said one
fractional component to said supply means.
Description
This invention relates to apparatus for separating or fractionating
whole blood into its various individual components and more
particularly it relates to a method, means, unit and system for
accomplishing separation or fractionation under the influence of
centrifugal force.
In general, the present invention relates to a machine which can be
linked with a human body to permit blood to continuously flow from
the body, through the machine and then back to the body. During its
passage through the machine, the blood is separated or fractionated
into plasma, red cells, white cells and platelets, and some of
these fractions are returned to the human donor while others of the
fractions can selectively be collected from the machine. As such,
it may be stated that the present invention relates to an "in vivo"
type unit wherein blood is taken from a live donor, is passed
through the machine, and is then returned to the donor.
To appreciate the nature of the present invention, as well as the
difficulties and complications necessarily inherent in any unit
such as that described hereinafter, one must first understand the
nature and character of whole blood itself. Blood is a tissue
composed of a series of cells suspended in plasma. Approximately 45
percent of the volume of blood is formed by these cells, while the
remaining 55 percent of the volume of blood is the plasma. Plasma
essentially is the fluid part of the blood which suspends the cells
and plasma itself is formed as a solution of approximately 92
percent water, 7 percent proteins and the remaining 1 percent of
various mineral salts.
The blood cells which are suspended in the plasma include red
cells, also referred to as erythrocytes, white cells also referred
to as leukocytes, and platelets. The present invention not only
separates the cells from their suspension in the plasma, but
additionally, serves to separate the individual types of cells
themselves, and for this reason, it is important to further
understand the specific nature, function and properties of each of
the aforementioned types of cells.
The red cells or erythrocytes are small solid particles containing
the substance hemoglobin, a chemical substance having a high degree
of affinity for oxygen and carbon dioxide. Accordingly, the main
function of the red cells is to transport oxygen from the lungs to
the body tissues and to transport carbon dioxide from the body
tissues to the lungs. The red cells are created by the bone marrow
of the body and virtually all of a person's red cells are within
his blood stream. There are approximately 5,000,000 red cells for
each cubic mm of blood with each red cell having a specific gravity
of approximately 1.1. The red cell survival or that period of time
in which a red cell is able to perform its function within the
body, is approximately 120 days. After this period of time, these
exhausted red cells are removed from the body circulatory system
and destroyed. Naturally, even while these exhausted red cells are
being destroyed, new red cells are being created and introduced
into the circulatory system.
Considering now the white cells or leukocytes, such cells generally
serve a protective function within the blood stream, and there are,
in fact, several different varieties of white cells, each of which
serves s specified function. One major variety of white cells are
the granulocytes, with this variety forming between 60 and 70
percent of the total white cells. Granulocytes are initially formed
by the bone marrow and act as a defensive mechanism which
counteracts the bacteria or other foreign substance. Granulocytes
have a specific gravity of approximately 1,057, somewhat less than
that of the red cells, and only about 5,000 granulocytes are
contained in each cubic mm of blood. The other common variety of
white cells are the lymphocytes which are initially formed by the
body lymph glands and which comprise about 30 to 40 percent of the
white cells. The main function of the lymphocytes is to participate
in the production of antibodies to thereby prevent the spread of
infection throughout the body and to aid, to some degree, in
developing immunity. There are only about 2,000 lymphocytes per
cubic mm of blood and the specific gravity of these lymphocytes is
somewhere between that of the red cells and the granulocytes. There
are other varieties of white cells present in very minor amount in
the blood stream, such as monocytes, eosins and basophils, but
these minor varieties need not be discussed in any detail
herein.
Finally, platelets are small colorless bodies which act as a source
of thromboplastin and thereby serve the function of aiding in the
clotting of blood. Platelets are derived from megakaryocytes which
are produced by the bone marrow and released therefrom into the
blood stream to control hemorrhage. A platelet has a specific
gravity of approximately 1.01 and there are about 200,000 platelets
per cubic mm of blood.
With the foregoing explanatory matter in mind, it becomes apparent
that each of these various components of blood has its own physical
and chemical properties and serves its own particular function.
Accordingly, it should be appreciated that it is highly desirable
to separate whole blood into these various individual fractions,
for a variety of different purposes. In particular, it is desirable
to produce yields of white cells for use in blood research and
experimentation, immunology studies and for clinical use in organ
transplants. Similarly, it is of clinical importance to produce a
yield of white cells to be used as supportive therapy for cancer
patients whose own white cells have been depressed by the use of
anticancer drugs. Along the same line, it must be recognized that a
patient suffering from leukemia has a very high white cell count
and treatment of such patient often centers about removal of the
excess number of white cells from the patient. Insofar as platelets
are concerned, it is desirable to produce a yield of platelets to
aid in study and supportive therapy with regard to the coagulation
process. As to the collection of plasma, the uses of fresh and
frozen plasma are well known for use in transfusion techniques.
Finally, with respect to red cells, it is desirable to produce pure
red cell yields for use in transfusing fresh packed red cells and
for preservation by freezing.
There are certain known techniques and types of equipment for
separating or fractionating whole blood directed to an "in vitro"
type of operation wherein a quantity of blood is processed after
the same has been removed completely from a donor's circulatory
system. In such known "in vitro" techniques and procedures, such as
plasmapheresis and leukapheresis, the yield of white blood cells
is, at best, very low, and moreover, such existing techniques and
procedures are extremely complicated, laborious and time consuming.
Thus, until the present time and the development of the present
invention, there has been no practical and rapid method for
removing white blood cells from a quantity of whole blood.
Similarly, there has been a need for an efficient and safe
equipment, technique or other means for a continuous flow in vivo
type of blood separation.
Perhaps the need for the present invention can best be understood
by considering the commonest form of in vivo blood transfer,
namely, a blood transfusion from a donor to a recipient. Virtually
all of the donor's red cells or erythrocytes are in his blood
stream and can thus be readily transfused to the recipient. About
90 to 100 percent of the transfused red cells will remain in
circulation in the recipient. Also, as previously indicated, the
red cell survival is about 120 days, and thus, if the recipient
only requires additional red cells, he need only receive
transfusion at widely spaced intervals. Furthermore, short term
preservation techniques for red cells have been perfected and such
red cells can thus be stored for up to three weeks and still remain
effective.
On the other hand, when platelets are transfused from a donor to a
recipient, only approximately 33 percent and often less thereof,
remain in circulation in the recipient. Also, platelet survival is
one to three days, and accordingly, transfusion must be given quite
frequently. Finally, there is no known preservation technique for
platelets, so only freshly drawn platelets can be used. Thus, it
can be seen that platelet transfusion is considerably more
difficult and expensive than red cell transfusion, but it is at
least possible.
However, considering white cell or leukocyte transfusion, until the
advent of the present invention, there was no known convenient and
efficient means for accomplishing this type of transfusion. This
will be more clearly understood when it is recognized that less
than 20 percent of the donor's white cells are contained within his
circulating blood stream. The remainder, somewhat near 80 percent
of the white cells, are contained within the bone marrow or lymph
nodes. Thus, in any event, a transfusion of whole blood from a
donor to a recipient is a rather poor source of white cell supply.
Accordingly, in the transfusion of whole blood from a normal donor
to a recipient, there is no measurable increase whatsoever in the
recipient's white cell count. In fact, tests have shown that to
obtain any appreciable increase in a recipient's white cell count
would require more than twice the number of white cells contained
in the normal donor's entire blood volume. Also, white cell
survival is very short and thus even if it were possible to provide
the recipient with a transfusion having an adequate number of white
cells therein, such as a transfusion from a donor suffering from
chronic myelocytic leukemia, the survival time of the transfused
white cells would be very short, and a further transfusion would
then be needed.
As a final point with respect to transfusion from a donor to a
recipient, it is generally known that a donor who has whole blood
removed from his circulatory system can donate only one unit or 500
cc of blood every 60 days. This is primarily because the red blood
cells, which have a very long life span, are normally replaced at a
very slow rate. Therefore, if a person donates whole blood more
frequently than every 60 days, he may develop anemia or low
concentration of red cells in his blood. However, if whole blood is
removed from the donor and the red cells alone are returned to the
donor, such donor can donate 1 liter of plasma, the equivalent of
four 500 cc units of blood, every week. In other words, the person
can donate plasma more than 30 times as frequently as he can donate
whole blood. This results because the platelets and the plasma
proteins, the liquid portion of the blood, are replaced by the
donor's body much more frequently than are the red cells. Since the
body replaces white blood cells most rapidly, the present invention
provides a valuable unit since it separates the white cells from
whole blood and returns the red cells, plasma, and, if desired,
platelets, to the donor, thereby greatly increasing the permissible
frequency of white cell donations.
Before development of the present invention, it was believed that
the problems in creating an "in vivo" type of blood separator were
virtually insurmountable. It must be remembered that in a separator
of this type, the donor's blood is continuously flowing out of his
body, is being separated, then recombined, and finally returned to
his body. Naturally, any damage to the blood during transit through
the separating apparatus could result in serious injury or even
death to the patient. Therefore, a great variety of safety factors
had to be considered in developing the present invention as a
practical, safe and reliable piece of equipment.
Foremost among the problems encountered in developing the present
apparatus, was a consideration of what would occur if the machine
power suddenly failed. The present invention had to be designed in
such a manner that even if such power failure did occur, the same
would not be injurious to the donor and the donor would not lose
too great a quantity of his blood.
Another problem was the consideration of the tendency of blood to
clot, and for this reason, provision had to be made for continually
admixing anti-coagulant with the blood to assure that the same
would flow readily through the separating apparatus. Also, in this
regard, a sensing mechanism had to be provided to assure that the
supply of anti-coagulant will not inadvertently become exhausted,
thereby permitting the blood to clot. Of course, another serious
problem in any apparatus of this type is that of sanitation, and
the present invention had to be particularly concerned with the
fact that no impurities contacted the blood during its travel
through the separation apparatus. To accomplish the desired degree
of sanitation, the present invention was designed with no air-blood
interface, so that the blood would contact only clean sterile
surfaces.
Other problems in the development of an apparatus of this type had
to be concerned with the possibility of undue temperature rise in
the blood during its travel through the apparatus, as, for example,
due to the heat of friction created at bearing seals and the like.
Along a similar line, since the blood was to be out of the
patient's body for some time during its transit through the
apparatus, such blood had to be restored to proper temperature
before being returned to the patient's body. Also, means had to be
provided to sense if any vein occlusion occurred, thereby
interrupting the flow of blood from the patient to the apparatus,
and simultaneously, causing damage to the donor and the vein.
Another problem which had to be considered was the problem of
hemolysis of the red cells during their travel through the machine.
It was feared that the passage of the red cells through pumps and
through a centrifuge apparatus would damage the red cells, and this
was one of the considerations which had to be taken into account in
design of the apparatus. Finally, there was the problem of leakage
of air into the blood as the same was outside the donor's body,
thereby creating potentially fatal bubbles in the blood stream.
With the foregoing matters in mind, it is, therefore, the principal
object of the present invention to provide a continuous flow blood
separator which can be linked with a live patient to accomplish a
continuous in vivo separation of human blood.
Another principal object of the present invention is to provide a
method and means for separating whole blood into its major
fractional components as such whole blood is being continuously
supplied from a live patient.
Another principal object of the present invention is to capitalize
on the differences in specific gravity between the major components
of whole blood by using such differences in specific gravity to
effect a separation of the components into individual
fractions.
Another principal object of the present invention is to provide a
method, means, unit and system capable of drawing whole blood from
a live patient, dividing such whole blood into its major fractional
components, removing selected fractional components from the
remainder thereof and thereafter recombining the remaining
fractional components and returning the same to the patient's
circulatory system, all of the foregoing being carried out on a
continuous flow basis.
