Automatic pleural-peritonal pump

Abstract

An automatic pump-based fluid management system, as described herein, comprises an intercostal pump that is, generally, a resiliently flexible bulb having an inlet and an outlet. The inlet is attached to a first tube that extends from the intercostal pump to a first area of a patient's body, for example, the patient's pleural cavity. The outlet is connected to a second tube that extends from the intercostal pump to a second area of a patient's body, for example, the patient's peritoneal cavity. In use, the intercostal pump is placed between a first rib and a second rib in a patient. The intercostal pump operates by being successively compressed and decompressed between the first and second ribs as the patient breaths.

1 - 22 . (canceled) 
     
     
         23 . A pump-based fluid management system comprising:
 a pump body having an interior chamber in fluid communication with an inlet and an outlet;   an inlet one-way valve in general proximity to the inlet configured to allow fluid movement from the inlet to the interior chamber and at least substantially preclude fluid movement from the interior chamber to the inlet;   an outlet one-way valve in general proximity to the outlet configured to allow fluid movement from the interior chamber to the outlet and at least substantially preclude fluid movement from the outlet to the interior chamber; and   a first tube configured to extend from the inlet and allow fluid movement from a first area of a body of a patient to the inlet; and   a second tube configured to extend from the outlet and allow fluid movement from the outlet to a second area of the body of the patient;   wherein at least one of the inlet one-way valve and the outlet one-way valve is configured to reseal with a differential back pressure of less than about 15 cmH 2 O; and   wherein the pump body comprises at least one of:
 an orientation feature configured to interface with at least one rib of the patient when the pump body is implanted between adjacent ribs of the patient and configured to orient the pump body at a desired angle relative the at least one rib; or 
 a transition portion that angles a first portion of the pump body comprising the inlet relative a second portion of the pump body comprising the outlet. 
   
     
     
         24 . The pump-based fluid management system of  claim 23 , wherein the differential back pressure to reseal the at least one of the inlet one-way valve and outlet one-way valve is less than about 5 cmH 2 O. 
     
     
         25 . The pump-based fluid management system of  claim 23 , wherein both the inlet one-way valve and the outlet one-way valve are configured to resist deformation from an applied back pressure once resealed. 
     
     
         26 . The pump-based fluid management system of  claim 25 , wherein an applied back pressure of 50 cmH 2 O on the inlet one-way valve or the outlet one-way valve correspondingly produces a deformation of the inlet one-way valve or the outlet one-way valve of less than 200 microliters. 
     
     
         27 . The pump-based fluid management system of  claim 23 , wherein at least a portion of the pump body comprises a generally cylindrical cross-section with an inner diameter of between about 4 mm and 10 mm and an outer diameter of between about 6 mm and 12 mm. 
     
     
         28 . The pump-based fluid management system of  claim 27 , wherein the inner diameter is between about 6 mm and 7 mm and the outer diameter is between about 8 mm and 10 mm. 
     
     
         29 . The pump-based fluid management system of  claim 27 , wherein the at least a portion of the pump body comprises a wall thickness of between about 0.7 mm and 1.0 mm. 
     
     
         30 . The pump-based fluid management system of  claim 23 , wherein the pump body comprises at least one reinforcing member integrated into or attached to a wall of the pump body and configured to distribute a force applied to the wall along a length of the wall. 
     
     
         31 . The pump-based fluid management system of  claim 23 , wherein at least a portion of the pump body is comprised of a self-sealing material. 
     
     
         32 . The pump-based fluid management system of  claim 23 , further comprising an accessory access port in fluid communication with the interior chamber. 
     
     
         33 . The pump-based fluid management system of  claim 32 , wherein the accessory access port is comprised of a self-sealing material. 
     
     
         34 . The pump-based fluid management system of  claim 23 , wherein:
 the pump body is comprised of a resilient flexible material selected such that when the pump body is implanted between adjacent ribs of the patient, expansion and contraction of the patient's rib cage causes decompression and compression, respectively, of the pump body and automatic pumping of fluid received at the inlet through the pump body and out the outlet; and   the pump body further comprises a manually depressible portion comprised of a deformable material that returns to its original shape after deformation, the manually depressible portion configured to face outward from the rib cage of the patient when the pump body is implanted between adjacent ribs of the patient, the manually depressible portion further configured, upon being depressed, to pump fluid from the interior chamber to the outlet.   
     
     
         35 . The pump-based fluid management system of  claim 34 , wherein the manually depressible portion comprises a generally domed-shaped portion of the pump body. 
     
     
         36 . The pump-based fluid management system of  claim 35 , wherein the generally domed-shape portion is comprised of a self-sealing material. 
     
     
         37 . An electro-mechanical pump-based fluid management system comprising:
 an electro-mechanical pump in fluid communication with an inlet and an outlet;   a first tube configured to extend from the inlet and allow fluid movement from a first area of a patient's body to the inlet; and   a second tube configured to extend from the outlet and allow fluid movement from the outlet to a second area of the patient's body;   wherein the electro-mechanical pump comprises:
 a pump body having an interior chamber in fluid communication with the inlet and the outlet; 
 an inlet one-way valve in general proximity to the inlet configured to allow fluid movement from the inlet to the interior chamber and at least substantially preclude fluid movement from the interior chamber to the inlet; 
 an outlet one-way valve in general proximity to the outlet configured to allow fluid movement from the interior chamber to the outlet and at least substantially preclude fluid movement from the outlet to the interior chamber; 
 an actuator operably connected with the interior chamber and which is capable of moving fluid from the inlet to the outlet; 
 a controller operably connected to the actuator and capable of controlling the actuator; and 
 a battery operably connected to the controller to provide energy to the controller and the actuator. 
   
     
     
         38 . The electro-mechanical pump-based fluid management system of  claim 37 , wherein the battery is configured to comprise sufficient energy to enable the electro-mechanical pump to move at least 27 liters of fluid from the inlet to the outlet. 
     
     
         39 . The electro-mechanical pump-based fluid management system of  claim 37 , wherein the controller is programmed to operate the actuator at each of a plurality of times over a first period of time and, for each of the plurality of times, continue to operate the actuator for a specified period of time less than the first period of time. 
     
     
         40 . The electro-mechanical pump-based fluid management system of  claim 37 , wherein the controller is programmed to operate the actuator for an amount of time to pump a desired volume of fluid on a first day post implantation of the electro-mechanical pump-based fluid management system in the patient and then decrease the amount of time the pump operates the actuator for at least one subsequent day post implantation. 
     
     
         41 . The electro-mechanical pump-based fluid management system of  claim 37 , further comprising a sensor that senses fluid flow through the electro-mechanical pump and wherein the controller is programmed to operate the actuator at each of a plurality of times over a period of time and, for each of the plurality of times, continue to operate the actuator until a sensed fluid flow drops below a designated value. 
     
     
         42 . The electro-mechanical pump-based fluid management system of  claim 37 , further comprising a sensor that senses pressure inside the electro-mechanical pump and wherein the controller is programmed to operate the actuator at each of a plurality of times over a period of time and, for each of the plurality of times, continue to operate the actuator until a sensed pressure drops below a designated value. 
     
     
         43 . The electro-mechanical pump-based fluid management system of  claim 37 , wherein the electro-mechanical pump comprises a liquid impermeable membrane separating the interior chamber from a housing compartment comprising the actuator, the controller, and the battery, wherein the actuator is operably connected with the liquid impermeable membrane and capable of deforming the liquid impermeable membrane.