Another object of the present invention is to provide a practical
equipment means which can process whole blood on an in vivo basis
with a minimum amount of effort and transportation of the blood
being encountered during such processing.
Other objects of the present invention include the provision of an
instrument wherein: (a) leukocytes are separated from whole blood
at a reasonable efficiency be sedimentation in a centrifuge; (b)
operation is conducted on a continuous flow basis to allow
processing of large quantities of blood at optimal speed and
efficiency; (c) a vein-to-vein procedure is used to avoid arterial
puncture; (d) an anti-coagulant that doesn't require
anti-coagulation of the donor, and risks associated therewith, is
employed; (e) the loss of platelets, red cells and plasma is
minimal to allow processing of large volumes of blood in a single
donor; (f) a completely closed needle-to-needle system is used,
without any air-blood interface, to obviate the danger of air
injection or bacterial contamination; (g) the entire system
contains a volume of blood less than 500 milliliters at all times;
and (h) the system can be easily cleaned, mostly disposable, and
sufficiently automated to be operated by a single nonprofessional
operator.
Further objects of the present invention include the provision of a
method and means for accomplishing continuous in vivo separation of
whole blood, which method and means: (a) efficiently separates
whole blood into its major fractional components, namely, red
cells, white cells, platelets and plasma; (b) enables any selected
major fraction or fractions of the separated blood to be collected
while the remaining fractions can be returned to the donor's
circulatory system; (c) produces high yields of white cells and
platelets which were heretofore only obtainable in small
quantities; (d) includes a variety of safety factors to ensure that
neither the patient nor his blood will be harmed in any way, even
if machine failure were to occur; (e) operates in an efficient,
economic manner to enable whole blood to be continuously processed;
and (f) provides the first known practical means for processing
blood on an in vivo basis, as opposed to the cumbersome and time
consuming techniques previously utilized.
Still further objects of the present invention include the
provision of a continuous flow blood separator which: (a)
automatically admixes anti-coagulant with the blood being drawn
from a live donor to facilitate flow through the separator; (b)
withdraws blood intermittently from the donor, thereby allowing the
donor to have rest periods, but returns blood to the donor on a
continuous basis; (c) collects the whole blood from the donor in a
weight-sensitive receptacle means which automatically controls the
commencement and termination of blood withdrawal from the donor;
(d) continuously provides blood from the receptacle means to a
centrifugal separator in which, due to the differences in specific
gravity in the parts of the whole blood, such whole blood is
separated into major fractional components; (e) permits selected
fractional components of the blood to be drawn off from the
centrifugal separator while the remaining fractions thereof are
recombined for return to the donor's body; (f) automatically
backfeeds a portion of the blood returning to the donor's body from
the centrifugal separator during the time periods when no blood is
being withdrawn from the donor's body, to thereby prevent any
undesired clotting at the donor needle; (g) automatically senses
any vein occlusion and in the event that such does occur,
automatically stops blood withdrawal to prevent any damage to the
patient or his vein; (h) automatically collects any air bubbles
from the recombined blood stream returning to the patient's body;
and, if desired (i) re-heats the returning blood stream until the
same is at proper body temperature, thereby eliminating any
possibility of trauma or shock to the donor when the blood
re-enters his body.
Still another object of the present invention is the provision of a
continuous flow blood separator having a variety of safety devices
included therein to prevent any damage to the patient and/or his
blood, such safety devices including the provision of: (a) highly
sterile transfer tubing which maintains full sanitary conditions
while contacting the blood; (b) gradually increasing the donor flow
rates to minimize the occurrence of an occluded vein; (c) minimized
transportation of the blood to decrease the time that the blood is
outside the donor's body; (d) minimized volume of the apparatus to
assure that only a small volume of the patient's blood will be
outside his body in the event that the machine should shut down due
to power failure; (e) means for sensing vein occlusion and for
automatically terminating withdrawal of blood from the donor's
body, should the same occur; (f) level sensing means to assure that
the intravenous saline solutions and the anti-coagulant solution do
not inadvertently drop below a specified safe level; (g)
specialized seal arrangements within the machine to minimize the
amount of temperature rise due to heat of friction and the like,
and to prevent hemolysis and the ingestion of air into the system;
(h) an automatic diverting arrangement to prevent the blood from
inadvertently clotting before the same is mixed with
anti-coagulant; (i) means for detecting and collecting any bubble
which might have formed in the blood before the same is returned to
the donor's body; (j) means for re-heating the blood to the proper
level before the same is re-introduced into the donor's body; (k)
an automatic saline prime diverting arrangement to prevent priming
solution from being returned to the donor's body, except when so
desired; and, (1) visual and audible signal means on the apparatus
to immediately indicate any unsafe condition to the operator.
Other objects, advantages and salient features of the present
invention will become apparent from the following detailed
description, which, taken in conjunction with the annexed drawings,
discloses a preferred embodiment thereof.
The foregoing objects are generally attained by providing an
apparatus or system of the type to be described in detail
hereinafter, which apparatus or system is linked with a donor by
needles inserted into the donor's limbs, as, for example, an output
needle inserted into one of the donor's arms and a return needle
inserted into the other of the donor's arms. Initially, the system
is primed with a saline solution to purge any air therefrom, and
after such priming has been effected, an arm cuff is inflated by
the machine on the donor's arm carrying the output or supply
needle. Simultaneously with expansion of the arm cuff, a first pump
is energized to initiate withdrawal of blood from the patient's
arm, and also simultaneously, a second pump is energized to supply
anti-coagulant which is mixed with the donor's blood. This
anti-coagulated blood is then supplied to a receptacle means, also
known as a buffer bag, and the same becomes gradually filled with
anti-coagulated blood. Once this buffer bag has been filled, a
sensing device automatically shuts off the blood and anti-coagulant
pumps and deflates the arm cuff, thereby temporarily terminating
withdrawal of the blood from the donor's arm and permitting the
donor to rest.
The anti-coagulated blood from the buffer bag is then continuously
fed to a centrifugal separator which operates to separate or
fractionate the blood into its major fractional components, namely,
red cells, white cells, platelets and plasma. A separate output
port is provided for each of these fractional components, except
the white cell port is used to collect platelets, and a separate
pump is linked with each of these ports, whereupon when a selected
pump is energized at a specified rate, the same will draw a
selected fraction of blood through its associated port and will
pull the withdrawn fraction through the pump at the specified
rate.
The red cells exit from the centrifugal separator and pass through
return tubing to the return needle located in a vein in the donor's
other arm. A waste divert arrangement is provided in the return
tubing to selectively exhaust certain products, such as the priming
solution, rather than letting such products return to the donor. A
bubble detector is provided in the return line to detect and
collect any bubbles which might inadvertently have been caused in
the red cell stream. Also, a heater is provided for bringing the
returned red cells back to normal body blood temperature. The
plasma can be recombined with the red cells in advance of the
bubble detector and return heater, and can be returned to the
donor's body with the red cells. Alternatively, the plasma may be
passed to a needle rinse arrangement which feeds the plasma back to
a short length of tubing between the output needle and the junction
where the anti-coagulant is mixed with the blood coming from the
donor's body. This plasma return will prevent any undesired
clotting within the short length of tubing. As an ancillary
feature, the plasma, which usually is rich with platelets when "G"
forces are low, may be passed through a second stage centrifuge
which can separate the platelets from the plasma to permit ultimate
collection of the platelets themselves. Alternatively, concentrated
platelets can be collected at higher "G" forces directly through
the white cell port.
When the level of anti-coagulated blood in the buffer bag drops to
a preselected level, a sensing mechanism automatically re-inflates
the arm cuff and energizes the blood and anti-coagulant pumps to
once again start withdrawal of blood from the donor. Such
withdrawal will again continue until the buffer bag is filled, at
which time, the arm cuff will again be deflated and the blood and
anti-coagulant pumps will again be stopped. The withdrawal from the
donor is thus intermittent, but the feed from the buffer bag to the
centrifugal separator is constant, and likewise, the return flow of
blood to the donor is constant.
Referring now to the drawings:
FIG. 1 is a schematic view of the system of the present
invention;
FIG. 2 is a top plan view of a separator machine embodying the
system of the present invention;
FIG. 3 is a front elevational view of the machine of FIG. 2;
FIG. 4 is a rear elevational view of the machine of FIG. 2;
FIG. 5 is a sectional view of the novel centrifuge means of the
present invention;
FIG. 6 is a top plan view of the filler piece used in the
centrifuge means of the present invention;
FIG. 7 is a top plan view of a rotating seal used in the centrifuge
means of the present invention;
FIG. 8 is a sectional view taken along line 8--8 of FIG. 7;
FIG. 9 is a side elevational view of a stationary seal used in the
centrifuge means of the present invention;
FIG. 10 is a bottom plan view of the stationary seal of FIG. 9;
FIG. 11 is a sectional view taken along line 11--11 of FIG. 10;
FIG. 12 is a top plan view of a typical pump means used in the
present invention;
FIG. 13 is a fragmentary sectional view of the pump means of FIG.
12;
FIG. 14 is a perspective view of one type of pump drive means used
in the present invention;
FIG. 15 is a perspective view of another type of pump drive means
used in the present invention;
FIG. 16 is a side elevational view of a typical valve means used in
the present invention;
FIG. 17 is a sectional view of the novel bubble detector used in
the present invention; and
FIG. 18 is a front elevational view of the novel control panel and
warning light assembly used in the present invention.
Referring now to FIG. 1, which represents a simplified schematic
diagram of the overall system of the present invention, it will be
seen that a donor or patient generally designated 50 is linked
through a series of lines and components with a centrifuge
generally designated 52. The entire objective of the present
invention is to supply whole blood from the donor 50 to the
centrifuge 52 wherein separation will occur due to differences in
rates of sedimentation and density, within a centrifugal field.
Thus, the centrifuge 52 separates the whole blood from the patient
50 into red cells or erythrocytes, white cells or leukocytes,
platelets and plasma. The platelets are drawn out of the centrifuge
52 either with the white cells or with the plasma in the form of
platelet-rich plasma. Certain of these blood fractions, such as the
white cells, can be separately collected from the centrifuge 52,
while the remaining fractions leave the centrifuge 52, are
recombined and are thereafter returned to the donor 50. Thus, the
centrifuge 52 effectively is coupled with and acts as a portion of
the donor's own circulatory system. It may be thus stated that the
present invention relates to an in vivo system having continuous
flow characteristics. The term "continuous flow" will be understood
to be applicable in the present invention even though blood is only
intermittently withdrawn from the donor 50, but is continuously
returned to him. This continuous flow in vivo type of operation
should be recognized as wholly distinct from prior art in vitro
techniques and prior in vivo techniques such as the Conn
Fractionator, wherein a quantity of blood was entirely withdrawn
from a donor's body and separated from the remainder of his
circulatory system, and was thereafter separated or otherwise
processed apart from the donor himself.
While the centrifuge 52 acts as the main fractionating or
separating mechanism of the subject invention, a second centrifuge
54, as shown in dotted lines in FIG. 1, may likewise be provided to
enable the system to be used in two stage procedures wherein
further subdivision or concentration of a particular blood fraction
may be required.
In describing the system of the present invention hereinafter, it
will be understood that the tubing, centrifuge bowls and centrifuge
face seals may be provided as disposable items which can be
discarded after each use of the system. In this manner, the
problems of sterilization are greatly diminished.
Electrocariogram apparatus is installed near the donor 50 to enable
the operator to periodically monitor the donor's heart condition
and to observe the effects of anti-coagulant on the action of the
heart muscle. Appropriate venipunctures are made in the donor's
limbs, and in the most usual instance, an output needle is linked
with one of the donor's arms and a return needle is linked with the
other of his arms. The output point is designated X in FIG. 1,
while the return point is designated Y in FIG. 1. Before the donor
is actually linked with the system of the present invention to
initiate separation of his blood, it is first necessary to prime
the system in order to purge any air therefrom. Such priming is
effectuated through use of an isotonic saline priming solution,
supplied by a source generally designated 56 in FIG. 1. To
understand the nature of the priming operation, it will first be
necessary to generally describe the other major components of the
system of the present invention. The major components include five
separate pumps which provide the force within the system to convey
whole blood, red cells, white cells, plasma and anti-coagulant
through the various lengths of tubing interconnecting the donor 50
with the centrifuge 52. More specifically, these pumps include an
anti-coagulant pump generally designated 58 and normally coupled
with a supply of anti-coagulant generally designated 60, a whole
blood pump generally designated 62 linked between the donor and a
receptacle means or reservoir generally designated 64 having an
inlet 63 and an outlet 65, such reservoir also being referred to as
a buffer bag. Additionally, the system includes a red cell pump
generally designated 66, a white cell pump generally designated 68
and a plasma pump generally designated 70, all of these latter
pumps being connected to outputs of the centrifuge 52.
To initiate the priming operation, the centrifuge 52 is started at
slow speed and the anti-coagulant pump 58 and blood pump 62 are
energized, the latter being set to draw the saline 56 into the
system at a rate of about 100 milliliters per minute. As this
saline priming solution enters the buffer bag 64, the same will
start to fill and when this bag is between one-third and one-half
full, the output pumps 66, 68 and 70 are each started to draw an
output at the rate of 25 to 30 milliliters per minute. Thus, the
saline priming solution will transfer from the buffer bag 64 into
the centrifuge 52 and since the priming fluid has a higher specific
gravity than the air, the same will displace any air within the
centrifuge. That is, the priming fluid will collect on the
outermost portion of the centrifuge walls thereby forcing any air
inwardly toward the center of the centrifuge. The operator
conducting the priming of the system visually observes the output
from the centrifuge to the various output pumps. When he observes
saline in the line leading to the white cell pump 68, this pump is
turned off. When the saline in the line leading to and past the red
cell pump 66 reaches the point designated R, where the plasma
ordinarily recombines with the red cells, the operator then turns
off the red cell pump 66.
The priming solution exiting from the centrifuge through the plasma
line passes the plasma pump 70 and is supplied to a needle rinse
mechanism generally designated 72, which will be described in
further detail hereinafter. This mechanism 72 includes a pair of
oppositely acting valves 74 and 76. That is, when the valve 74 is
open, the valve 76 is closed, and vice versa. As the priming is
being carried out, the mechanism 72 is set for a needle rinse, thus
meaning that the valve 74 is opened and the valve 76 is closed. The
saline priming solution will thus flow through the valve 74 and
upwardly, as indicated by the arrows, toward the output side X of
the donor 50. This operation purges the air from the donor line.
When such purging has been completed, the needle rinse mechanism 72
is shut off, thereby opening the valve 76 and closing the valve 74.
The priming solution will then pass through the valve 76 to the
re-combination point R and will continue through the return line
toward the return side Y of the donor. The priming solution finally
reaches the return point Y of the donor, and when this occurs, the
return line will have been completely purged of air. At this time,
the priming solution can be diverted through a waste divert
assembly generally designated 78 to an exhaust means generally
designated 80.
At this time, the entire system will be filled with priming
solution and all air will be purged therefrom. Accordingly, the
donor 50 can then be linked with the system to enable whole blood
to enter the system. Because the whole blood has a higher specific
gravity than that of the priming fluid, the whole blood introduced
into the system will serve to displace the priming fluid, just as
the priming fluid itself served to displace any air previously
within the system.
As the system is set into normal operation, an intravenous saline
supply 82, linked with the return line, is turned on at a slow
drip. An inflatable arm cuff means generally designated 84,
surrounds the donor's arm near the output point X. A short length
of tubing generally designated 86 extends from the output point X
to a junction J where the anti-coagulant from the supply 60 is
admixed with the whole blood flowing from the donor. The centrifuge
52 is gradually brought up to operating speed, the arm cuff means
84 is expanded, and the anti-coagulant pump 58 and blood pump 60
are started into slow operation. The pumps 58 and 62 are geared
together for synchronous operation, and as these two pumps operate,
blood is drawn from the donor's arm through the length of tubing 86
to mix with the anti-coagulant coming from the supply 60 thereof,
such mixing taking place at the juncture point J. The gearing
arrangement between the pumps 58 and 62, is such that a
predetermined volume ratio of blood to anti-coagulant is
maintained, for example, a 7:1 ratio. The anti-coagulated blood
then flows from the juncture J through a line 88 and to the buffer
bag 64. The speed of the blood pump 62 is slow at first to prevent
occlusion of the donor vein, but this pump gradually increases in
speed up to a maximum flow rate of 100 milliliters per minute. The
volume of the buffer bag means 64 is about 150 milliliters and the
volume of the centrifuge 52 is about 125 milliliters. All of the
various other components, tubing, and other parts of the system
accommodate about 140 milliliters, so that even when the system is
entirely filled with blood, the total quantity of blood outside the
donor's body is only about 415 milliliters. The average 150 lb.
person has about 6,000 milliliters within his circulatory system
while the average 200 lb. person has about 7,600 milliliters within
his circulatory system, so it can be seen that the total quantity
of blood outside the donor's circulatory system at any one time is
rather small. The system of the present invention is purposely
designed in this manner, so that in the event of any power failure,
the donor 50 will not lose any more blood than is normally given
during a conventional blood transfusion.
Level control means to be described in further detail hereinafter,
are associated with the buffer bag 64 to sense when the same is
filled and to further sense when the level therewithin drops to a
specified point. Once the anti-coagulated blood flowing through the
line 88 fills the buffer bag to a predetermined level, the system
automatically deflates the arm cuff means 84 and stops the pumps 58
and 62. This allows the donor 50 to rest while the anti-coagulated
blood from the buffer bag 64 drains into the centrifuge 52.
However, once the pumps 58 and 62 have stopped, there is a danger
that the blood within the tubing 86, between the output point X and
the junction J, will clot, due to the fact that no anti-coagulant
is mixed therein. To prevent clotting from occurring within this
length of tubing 86, the needle rinse mechanism 72 is operated to
open the valve 74 so that priming fluid will pass therethrough and
up to and past the junction J. This priming fluid is used during
the initial operation of the machine to prevent clotting within the
tubing 86; however, after the machine has been in operation for a
few minutes, all of the priming fluid has been exhausted from the
system and the donor's own plasma is utilized for subsequent needle
rinse operation.
When the buffer bag 64 is initially filled with anti-coagulated
blood, the operator must make sure that the pumps 66 and 70 are
turned on. Naturally, the plasma pump 70 has to be utilized to
accomplish the needle rinse operation described immediately
hereinabove. The anti-coagulated blood from the buffer bag drains
by gravity from outlet 65 through a line generally designated 90 to
the centrifuge 52. The whole blood enters the centrifuge 52 through
a seal means and the action of the output pumps 66 and 70 causes
this blood to move into a centrifugal field set up by the rotating
centrifuge. The centrifugal forces within the separator cause the
whole blood to climb along the walls of the centrifuge and to
simultaneously separate into fractions based mainly upon
differences in specific gravities of the various componential
portions of the whole blood. The fraction having the heaviest
specific gravity is the red cells or erythrocytes and this fraction
is the one contained on the outermost wall of the centrifuge 52.
The next heaviest and hence next inwardly displaced fraction is the
white cells or leukocytes, then come the platelets and finally the
innermost or lightest layer is the plasma. The top cover of the
centrifuge 52 is fabricated of transparent material so that the
whole blood separation within the centrifuge 52 can be visually
observed. Such a visual observation of the separation would show
the outermost red cell fraction to be of a dark red color, the
center or middle white cell and/or platelet fraction to be of a
pinkish or white color, commonly called the buffy coat, and the
innermost plasma fraction to be of a yellowish color.
The saline previously contained in the centrifuge 52 is moved out
ahead of the blood being separated and is diverted to the waste
divert mechanism 78. Separate output ports are provided in the
centrifuge 52, one for the red cells, one for the white cells and
one for the plasma. The platelets can be drawn out either through
the white cell port or the plasma port. As the centrifuge is
initially filling, the red cells are allowed to accumulate along
the outer wall thereof by turning off the red cell pump 66, but the
plasma pump 70 remains in operation so that the plasma is
continuously drawn out from the centrifuge 52. When the interface
between the red cell and the plasma reaches the white cell port,
the red cell pump 66 is turned on and the pumps 66 and 68 are
adjusted relative to one another to maintain such interface in
alignment with the white cell port. The return rate of the red
cells and plasma to the donor is about 50 milliliters per minute.
Assuming that no needle rinse is occurring, the plasma will combine
with the red cells at the recombination point R and such recombined
plasma and red cells will then traverse the return line generally
designated 92 toward the waste divert assembly 78.
The waste divert assembly 78 includes a pair of oppositely acting
valves 94 and 96. That is, the valve 94 is open when the valve 96
is closed, and vice versa. When the saline priming fluid is being
exhausted from the system, the valve 94 is closed and the valve 96
is opened, thereby diverting the saline priming fluid through a
line 98 to the exhaust means 80. However, once the priming fluid
has been completely exhausted from the system, the valve 96 is
closed and the valve 94 is opened. Thereafter, the recombined
plasma and red cells traversing the return line 92 will pass
through the valve 94 and continue toward the donor's body.
The recombined flow of plasma and red cells then re-enters the
donor's body at the return point Y, and at this time, the
intravenous drip from the saline supply 82 may be turned off.
Control of the amount of any one fraction being withdrawn from the
centrifuge 52 may be accomplished by varying the settings of the
output pumps 66, 68 and 70. Thus, if one wanted to increase the
amount of plasma in the centrifuge, the speed of the plasma pump 70
would be slowed down while the speed of the red cell pump 66 would
be increased. Conversely, if one wanted to increase the amount of
red cells in the centrifuge, the speed of the red cell pump 66
would be slowed down and the speed of the plasma pump 70 would be
increased. Thus, by properly regulating and correlating the speeds
of the pumps 66 and 70, the relative radial location of the
interface between the plasma and the red cells can be
controlled.
Insofar as the white cells are concerned, the volume of white cells
in normal blood is only about 1 percent of the total. Accordingly,
the white cell layer or buffy coat within the centrifuge builds up
slowly and does not even become noticeable for sometime. Therefore,
when the donor 50 has normal blood, the white cells from the
centrifuge 52 are drawn out only at intervals, such drawing out
occurring by operation of the white cell pump 68. On the other
hand, if the donor 50 has a high white cell count, such as he would
have if he were suffering from chronic lymphocytic leukemia, the
volume of white cells within the blood would be considerably higher
and the same could be drawn out continuously at a slow rate of 2 to
4 milliliters per minute.
It will be recalled that the buffer bag 64 was initially filled
with anti-coagulated blood, and when this blood reached the high
level within the buffer bag, a sensing mechanism automatically
deflated the arm cuff 84 and terminated operation of the pumps 58
and 62. Thereafter, the blood from the buffer bag drained
continuously by gravity through the line 90 to the centrifuge 52.
This drainage of the blood from the buffer bag eventually operates
a first low level signal device which serves to re-inflate the arm
cuff 84, to start the pumps 58 and 62, and to terminate the
operation of the needle rinse mechanism 72. As the pumps 58 and 62
again start to operate, blood will again be drawn from the donor 50
and transferred to the buffer bag 64, and the foregoing cycle will
start again. From this time on, operation of the system will be
completely automatic except in the event that the operator switches
the red cell-plasma pumps into complementary mode. Such mode
adjusts the relative red cell-plasma flow rates to keep the
interface therebetween at a constant radial position within the
centrifuge, such position being just before the white cell port.
Once the buffer bag is again filled to high level, the pumps 58 and
62 will stop, the arm cuff 84 will deflate, and the machine will
again to into needle rinse. It can thus be seen that donations from
the donor 50 into the system are intermittent, in units of
approximately 150 milliliters each. This is done to permit the
donor to rest and to minimize the length of time that the cuff 84
is inflated. On the other hand, the return flow rate to the donor
is about 50 milliliters per minute and is maintained constant.
As was previously mentioned, a sensing mechanism is associated with
the buffer bag 64 to determine when the same reaches a
predetermined high or low level. To further understand this sensing
mechanism, it will be seen from FIG. 1 that the buffer bag 64 is
supported from one end of a beam balance arm means generally
designated 100, such beam balance arm means being supported upon a
pivot point 102. A suitable weight in the form of a brass block 104
is supported from the opposite end of the beam balance arm to serve
as a counterbalance against the weight of the buffer bag. Giving
due consideration to the weight of the beam balance arm itself, it
will be appreciated that variations in the amount of fluid within
the buffer bag 64 will cause the beam balance arm to pivot, in one
direction or the other, about the pivot point 102.
Three different sensing means are associated with the beam balance
arm 100 for causing various machine operations in response to
different buffer bag weights. The first of these sensing mechanisms
is a microswitch 106 which acts as the buffer bag high limit switch
and which is actuated when the weight of the buffer bag plus the
fluid contained therein is approximately 280 grams. Actuating of
the switch 106 stops the blood or input pump 62 and simultaneously
initiates a needle rinse cycle. This needle rinse cycle continues
until the next lower microswitch, designated 108 and generally
called the refill buffer switch, is actuated. As the fluid flows
out of the buffer bag through the line 90 to the centrifuge 52, the
weight of the buffer bag gradually decreases, and when this weight
drops to about 60 grams, the switch 108 is actuated. Actuation of
the switch 108 turns off the needle rinse cycle and starts the
input or blood pump 62 and its coupled anti-coagulant pump 58.
Since it takes about 12 seconds for the input pump 62 to accelerate
to its normal speed, and since the output pumps 66, 68 and 70 are
operating, there must be a sufficient quantity of fluid remaining
in the buffer bag to supply these output pumps so that the buffer
bag will not become completely depleted before the new
anti-coagulated blood supply is furnished thereto. Actuation of the
switch 108 also sounds an audible chime device to indicate to the
donor and the operator that blood is again being pumped from the
donor's body. Finally, the lowest of the switch devices is a
microswitch generally designated 110, which is called the buffer
low switch. This switch is actuated when the level of the fluid
within the buffer bag 64 drops to such a degree that the weight of
the buffer bag and fluid is only 30 grams. This condition could
occur if the input or blood pump 62 is accelerating at too low a
rate for the flow rate of the output pumps. When the switch 110 is
actuated, the same acts as a safety device to automatically stop
the output pumps 66, 68 and 70 until the quantity of
anti-coagulated blood in the buffer bag has had a chance to build
up to a proper level. When this occurs, the output pumps are again
started automatically. Actuation of the switch 110 will also cause
a buzzer to sound and a low limit light to flash on and off, such
flashing and buzzing continuing until a safe fluid level is reached
within the buffer bag. Switches 106, 108, and 110 are shown in FIG.
1 as being operatively connected to AC pump 58 and blood pump 62
through connecting means 107 and 109.
To give a further understanding of the system as shown in FIG. 1,
it will be seen that level sensing means 112 are associated with
each of the IV or intravenous bottles. Specifically, these bottles
are the priming saline source 56, the anti-coagulant source 60 and
the intravenous saline drip source 82. Each of the sensing means
112 uses microswitches to perform two functions, namely, a warning
function and a stop function. The warning function serves to
indicate that a particular IV bottle is running low and that a
fresh bottle should be used to replace the same. Since these
bottles drain very slowly, there is ample time for the operator to
replace a partially empty bottle with a new or fresh bottle. The IV
bottle warning signal will operate only when the buffer bag beam
balance arm is in a high limit condition since, at this time, the
buffer bag is full and the anti-coagulant pump 58 and blood pump 62
are turned off. This condition will be sensed when the weight of an
IV bottle is 120 milliliters, plus or minus 20 percent, and at this
time, a buzzer will sound continuously until the low IV bottle is
replaced by a new bottle. Also, a flashing light on the console
will indicate that the IV bottle is low. However, in the event that
the warning buzzer and the IV bottle low light are ignored, then
eventually one IV bottle supply will become depleted, and when this
occurs, the sensor 112 must perform the stop function. This stop
function is reached when the quantity of fluid remaining in an IV
bottle is 60 milliliters, plus or minus 20 percent. At this minimum
level, a further switch in the sensor unit 112 will transmit a
signal to the buffer high limit switch 106, thereby stopping the
anti-coagulant pump 58 and blood pump 62 and simultaneously
initiating a needle rinse cycle. The warning buzzer and IV bottle
low light still continue to operate to indicate the condition to
the operator. If the operator should push the reset switch, this
will momentarily start the input pump 62 operating, but immediately
upon release of such switch, this pump will again stop. In any
event, operation of the reset switch does not silence the buzzer or
stop the indicating light from flashing. It will be understood and
appreciated that if this condition continues for any length of
time, the quantity of fluid in the buffer bag will gradually lower
and the buffer bag beam balance arm will attempt to actuate the
buffer refill switch 108. However, the sensor switch 112 will
override this refill switch and will prevent the blood pump 62 from
being started to refill the buffer bag. Finally, the buffer bag
will reach its low level at which time the switch 110 will be
operated to stop the output pumps. At this time, all of the machine
pumps and hence all blood flow will be stopped but the audible and
visible signal means will continue to operate to indicate the
dangerous condition of the machine. Of course, the prime reason for
arranging the system so that the IV stop function overrides the
refill function, is to prevent the machine from operating if the
supply of anti-coagulant 60 becomes exhausted. The donor's blood
cannot be run through the machine without first being
anti-coagulated since this would create a condition wherein the
blood would readily clot.
To complete the description of the schematic diagram shown in FIG.
1, it will be seen that a vacuum pump means 114 is coupled to the
casing of the centrifuges 52 and 54. This vacuum pump means serves
to drain any fluid spill-over into the centrifuge casings.
Insofar as the output from the centrifuge 52 is concerned, it will
be seen that the red cells pass through the line 92 and are
returned to the donor 50. The plasma passes through the needle
rinse assembly 72 and is either used to perform a needle rinse
function, or alternatively, is recombined with the red cells for a
return to the donor. The white cells pumped from the centrifuge 52
go to a collection means generally designated 116.
Insofar as the second centrifuge 54 is concerned, it was previously
mentioned that this centrifuge could be used to further refine a
particular fraction of blood from the centrifuge 52. For instance,
the platelets may be removed from the centrifuge 52 along with the
plasma in the form of platelet-rich plasma. If it was desired to
separate the platelets from the plasma, the same could be passed
through the second centrifuge 54 with the platelets being supplied
to a collection means 118 and the plasma being returned to the line
flowing to the needle rinse assembly. Alternatively, if the
platelets were removed with the white cells, such a combination
fraction could again be passed through the second stage centrifuge
54 to separate the platelets from the white cells. Finally, it is
possible to use the second stage centrifuge 54 to process other
components. For example, it can be used to remove cryogenic
proteins previously precipitated by chilling the plasma as it
passes from the first stage centrifuge to the second stage
centrifuge.
Finally, associated with the output tubing 86, there is an occluded
vein sensor generally designated 120, which can be of any suitable
type for sensing collapse of a vein. In the return line or tubing
92, there is a bubble detector unit generally designated 122, and a
return heater generally designated 124, each of which will also be
described further hereinafter.
Considering now the more detailed aspects of the present invention,
FIGS. 2, 3 and 4, respectively, illustrate top, front and rear
elevational views of the in vivo blood separator machine, the same
being generally 150. A control console generally designated 152 is
mounted on the top or upper surface 154 of the machine, and the
details of this console will be described more fully hereinafter.
The machine includes a main framework, generally designated 156,
which is supported on wheels or casters 158 to enable ready
transport of the machine. A bottom mounting plate extends across
the bottom of the frame means 156 for mounting some of the
components of the machine 150, others of such components being
supported by the upper or top surface 154 or by an intermediate
supporting plate member 160. An examination of FIGS. 2, 3 and 4
will show the general location of the centrifuge means 52, and 54,
of the various pump means, of the waste divert assembly, and the
needle rinse assembly, and of the various driving or operating
means for each of these portions of the machine. The details of
such driving means will be described further hereinafter.
To understand the specific nature of the centrifuge assembly 52,
attention is directed to FIG. 5 wherein the details of the same are
shown. The centrifuge includes a casing 162 mounted beneath an
opening in the top 154 of the machine. Such casing includes an
enlarged central bottom hole or aperture 164 for receiving a
driving plate 166 mounted on a shaft 168 of a 110 volt direct
current shunt wound drive motor 170. The casing 162 also includes
at least one drain hole 172 radially displaced from the central
aperture 164, with the purpose of the drain hole being to couple
the interior of the casing 162 with the vacuum pump means 114. As
such, the vacuum pump will serve to draw off any fluid spill-over
interiorly of the casing. A drive belt 174 extends between the
motor drive shaft 168 and a motor tachometer generator unit 176. A
motor control unit senses any back EMF generated by the armature of
the centrifuge drive motor 170 and compares the same with the
setting of the motor speed control potentiometer. Any speed
variation of the drive motor 170 caused by an increase or decrease
in the load thereupon will cause a corresponding increase or
decrease in back EMF which will be sensed and corrected for by the
control unit.
The centrifuge also includes a bowl or shell generally designated
178 which is disposed within the casing 162. The shell 178 has an
upstanding cylindrical side wall means 180 which terminates in an
outwardly directed flange 182. The bottom wall 184 of the shell is
provided with an alternating rib and groove assembly 186, which
cooperates with a similar assembly 188 on the driving plate 166. In
this manner, operation of the drive motor 170 will impart a
rotation to the driving plate 166, and this rotation will in turn
be imparted to the centrifuge shell 178 to rotate the same.
Rotational speeds of the centrifuge range from 0 to 2,500 rpm plus
or minus 10 percent. Rotational speeds within this range will cause
gravitational forces from 0 to 560 G, plus or minus 20 percent, at
the outermost separation surfaces.
The interior of the side walls 180 of the centrifuge shell 178
serve to provide the outer boundary for the separation channel.
Starting at the top of the centrifuge shell, a wall portion 190
extends linearly downwardly for a predetermined distance, then
merges smoothly into an inwardly and downwardly inclined wall
portion 192 which in turn merges into another linearly extending
wall portion 194. This wall portion 194 extends downwardly until
the same intersects the inner surface 196 of the bottom wall
184.
Another portion of the centrifuge assembly 52 is the center or
filler piece generally designated 200. This filler piece is
suitably suspended from the top cover of the centrifuge assembly,
in a manner which will be described hereinafter. A central bore 202
extends completely from the upper surface of the filler piece to
the bottom surface 204 thereof. This bore 202 provides the input
channel to the centrifuge. The filler piece itself is cylindrically
shaped and of a somewhat smaller diameter than that of the shell
wall portion 194. As such, the outer or side wall 206 of the filler
piece is spaced slightly away from the wall portion 194 to thereby
provide the other boundary of the separation channel. This channel
itself is designated 208 and extends with uniform thickness
substantially for the height of the shell wall portion 194.
Substantially opposite to the inclined portion 192 of the
centrifuge shell, the side wall 206 of the filler piece is radially
curved, as shown at 210. This curve merges into an inwardly
extending shoulder portion 212 which again turns into an upwardly
extending portion at 214 to blend into the top surface 216.
By referring to FIG. 6, as well as FIG. 5, it will be seen that a
central recess is provided in the top wall 216 of the filler piece
200, and an O-ring 218 of substantially rectangular cross-sectional
configuration is disposed within a groove about the periphery of
this recess portion. Four equally spaced tapped holes 220 are
provided in the upper surface 216 of the filler piece for the
purpose of receiving screws which couple the filler piece to the
top cover of the centrifuge assembly. O-rings 222 having a
rectangular cross-sectional configuration similar to that of the
O-ring 218 are seated within grooves surrounding each of these
tapped holes 220. Radially extending channels or passages 224 are
provided at 90.degree. intervals along the top surface 216 of the
filler piece, with each of these channels extending between the
wall surface 214 and the side wall surface of the O-ring 218. These
grooves or channels 224 serve as plasma ports as will be described
more fully hereinafter.
Referring back to FIG. 5, it will be seen that the centrifuge
assembly also includes a top cover means generally designated 226,
such cover means being fabricated of a clear polycarbonate plastic
material which permits visual observation of the separation
occurring within the centrifuge. The top cover includes a flange
portion 228 which abuts against the top of the flange portion 182
of the centrifuge shell. A sealing O-ring 230 is interposed between
the two flange portions to prevent any leakage. Also, aligned
apertures are formed through the flanges 182 and 228 to permit
reception of a nut and bolt fastening means 232 which couples the
cover to the shell. A short vertical wall portion 234 extends
downwardly from the top cover to mate contiguously with the wall
portion 190 of the centrifuge shell, thereby properly positioning
the cover on the shell. At the end of the vertical wall portion
234, there is a horizontal or radially inwardly stepped portion 236
which merges with the top of another short vertical wall portion
238. At the bottom of the wall portion 238, there is another
radially inwardly stepped portion 240 which merges with the top of
a further vertical wall portion 242. The bottom of this vertical
wall portion 242 merges with the bottom surface 244 of the top
cover. This surface 244 rests upon the top surface 216 of the
filler piece 200. A small central boss 246 depends beneath the
bottom wall 244 to rest in the recess formed in the central top of
the filler piece.
Four holes 248 are formed through the top cover means 226, with
such holes being spaced 90 degrees from one another. Thus, these
holes 248 align with the holes 220 formed in the top of the filler
piece. Screws 250 extend through the holes 248 and into the holes
220 to thereby securely attach the filler piece to the cover. As
can be seen from FIG. 5, when the filler piece is attached in this
manner, the bottom surface 204 thereof is spaced slightly away from
the bottom inner surface 196 of the centrifuge shell. Hence, a
small space is provided so that the whole blood flowing into the
centrifuge through the bore 202 can spread outwardly to the
separation channel 208 and can then climb upwardly therealong as
the centrifuge is operated.
A seal means generally designated 252 forms the upper part of the
centrifuge means 52, as can be seen in FIG. 5. Such seal means
includes a lower rotating seal means generally designated 254 and
an upper stationary seal means generally designated 256. The lower
or rotating seal means 254 fits within a first stepped recess 258
on the top of the top cover means 226. A second stepped recess 260
is also provided in the top cover means, with the stepped portion
260 being somewhat smaller than the stepped portion 258. A central
bore 262 extends completely through the top cover means at the
center thereof, with such bore extending from the stepped portion
260 to the bottom projection 246. As can be seen, the bore 262 in
the top cover is coaxial with the central bore 202 of the filler
piece 200.
The stepped portion 260 in the top cover contains a plurality of
spaced grooves concentrically arranged about the central bore 262
thereof. An O-ring having a rectangular cross-sectional
configuration is mounted within each of these grooves. All of such
O-rings can be designated 264, but it will be appreciated that the
size or diameter of such O-rings continuously increases. Since the
bottom of the lower seal means 254 abuts against the top of the
various O-rings 264, the overall effect of such an arrangement is
to set off a series of channels or annular spaces between the
stepped portions 260 and the bottom of the seal means 254. The
smaller or innermost O-ring 264 defines therewithin a circular
opening designated 266, with such opening being axially aligned
with the central bore 262. Between this innermost O-ring and the
next adjacent O-ring, a first annular channel 268 is formed.
Between the second O-ring and the next adjacent O-ring, a second
annular channel 270 is formed. Finally, between said next adjacent
O-ring and the outermost O-ring, a third or outer annular channel
272 is formed. Each of the annular channels 268, 270 and 272 serves
to receive a separate fraction of the blood separated in the
centrifuge means 52.
To more fully understand the nature of the separation or
fractionation which occurs within the centrifuge means 52, it can
be seen from FIG. 5 that the separation channel 208 having an
optimum radial dimension of 1 millimeter, extends upwardly with
uniform thickness until it reaches the inclined wall portion 192 of
the centrifugal shell. At this point, the separation channel 208
merges into an enlarged separation space or chamber 274. When whole
blood enters the centrifuge means 52, it travels downwardly through
the central bore 202, then outwardly in the space between the
bottom 204 of the filler piece and the bottom surface 196 of the
shell. Then, such outwardly extending whole blood turns upwardly
and climbs through the separation channel 208 to enter the space
274. Such climbing action is created by the centrifugal force
generated by rotation of the centrifuge shell, filler piece and top
cover. Due to this centrifugal force, the whole blood in the space
274 starts to separate due to differences in specific gravities of
the various fractions thereof. The red cells are the heaviest of
the fractions, and these are thus outermost within the space 274.
The white cells are the next heaviest and these are thus positioned
adjacent the red cells, and the plasma is the lightest and hence is
disposed furthest inwardly within the centrifuge. For purposes of
illustration, blood is shown in the space 274 of the centrifuge
assembly in FIG. 5, with the red cells being designated R, the
white cells being designated W, and the plasma being designated P.
As was previously mentioned, the quantity of white cells in the
blood is extremely small, and accordingly, as separation initially
starts, there is merely an interface line between the plasma P and
the red cells R. As was also previously mentioned, proper
regulation of the output pumps can adjust the position of this
plasma-red cell interface line to space the same closer to the
shell wall 190 or further away therefrom. However, after the blood
has been separating for a while, the white cells W start to build
up within the centrifuge to form a buffy coat of the shape
generally illustrated in FIG. 5. It will be seen that the white
cell layer effectively "floats" on the red cells and plasma. Then,
each of these individual fractions is transferred to its own
particular annular channel in the top cover.
To transfer the red cells, a red cell port 276 extends from the
wall portion 238 of the cover to the first annular channel 268.
Hence, as the red cell output pump 66 is operated, providing a pull
through the seal means 252 in a manner to be presently described,
the red cells from the layer R are drawn through the port 276 and
into the annular channel 268. The white cell port 278 extends from
the portion 242 of the top cover to the annular channel 270. Thus,
as the white cell output pump 68 is operated through the seal means
252, the white cells W are drawn through the port 278 to the
annular channel 270. Finally, as was previously mentioned, the
plasma port 224 extends through the top surface 216 of the filler
piece 200. These ports communicate with bores 280 which in turn
communicate with the annular channel 272. Thus, as the plasma
output pump 70 is operated through the seal means 252, the plasma P
is drawn through the ports 224, and the bores 280 to enter the
outermost annular channel 272.
To now understand the nature and construction of the seal means
252, attention is directed to FIGS. 7 through 11 which show the
individual seal means 254 and 256 in detail. The rotating seal
means 254 is formed of a synthetic resin and includes a circular
base portion 300 having a flat bottom surface 302. The size of the
base portion 300 corresponds substantially to the size of the
stepped portion 258 in the top cover 226 and when the rotating seal
254 is positioned within the top cover, the bottom surface 302
thereof abuts against the top of the O-rings 264. To prevent
rotation of the seal means 254 relatively to the top cover 226, a
small notch 304 is provided in the periphery of the base 300. This
notch 304 mates with a guide pin 306 positioned at one edge of the
stepped recess 258 in the top cover. The seal means 254 also
includes an upstanding cylindrical body portion 308 integral with
the base portion 300, but having a cross-sectional diameter
somewhat smaller than that of the base 300. The top surface 310 of
the portion 308 is divided into a series of concentrically arranged
grooves and channels. At the center of the piece, a central bore
goes straight through the seal means 254. Then, annular channels
are concentrically arranged about the central bore 322, with such
channels, in order of increasing diameter, being designated 314,
316, 318 and 320. The central bore 322 extends from the top surface
310 to the recess or opening 266, and when the seal piece 254 is
properly positioned in the top cover, the bore 322 is coaxial with
the bores 262 and 202. The channel 314 is of substantially the same
diameter as the previously described red cell channel 268 and eight
small bores 324 communicate therebetween, thereby assuring that the
red cells can be transferred from the channel 268 to the channel
314. The channel 316 is of substantially the same diameter as the
white cell channel 270 and communicates therewith through four
equally spaced bores 326. Thus, the white cells from the channel
270 can be transferred through the bores 326 to the channel 316.
The channel 318 is of substantially the same diameter as the
previously described plasma channel 272 and communicates therewith
through four spaced bores 328. Hence, the plasma can be transferred
from the channel 272 through the bores 328 to the channel 318. The
outermost channel 320 has no bores extending therefrom through the
means 254, and instead, in a manner to be presently described, this
outer channel 320 is filled with a saline solution to act as a
barrier between air and the nearest internal blood passage.
As will be seen, there is a series of small annular lands which act
as boundaries separating each of the channels 314, 316, 318 and
320. Each of these lands has a flat top defined by the top surface
310 of the seal means 254.
By referring to FIGS. 9-11, the exact nature of the upper or
stationary seal means 256 can be understood. This seal means is
fabricated of stainless steel and is essentially formed as a flat
disc 340 having a flat lower surface 342 which is lapped to a
flatness of three light waves or less, and a spaced parallel flat
upper surface 344. The lower surface 342 rests upon the upper
surface 310 of the seal means 254, which upper surface is also
lapped to a flatness of three light waves or less. Concentrically
arranged annular channels 348, 350, 352 and 354 are designed to
mate respectively with the annular channels 314, 316, 318 and 320,
of the seal piece 254. Hence, the channel 348 in cooperation with
the channel 314 serves to define the red cell annulus. Similarly,
the annular channel 350 in cooperation with the annular channel 316
serves to define the white cell annulus. Similarly, the annular
channel 352 in cooperation with the annular channel 318, serves to
define the plasma annulus. Finally, the annular channel 354 in
cooperation with the annular channel 320, serves to define the
saline seal annulus. A central bore 356 extends through the member
340 with such bore being coaxial with the bore 322 in the companion
seal means. A bore 360 extends through the member 340 from the
annular channel 350 to allow the white cells to be pumped out. A
bore 362 extends through the member 340 from the annular channel
352 to allow the plasma to be pumped out. A bore 364 extends
through the member 340 from the annular channel 354 to allow saline
to be pumped in.
Each of the various bores extending through the member 340
terminates at the upper surface 344 in communication with small
tube means generally designated 372. These tubes, in turn, are
coupled with the tubing harness to receive the plastic tubing from
the machine.
In use, with the stationary seal means 256 juxtaposed to the
rotating seal means 254, saline is pumped inwardly through the port
364. In the outermost annulus, this saline acts as a seal to
prevent any air from working its way inwardly and also acts as a
barrier between air and the nearest blood passage. A pair of small
holes 374 are provided on opposite sides of the top surface 344 of
the stationary seal means 256. The purpose of these holes 374 is to
receive guide pins which maintain the seal piece in a stationary,
non-rotating manner, while at the same time, applying adequate
downward pressure thereto. By referring back to FIGS. 2 and 3, it
will be seen that an arm means 380 overlies each of the centrifuge
means 52 and 54. The outermost end of the arm means is pivotally
mounted at 382 to permit the arm 380 to be raised and lowered. Two
small guide pins 384 depend from the inner end of the arm 380 where
the same overlies the centrifuge means, with these pins 384 fitting
into the holes 374 in the stationary seal means 256. A screw knob
386 is removably threaded upon a stud, not shown, which extends
upwardly from the top 154 of the machine and through a slot in each
arm 380. Thus, when the threaded knob 386 is removed, the arm 380
can be swung upwardly to permit the centrifuge assembly to be
removed from or introduced into its casing 162. Once the entire
centrifuge assembly has been properly positioned within its casing,
the arm 380 is swung downwardly and the positioning pins 384 are
located in the guide holes 374 thereby maintaining the seal piece
in a stationary, non-rotating manner. Then, the threaded knob 386
is applied to its mounting stud and is tightened down, thereby
causing the arm to apply a pressure against the seal means, such
pressure being effective to maintain proper contact at the seal
means 252.
With the foregoing explanation in mind, it might be well to
summarize the operation of the centrifuge means 52. Assuming that
all of the parts are properly positioned, as shown in FIG. 5, and
further assuming that the machine tubing harness is coupled to the
tubes 372, and that the arm 380 is properly tightened down, the
drive motor 170 can be set into operation to cause a rotation of
the centrifuge, and the whole blood can then be introduced
thereinto from the buffer bag. Such whole blood enters through the
central bore 356 in the stationary seal means, traverses the
aligned central bore 322 in the rotating seal means, then traverses
the central bore 262 in the top cover, and finally traverses the
central bore 202 in the filler piece. The whole blood then spreads
out along the bottom of the centrifuge and climbs along the walls
thereof through the separation channel 208, finally entering the
space 274. As separation is occurring within the centrifuge, saline
is being pumped into the grooves and the outermost channel of the
seal means. Operation of the red cell pump 66 will cause the red
cells R from the space 274 to be withdrawn through the port 276,
into the channel 268, through the bores 324, into the annular
channels 314 and 348, through the outlet port 358 and its
associated tubing and eventually through the pump. Similarly,
operation of the white cell pump 68 will cause the white cells W
from the space 274 in the centrifuge to be withdrawn through the
white cell port 278, into the annular channel 270, then through the
bores 326 in the rotating seal, into the annular channels 316 and
350 between the seals, then through the outlet port 360 in the
stationary seal, through its associated tube 372, and finally
through the white cell pump itself. Finally, operation of the
plasma pump 70 will cause the plasma P from the space 274 to be
withdrawn through the plasma ports 224, then through the bores 280
in the top cover and into the annular channel 272, thereafter
traveling through the ports 328 in the lower or rotating seal into
the annular channels 318 and 352 between the seals, then through
the outlet port 362 in the stationary seal, through its associated
tube 372 and finally through the plasma pump itself. Variations in
the speed at which the pumps 66, 68 and 70 are driven will
naturally vary the rates at which the separate fractions are
withdrawn from the centrifuge.
Considering now the various pumps utilized in the machine 150,
attention is directed to FIGS. 12 and 13, wherein a typical pump is
illustrated. All of the five pumps in the machine 150 are of the
peristaltic type having a rotating portion which progressively
occludes the plastic tubing passing through the pump. The input or
blood pump 62 is illustrated in FIG. 12 merely as a typical pump
construction. All of the other pumps except the white cell pump 68
are similar to the pump shown in FIG. 12. The pump includes an
upstanding outer casing or sleeve designated 400, such sleeve
having a circular inner race 402. An inlet opening 404 and an
outlet opening 406 are spaced apart along the sleeve 400 to permit
the plastic tubing carrying the blood or other fluid to be pumped
to be inserted within the pump. Insertion of such tubing within the
pump is facilitated by the construction of the pump cap generally
designated 408, and as can best be seen in FIG. II. This pump cap
408 includes a flange having a small groove 410 therein and the
tubing to be introduced into the pump is placed within such groove
410. Then, as the cap 408 is rotated, either automatically or
manually, the tubing is effectively "threaded" into the interior of
the pump to follow the contour of the race 402, except for that
small portion thereof between the openings 404 and 406.
The pump is operated by a pump motor and drive means of a type to
be presently described, and operation of such motor and drive means
serves to rotate a driving disc 412 located within the sleeve 400,
as can be seen in FIGS. 12 and 13. A pair of rollers 414 are
rotatably mounted on the top of such disc 412, with the rollers
being spaced 180 degrees apart. The periphery of the rollers 414
extends slightly beyond the edge of the driving disc 412 but is
spaced away from the inner race 402 of the pump by a distance
substantially equal to twice the wall thickness of the tubing to be
passed through the pump. Thus, as the driving disc 412 rotates, it
causes a simultaneous rotation of the rollers 414, with these
rollers serving to collapse or occlude the plastic tubing between
the outer periphery of the rollers and the sleeve race 402. The
progressive rotation of the rollers 414 serves to progressively
occlude the tubing, thereby conveying or advancing any fluid
contained therewithin.
In order to properly position the tubing within the pump housing or
sleeve 400, tubing guide means are provided. Such guide means
includes a flat plastic butterfly disc 416 which rests upon the
driving plate 412 and extends therebeyond substantially to the
inner race 402. A top or overlying butterfly plate 418 is provided
with a peripheral notch 420, as shown in FIG. 13, within which the
tubing, designated T in FIG. 13, can be positioned. A pair of
spaced holes 422 extend through the guide pieces 416, 418 and
terminate in aligned threaded holes in the driving plate 412.
Similarly, spaced holes are provided in the cap 408 and thus
through the use of a pair of elongated screws, the cap 408 and the
tubing guide means 416 and 418 can be coupled to the driving plate
412 for simultaneous rotation therewith.
To understand the manner in which the various pumps of the present
invention are driven, attention is directed to FIGS. 14 and 15
hereof. The driving motors for the pumps of the present invention
are 110 volt direct current shunt wound gear head motors. Each of
the output pumps 66, 68 and 70 is driven by its own individual
motor, and the drive means for these output pumps is shown in FIG.
14. On the other hand, a single motor drives both the
anti-coagulant pump 58 and the whole blood input pump 62, and this
driving arrangement is shown in FIG. 15.
Referring to FIG. 14, the output pump drive arrangement includes an
electric driving motor 430 having an outboard shaft 432 at one end
thereof and a coupled gear head or gear drive arrangement 434 at
the opposite end thereof. The gear head, when operated by the drive
motor 430, serves to rotate an upstanding shaft 436 which in turn,
mounts a drive pulley 438. The drive pulley 438 operates a driving
belt 440 which is coupled to another pulley 442 on the depending
shaft 444 of an electric clutch mechanism 446. When the machine
power is on, the electric clutch 446 is energized to prevent the
pumps from being manually operated. The electric clutch mechanism
446, in turn, is coupled by a shaft coupling means 448, to the
driving disc 412 of any of the output pumps. For purposes of
illustration, the plasma pump 70 has been illustrated in FIG.
14.
At the forward end of the drive motor 430, an elongated bracket 450
is provided, such bracket serving to support a tachgenerator 452
having a forwardly extending shaft 454. A first drive pulley 456 is
mounted on the motor shaft 432 and a superposed pulley 458 is
mounted on the tachgenerator shaft 454. A driving belt 460 extends
between these pulleys whereupon operation of the drive motor 430
causes a simultaneous operation of the tachgenerator 452. For the
red cell and plasma pumps, the bracket 450 is in upstanding
relationship, as shown in FIG. 14. However, for the white cell
pump, the bracket 450 depends downwardly and the tachgenerator 452
is mounted beneath the drive motor 430, as shown in FIG. 3.
The various tachgenerators 452 are utilized to convert the rpm of
the drive motor 430 into a related output on the unit console 152.
Each tachgenerator 452 is a permanent magnet generator which
delivers 3.8 volts for each 100 revolutions per minute of the drive
motor 430. The output of each individual tachgenerator is fed to a
meter calibration circuit which consists of a voltage dropping
resistor and a calibration potentiometer to match the output of the
tachgenerator at a given speed to the dial calibration of an
individual meter on the console 152.
Referring now to FIG. 15, which shows the drive arrangement for the
anti-coagulant pump 58 and the blood pump 62, it will be seen that
the drive motor, its attached gear head, the bracket and the
tachgenerator are all identical to that just described in
connection with FIG. 14. However, on the gear drive shaft 436, an
enlarged driving pulley 470 is provided, and on the depending shaft
444 from the clutch mechanism 446 for the whole blood pump 62, a
small upper pulley 472 and a small lower pulley 474 are provided. A
driving belt 476 couples the pulley 470 with the uppermost pulley
472. Another driving belt 478 extends from the lowermost pulley 474
to an enlarged idler pulley 480. The idler pulley 480 carries a
connected smaller pulley 482 which is connected by a driving belt
484 to an enlarged pulley 486 on the shaft 444 from the clutch
mechanism for the anti-coagulant pump 58. The purpose of this type
of drive arrangement becomes apparent when it is remembered that
the driving motor shown in FIG. 15 operates both the whole blood
pump 62 and the anti-coagulant pump 58, but that the anti-coagulant
pump is to operate at only a fraction of the speed of the whole
blood pump. When using the anti-coagulant solution commonly used in
the machine, namely ACD, an acid-citrate-dextrose solution, the
ratio of the whole blood to anti-coagulant is 7:1. This 7:1
reduction in the speed of the blood pump is accomplished through
the use of the idler pulley 480 which reduces the speed of the
blood pump shaft by a factor of 7. This reduced speed is then
transmitted to the anti-coagulant pump shaft.
All of the driving mechanisms for the pumps is located on the
mounting plate 160 within the machine, as can best be seen from
FIGS. 3 and 4. To complete the description of the various pumps and
their driving means, the motor 430 driving the blood pump 62 also
drives a cam which strikes a microswitch for every 0.7 revolutions
of the input pump. This generates an impulse which initiates an
advance in the total milliliter input counter on the console 152.
Each count on the counter represents an inflow of 1 milliliter. An
acceleration control device to be described presently controls the
operation of the whole blood pump 62. This pump always starts at 0
revolutions per minute and gradually builds up to a preselected
speed. The speed of the input pump varies between 0 and 255
milliliters per minute, plus or minus 10 percent. The red cell,
plasma and white cell pumps all operate between 0 and 100
milliliters per minute, plus or minus 10 percent. The plastic
tubing utilized in all of the pumps has a basic size of 0.25 inches
outside diameter and 0.125 inches inside diameter. However,
provision is made to substitute various diameters of rollers 414 to
permit the optional use of tubing of various diameters and wall
thicknesses.
As was previously described, the needle rinse assembly 72 includes
a pair of valves 74 and 76. Similarly, the waste divert assembly
includes a pair of valves 94 and 96. For an understanding of the
construction of such valves, attention is directed to FIG. 16
wherein a typical valve is illustrated. All of the valves used in
the machine 150 are of the solenoid type, that is, electrically
operated valves including a solenoid core designated 500. The core
carries a projection 502 having an aperture extending centrally
therethrough, through which the solenoid core or plunger 504
passes. A head 506 is provided on the end of the solenoid plunger
and as the plunger is drawn into the core, the bottom of the head
506 abuts against the top of the projection 502. The projection 502
includes an elongated slot 508 communicating with the bore through
which the plunger 504 passes. A first pin 510 is attached to the
projection 502 at one end of the slot 508. A second pin 512 is
attached to the plunger 504 and extends through the slot 508 in
parallel relation with the fixed pin 510. The plastic tubing
utilized in the machine 150 passes between the pins 510 and 512,
and when the valve is in closed position, as shown in solid lines
in FIG. 16, the pins 510 and 512 serve to pinch closed the tubing
passing therebetween, thereby preventing flow through such tubing.
On the other hand, when the valve is moved to opened position, as
shown in dotted lines in FIG. 16, the movable pin 512 is moved to
the opposite end of the slot 508 and the tubing is therefore not
collapsed or pinched. Accordingly, flow through such tubing can be
accomplished.
In practice, one of the valves of each assembly is normally opened
while the other valve thereof is normally closed. For example, in
the needle rinse assembly 72, the valve 74 is normally closed and
the valve 76 is normally opened. Similarly, in the waste divert
assembly 78, the valve 94 is normally opened and the valve 96 is
normally closed. However, when the machine goes into a needle rinse
cycle, the positions of the valves in the assembly 72 are reversed,
and at that time, the valve 74 is opened and the valve 76 is
closed. Similarly, if the machine goes into a waste divert cycle,
the valve 96 is opened and the valve 94 is closed.
Continuing with the description of the machine 150, attention is
directed to FIG. 3, wherein the vacuum pump means 114 can be seen
mounted on the bottom of the machine frame 156. Two vacuum pumps
are provided, with one being attached to the centrifuge casing bore
172 of the centrifuge means 52, and the other being attached to the
same casing bore for the centrifuge means 54. Each vacuum pump
consists of a hysteresis disc motor 540 which drives a miniature
suction pump 542. These motors are under control of the main
machine power switch and thus run continuously as soon as the power
to the machine is turned on.
Also mounted on the bottom of the machine frame 156, as can be seen
in FIGS. 3 and 4, is an acceleration control device generally
designated 546. This device is intended to control the acceleration
of the input or blood pump 62. The acceleration control device 546
includes a 4 rpm two-phase synchronous reversible motor 548, a
powerstat unit 550, an associated power transfer relay and
associated limit switches. The powerstat is mechanically connected
to the motor and controls the amount of 115 volt AC power being
supplied to the input pump variable control on the control panel or
console 152. When the buffer bag drains to a point where the refill
buffer switch 108 is actuated, a signal will be transmitted to the
motor 548 thereby causing the same to drive the powerstat in a
forward direction which increases the voltage to the input pump
variable control. The length of time needed to increase the
powerstat 550 from 0 to 115 volts AC, as applied to the variable
control means on the console 152, is about 12 seconds. At the
expiration of this 12 second time, the power transfer relay of the
device 546 transfers the full 115 volts AC to the control panel
input pump variable control.
As was also mentioned, the acceleration control device 546 includes
a forward and a rearward limit switch actuatable by the motor 548.
When the motor actuates the forward limit switch, the direction of
driving is reversed and thus, the motor returns the powerstat 550
to a 0 volt output to be ready to start the next cycle for drawing
blood from the patient. This reverse driving of the powerstat will
end when the motor actuates the reverse limit switch. Thus, while
it will be appreciated that the maximum speed of the input or blood
pump 62 is controlled by the variable pump control on the control
panel or console 152, the time period required for the blood pump
62 to reach this preselected speed is governed by the acceleration
control device 546. In other words, regardless of the setting on
the console, it will require about 12 seconds for the pump to
accelerate to its preset speed. This type of control is important
to prevent the occurrence of a vein occlusion which might otherwise
occur if the pump instantaneously went into operation and withdrew
a high flow rate from the donor's vein, and also is important to
prevent any hemolysis or trauma damage to the red cells.
Referring again to the inflatable cuff 84, the same need not be
illustrated in detail herein since it merely corresponds to the
conventional form of inflatable arm cuff, such as is commonly used
in connection with sphygmomaneters. However, instead of being
manually inflated and deflated, as is the conventional arm cuff,
the arm cuff 84 of the present invention is actuated by a cuff pump
assembly generally designated 554 and carried on the bottom of the
machine frame 156, as shown in FIG. 4. The cuff pump assembly 554
includes a solenoid pinch valve means 556, of the type previously
described, a pressure switch 558 and a combined pump and motor 560.
The cuff pump automatically inflates the arm cuff 84 around the
patient's donating arm to a pressure between 40 to 60 millimeters
of mercury. The solenoid valve 556 is normally opened, however,
when the buffer bag drains to a point where the refill buffer
switch 108 is actuated, then the valve 556 will close on an air
exhaust tube leading from the motor and pump 560. This will cause
the motor to operate a piston within a pressure chamber, thereby
acting as a pump to provide pressurized air to the arm cuff 84.
This air will begin to inflate the arm cuff and will continue to do
so until the pressure switch 558 senses the preselected pressure of
between 40 to 60 millimeters of mercury. At such time, the switch
558 cuts off power to the motor, but if the pressure at the cuff
drops below the preselected range, the pressure switch 558 will
again start the motor 560 to maintain proper pressure at the cuff.
The cuff will remain inflated until the buffer bag is filled,
thereby reaching its high limit and actuating the switch 106. When
this switch is actuated, the valve 556 is de-energized, thereby
opening the same to allow any pressurized air from the motor to
vent off or exhaust. Simultaneously, power to the motor 560 is
interrupted. Except as described herein, the arm cuff is not
normally inflated and therefore, arm cuff inflation is only
intermittent for periods of time sufficient to refill the buffer
bag 64. Provision is made for manual inflation of the cuff during
preparation of the machine for use. The purpose of only
intermittently inflating the cuff 84 when the donor is attached, is
to provide the maximum degree of comfort for the donor 50.
The power supply for the machine 150 is carried at the bottom of
the frame 156 and is generally designated 564. Such power supply
includes a 48 volt DC power supply generally designated 566 and a
110 volt DC power supply generally designated 568. The 48 volt
power supply 566 is a ferro-resonant transformer supply which is
utilized to supply power to all of the relays, signal lights,
sensing units and chime on the machine. Taps are provided on the
secondary side of the power transformer to allow the output voltage
to be adjusted to a nominal 48 volts. The 110 volt power supply 568
is used to supply power to the pump motor fields, the solenoid
valves and the electric firction clutch mechanisms. This power
supply is unregulated and line voltage variations will cause
proportional variations in the output voltage. Therefore, the power
supply 568 includes a variable auto-transformer, which permits
adjustment to the output voltage of 110 volts so long as the line
voltage is within plus or minus 10 percent of 115 volts AC. The
power supply 568 also includes a meter for reading the value of the
power supply output voltage.
Referring again to FIGS. 3 and 4, there is shown therein at one end
of the machine frame 156, beneath the console 152, a relay gate
means generally designated 580. This relay gate means includes 28
separate 48 volt DC dual relays for accomplishing logic control
function. Also, it includes one 48 volt DC power transfer relay
which is utilized in connection with the acceleration control unit
546. Additionally, the relay gate includes a fuse panel 582 having
six fuses 584 mounted therein to assure electrical safety of the
machine circuit. Finally, the relay gate means 580 includes a pair
of 115 volt AC timing motor assemblies generally designated 586,
such assemblies providing timing pulses for the indicating lights,
the buzzer and the auxiliary needle rinse cycle. Each of the timing
units 586 includes a small synchronous timing motor which drives a
circuit breaker unit for timing pulses and a cam segment to provide
a longer time interval than is provided by the circuit breaker
unit. The timing motors are under the control of the main power
switch drive 590 of the machine, such switch being mounted on the
front of the machine at the upper right hand corner thereof, just
beneath the console 152. When the main power switch 590 is turned
on, the timing motors 586 are energized and will thereafter run
continuously so long as the machine is turned on. One of the timing
units provides 48 volt DC pulses to pulse all of the indicating
lights except the power on light and the run light, and further
serves to supply a timing pulse to sound the buzzer for a period of
about 3 seconds when an occluded vein is sensed. This is the only
time when the buzzer will be sounded for a preselected interval of
time, and in all other circumstances, when the machine reaches a
condition where the buzzer is actuated, the same will remain on
until the condition is corrected. The other timing unit 586 is used
to control the needle rinse cycle at the beginning of operation of
the machine when the priming solution is being utilized to
accomplish the needle rinse rather than the patient's own citrated
plasma. This timing unit supplies a timing pulse of about 3 seconds
when the priming fluid is supplied to the needle rinse, thereby
creating a "fast rinse". After such 3 second period, the needle
rinse cycle is stopped. It will, however, be understood that this
timing cycle is not utilized when the patient's own citrated plasma
is being utilized for the needle rinse operation.
The machine also includes a control box generally designated 592,
such control box being located along the bottom of the machine
frame 156. The control box 592 includes a series of calibration
potentiometers, a buzzer device and a chime device. The buzzer is
intended to operate as a warning device to call the attention of
the machine operator to the fact that an unsafe condition has been
sensed. Thus, the buzzer will operate when an occluded vein is
sensed, at an IV bottle warn or stopped condition, at the buffer
low limit condition when the switch 110 is operated, and at a
bubble detect condition. Under all of these conditions, except the
occluded vein, the buzzer will operate continuously until the
operator has taken appropriate corrective action. As just
described, in the case of an occluded vein, the timing unit 586
controls the buzzer to sound the same for a period of about three
seconds.
The chime is a two-tone device which is energized when the buffer
refill cycle is reached. The purpose of the chime is merely to
indicate to the donor 50 that the buffer bag needs refilling and
that the arm cuff is going to inflate and that the input pump will
start to draw blood from the donor's vein.
Finally, the control box 592 includes a series of calibration
potentiometers which can be adjusted by means of a screw driver. A
calibration potentiometer is provided for each of the centrifuge
assemblies 52 and 54, each of such potentiometers being a 50K, two
watt current limiting device used to calibrate the centrifuge
meters on the console 152. Similarly, a calibration potentiometer
is provided for calibrating the white cell flow meter and for
calibrating the return flow rate meter. However, in the case of the
calibration potentiometer for the return flow rate meter, the
driving source is a series arrangement of the red cell and plasma
tachgenerators 452.
The details of the bubble detector 122 can be seen from FIG. 17 to
include an inverted drip chamber receptacle 600 which is supported
by an assembly 601 having a pivotally mounted arm 602 upon which
the receptacle is hung. A fitting 604 is provided at the bottom of
the receptacle 600 for receiving the return tubing 92. The
receptacle 600 is normally completely filled with whole blood which
communicates with the blood flowing through the return tubing 92.
However, if an air bubble comes through the tubing 92, it rises
into the receptacle 600 to displace a portion of the blood therein.
As this portion of blood is displaced from the receptacle, the
weight of the receptacle is lessened. When eventually a sufficient
volume of blood has been displaced from the receptacle, such volume
being approximately 8 grams, the weight of the receptacle will be
lightened to such a degree that the arm 602 will actuate a sensing
switch 606, thereby initiating a bubble detect condition.
Specifically, closure of the switch 606 sounds the warning buzzer,
causes an on and off flashing of the bubble detect light on the
console and stops the centrifuge output pumps 66, 68 and 70.
To correct a bubble detect condition, the receptacle 600 must be
removed from the arm 602 and turned upside down, thus causing the
air to rise toward the fitting 604. Then, a clamp 608 on an air
bleed tube 610 is opened to permit the collected air to bleed off
from the receptacle 600 through the tube 610. The receptacle 600 is
thus refilled completely with blood after which it is once again
inverted and attached to the arm 602. Since the weight of the
filled receptacle is once again normal, the clamp 602 will move
downwardly, thereby releasing the sensing switch 606. The warning
indicia and the output pumps can then again be reset for normal
operation.
As previously mentioned, a return heater 124 is provided along the
return tubing 92, adjacent the bubble detector 122. The return
heater is formed by a tank of heated water which is kept in
circulation by a circulating pump. The return tubing 92 is formed
into a coil portion within this tank to increase the distance and
length of time required for blood flowing through the tubing to
traverse the tank. The heat from the water in the tank is
transferred through the tubing 92 to raise the temperature of the
blood therewithin back to normal body temperature.
Referring again to FIG. 4, the back panel of the machine 150 will
be described. Such back panel is designated 620 and includes a left
waste connector 622 and a left vacuum connector 624. The left waste
connector 622 is attached by tubing to the waste collect means 80
associated with the left centrifuge means 54. An external tube can
be attached to this connector to lead to a waste collection
receptacle. The left vacuum connector 624 is attached by tubing to
the vacuum pump 542 associated with the centrifuge means 54 and
again external tubing should be attached to this connector to
permit the waste from the centrifuge casing to be drained to a
waste receptacle. In a similar manner, a right waste connector 626
and a right vacuum connector 628 are provided to cooperate with the
right centrifuge means 52.
The back panel 620 also includes a three prong female electrical
connector 630 for connection of the bubble detector sensor cable.
Finally, the back panel includes three four prong female electrical
connectors 632, 634 and 636 provided for connection of the IV
bottle sensor cables for the sensing mechanism 112. These three
connectors are internally wired in parallel. Thus, the connector
632 is provided for the priming saline source 56, the connector 634
for the anti-coagulant source 60 and the connector 636 for the
intravenous saline source 682. A two-receptacle output 638 is also
provided on the back panel 620 to permit attachment of devices such
as an electrocardiogram where it is important for patient's safety
that the electrical ground be the same as that of the machine
itself.
Having now described the various components of the machine,
attention is directed to FIG. 18 where the control panel or console
152 is shown in greater detail. The control panel includes a front
face 640 having a series of lights, switches, dials and meters
thereon. Considering first the lights used on the face 640 of the
control panel, there is a Power On light 642 connected across the
output of the 48 volt DC power supply 566. This light indicates
that AC power is being supplied to the machine, that the power
supply fuse circuit is working and that there is an output from the
48 volt power supply 566.
An Occluded Vein light 644 is provided to give a flashing signal
when the occluded vein sensor 120 detects occlusion of the donor's
vein. Once the occluded vein situation has been corrected, the
operator depresses the Push For Reset switch to restore the light
644 to its off condition.
A Bubble Detector light 646 is provided to flash on and off when
the bubble detector unit 122 senses a particular volume of air in
the return line 92 leading back to the donor 50. The light 646 will
continue to flash until the bubble detector collecting receptacle
600 is voided of the collected air by permitting the same to escape
through the release tube 610. Even if the operator pushes the Reset
switch, such switch will not restore the machine to normal
operation and will not turn off the light 646 unless and until the
bubble detect condition has been corrected.
An IV Bottle Low light 648 is provided with three parallel inputs
to the connectors 632, 634 and 636 on the back panel 620 of the
machine. When the IV sensor unit 112 senses a liquid low limit by
weight determination in any or all of the bottles 56, 60 and 82,
the light 648 will begin to flash. This light will continue to
flash on and off until a fresh bottle of the proper solution
replaces the depleted bottle which initiated the signal.
A buffer Low Limit light 650 is provided to flash on and off
whenever the switch 110 is actuated due to the amount of fluid in
the buffer bag reaching a low limit. This light 650 will continue
flashing until the blood pump 62 has increased the amount of fluid
in the buffer bag 64 to a level adequate to release enertization of
the low limit switch 110.
System indicating lights include a small light 652 designating the
prime condition of the system and a small light 654 designating a
run condition of the system. The prime light 652 will flash on and
off whenever the prime-run switch is in the prime position. Once
priming has been completed and a patient has been coupled with the
machine, the prime-run switch is turned to the run position at
which time the light 654 will be steadily energized.
To now describe the switches utilized on the control panel, a Push
For Waste Divert switch 656 is provided and such switch can be
manually depressed at any time after the prime-run switch is moved
to prime position. Once the machine is switched to such a prime
position, depression of the switch 656 causes an on and off
flashing of a light 658 disposed behind the switch. Since the
switch is translucent, this flashing of the light can be seen by
the operator. The light 658 will continue to flash until the push
for reset switch is depressed. Depression of the switch 656 will
also activate the solenoids of the waste divert solenoid assembly
78, thus closing the normally opened solenoid valve 94 and opening
the normally closed solenoid valve 96.
A Push For Needle Rinse switch 660 is provided in conjunction with
a needle rinse light 662. Depression of the switch 660 initiates a
cycle of the needle rinse assembly 72 thereby causing the patient's
own citrated plasma to return to the tubing section 86, thus
flushing back into the patient the whole blood which was previously
contained in that section of tubing. As the switch 660 is
depressed, the light 662 will flash on and off, with such flashing
continuing until the Push For Reset switch is actuated, or
alternatively, until the refill buffer bag signal is energized.
Naturally, depression of the switch 660 will also activate the
solenoid valves in the needle rinse assembly to open the normally
closed valve 74 and to close the normally opened valve 76. In the
event that the operator pushes the button 660 at the same time that
the switch 108 is energized, thereby indicating a refill buffer
signal, the needle rinse will be only momentary.
A Push For Reset switch 664 is also provided on the control panel,
and depression of this switch causes a restoration of the occluded
vein light 644 to its off state after the occluded vein condition
has been corrected, causes a restoration of the waste divert
solenoids from their waste divert condition to their normal
condition, and causes restoration of the needle rinse assembly to
its off condition, which in turn automatically inflates the arm
cuff 84 and starts the blood pump 62 into operation to pump blood
to the buffer bag 64.
A prime-run switch 666 is provided for determining which mode of
operation the system will assume. If the switch 666 is moved to the
run position, it causes the run light 654 to be energized and makes
it impossible to operate the waste divert solenoids. On the other
hand, when the switch 666 is moved to the prime position, it
energizes the prime light 652, permits the waste divert assembly to
be controlled through the waste divert switch 656, and interrupts
power to the cuff pump 560 so that the cuff 84 cannot be inflated,
and finally, interrupts power to the needle rinse assembly so a
needle rinse cycle cannot be initiated.
Finally, a complementary-individual switch 668 is provided to pinch
or release a belt linking the controls which govern the plasma pump
70 or red cell pump 66 when the switch is in complementary mode.
That is, when the switch 668 is turned to individual mode, a
mechanical pincher releases the belt so that individual control of
the plasma pump 70 and red cell pump 66 may be achieved, without
the control of one affecting the control of the other. On the other
hand, when the switch 668 is in complementary position, the
mechanical pincher pinches the belt so that an increase in the
speed of the plasma pump 70 causes a decrease in the speed of the
red cell pump 66, and vice versa. While the switch 668 is in
complementary mode, the algebraic sum of the present speeds for the
red cell pump 66 and plasma pump 70 may be maintained over a small
variance in pump speeds desired by the machine operator.
A spare switch 670 is also provided but the same is not
electrically or mechanically connected into the machine.
Considering now the meters that are utilized on the control panel,
such meters are of the 0 to 1 milliamp full scale type, with
accuracy of the meters being plus or minus 2 percent of full scale.
Each meter has its own calibration circuit consisting of a series
circuit having a fixed voltage dropping resistor and a calibration
potentiometer mounted in the control box 592 as previously
described. The meters are driven by the tachgenerators 452
mentioned hereinabove.
A left centrifuge rpm meter 676 is provided to indicate the speed
and rpm of the left centrifuge drive motor 170, that is, the drive
motor for the centrifuge means 54. The meter face is calibrated
from 0 to 250 and actual speed of the centrifuge motor is one tenth
of the reading shown on the meter 676. That is, the meter actually
represents motor speeds of 0 to 2,500 rpm although the readings are
only from 0 to 250. Indications on the meter 676 are accurate
within plus or minus 5 percent of actual motor speed.
Another meter 678 is provided for the right centrifuge means 52,
with the meter 678 being identical to the meter 676.
A white blood cell meter 680 is provided to indicate in milliliters
per minute the flow rate of the white cell pump 68. The meter face
is calibrated from 0 to 100 milliliters per minute and meter
indication is accurate within plus or minus 5 percent of actual
pumping rates.
A return flow rate meter 682 is provided to indicate the algebraic
output of the red cell pump motor and the plasma pump motor, with
such indication being created by a series connection of the
tachgenerators 452 for each of these motors. The return flow rate
to the donor 50 is important because of the possible effects of
anti-coagulant on the donor. That is, if the return flow rate were
too high, it would introduce anti-coagulant into the patient's
circulatory system at too fast a rate. Indication on the meter 682
should be accurate within plus or minus 5 percent of the actual
pumping rates of the plasma and red cell pumps. When the switch 668
is turned to complementary mode, the meter will be accurate within
plus or minus 10 percent of the actual pumping rate.
A total milliliter input meter 684 is provided to indicate the
quantity of blood and anti-coagulant flowing into the system due to
operation of the pumps 58 and 62. As was previously described, the
shaft of the driving motor 430 associated with the blood pump 62,
drives a lobed cam which actuates a switch every 0.7 revolutions.
Thus, every 0.7 revolutions of the input pump represents an input
flow of 1 milliliter into the system and a count of 1 on the meter
684. The input flow, as read by the meter 684, can be considered as
the fluid flowing through the input pump 62, that is, seven parts
of whole blood to one part anti-coagulant. The meter 684 is a six
digit counter which can count at a rate better than five impulses
per second. A mechanical reset wheel 686 is provided for the meter
684.
Finally, considering the variable controls on the control panel, a
left centrifuge control generally designated 690 and a right
centrifuge control generally designated 692 are provided. Each of
these controls is a 6.8K linear potentiometer supplying a
controlled voltage to the armature of the associated centrifuge
driving motor 170. Each centrifuge control includes a transparent
dial 694 having indicia 696 thereon ranging from 0 to 9. A knob 698
is provided for rotating each dial 694, and a darkened indicating
section 700 is provided on the surface 640 of the control panel to
permit the operator to see the exact number at which the dial is
set.
The machine also includes an input pump control generally
designated 702, a plasma pump control generally designated 704, a
red cell pump control generally designated 706 and a white cell
pump control generally designated 708. Each of these controls is a
powerstat controlling the quantity of 115 volt alternating current
fed to a full wave rectifier which supplies the direct current
voltage to the armatures of the motors associated with each of the
various pumps. Each of the controls 702, 704, 706 and 708 includes
the transparent dial 694 having the indicia 696 thereon, and
actuating knobs 698 and an indicating section 700 on the control
face 640.
Having now described the invention in considerable detail, it will
be apparent that the objects set forth at the outset of the
specification have been successfully achieved. Accordingly,
* * * * *