Abstract:
A line management apparatus for managing multiple IV lines connected in a Y fitting or multi-way fitting provides for flow sensing and for electronic control of flow in the multiple lines. The line management apparatus may be used independently as a precise gravity feed IV system or may provide for use in combination with an infusion pump to ensure proper delivery of multiple solutions without blending of the two.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit of U.S. provisional application 61/483,321 filed May 6, 2011 entitled “Infusion Line Management Apparatus and Method” hereby incorporated by reference in its entirety. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    The present invention relates to systems for intravenous (IV) administration of drugs and in particular to a system allowing the delivery of multiple IV solutions to a patient. 
         [0003]    At times it is desirable to deliver to a patient multiple solutions or medications including a primary solution and a secondary solution. In such circumstances, IV bags containing the primary solution and the secondary (“piggyback”) solution may be joined with a Y-connector and a tube from the Y-connector connected to an infusion pump. The infusion pump may include, for example, a peristaltic pump element controllably pumping the solution to the patient as well as pressure sensors for sensing occlusion and the like as well as air-in-line sensors such as may detect bubbles in the fluid. 
         [0004]    Preferential delivery of the piggyback solution may be obtained by elevating the IV bag containing the piggyback solution above that which contains the primary solution. The infusion pump will pump material from the bag at the higher elevation. 
       SUMMARY OF THE INVENTION 
       [0005]    The present inventor has recognized a number of problems that can occur when administering multiple fluids using an IV pump as described above. First, at some pump rates, solution may be pulled both from the primary and secondary IV bags despite the higher elevation of the secondary bag. Second, in the event of an infusion pump failure, gravity feeding of the materials from the primary and secondary bag may occur at a higher than desired flow rate. 
         [0006]    The present invention addresses these problems by providing a line management apparatus connectable to a primary and secondary IV bag for monitoring flow rate and independently controlling flow through the separate tubes leading to each of the primary and secondary IV bags. By monitoring flow and pinching off one of the tubes, a switchover between bags may occur only after the secondary bag is depleted as sensed by flow. Flow monitoring also allows detection of an infusion pump failure and controlling the flow rate independently of the infusion pump. In this regard, the present invention can also be used as a highly precision gravity flow infusion system. Finally, during switchover, a signal can be provided to the operator positively signaling the switchover has occurred, therefore providing convenience if immediately adding a different piggyback solution is desired. 
         [0007]    Specifically then the present invention provides an IV line management apparatus for intravenous administrations of multiple solutions having a housing for receiving a piggyback tubing assembly comprising a primary IV tube from a primary solution IV bag as joined to a secondary IV tube from a secondary IV solution bag with a manifold connector (for example, a Y-connector or multi-way connector) and an exit tube passing from the manifold connector. First and second metering clamps engage the primary IV tube and secondary IV tube respectively when the piggyback tubing assembly is received within the housing for controlling flow through the primary IV tube and secondary IV tube according to electrical signals received by the first and second metering clamps, and at least one flow rate sensor senses flow through the tubing assembly. A controller comprising an electronic computer executing a stored program receives at least one signal from at least one flow rate sensor and provides electrical signals to the first and second metering clamps according to the stored program. 
         [0008]    It is thus a feature of at least one embodiment of the invention to provide superior management of piggyback IV administration by allowing independent control of the streams from two IV bags. 
         [0009]    The electronic computer may execute the stored program to control the first or second metering clamps to limit flow through the flow rate sensor to a predetermined maximum value. 
         [0010]    It is thus a feature of at least one embodiment of the invention to provide a backup for limiting fluid flow in the event of an infusion pump failure. 
         [0011]    The electronic computer may execute the stored program to provide electrical signals to the first and second electrical metering clamps in a first state to stop flow through the primary IV tube while allowing flow through the secondary IV tube until a flow rate lower than a second predetermined value is detected, and then to provide electrical signals to the first and second electrical metering clamps in a second state to stop flow through the secondary IV tube while allowing flow through the primary IV tube. 
         [0012]    It is thus a feature of at least one embodiment of the invention to provide for automatic switchover between solution bags preventing flow from both bags simultaneously. 
         [0013]    The IV line management apparatus may further include an alarm annunciator for indicating a transition between the first and second states. 
         [0014]    It is thus a feature of at least one embodiment of the invention to positively signal a depletion of the secondary solution. 
         [0015]    The first and second metering clamps may provide opposed jaws fitting about the primary IV tubing and secondary IV tubing and the electrical signals to the first and second metering clamps may control a separation of the jaws in pinching off the primary IV tubing or the secondary IV tubing. 
         [0016]    It is thus a feature of at least one embodiment of the invention to provide a system for controlling fluid flow in separate IV lines that maintains a sterile envelope around the IV solution. 
         [0017]    The electrical signals to the first and second metering clamps may control a separation of the jaws in pinching off the primary IV tubing or the secondary IV tubing to multiple different separations within a range of separations to provide control between a fully open and fully closed separation. 
         [0018]    It is thus a feature of at least one embodiment of the invention to provide the ability to meter fluid as well as to shut fluid flow off. 
         [0019]    The IV line management apparatus may include electrical switch operators positioned on the housing near the primary IV tubing and secondary IV tubing wherein the controller executes a stored program to respond to an operator actuation of a switch operator near one of the primary IV tubing and secondary IV tubing to cause a pinching off of alternate ones of the primary and secondary IV tubes depending on the operator actuated. 
         [0020]    It is thus a feature of at least one embodiment of the invention to provide a simple method of designating a source of fluid flow. 
         [0021]    The IV line management apparatus may include display elements positioned on the housing near the primary IV tubing and secondary IV tubing and communicating with the controller to indicate a state of flow through the primary IV tubing and secondary IV tubing. 
         [0022]    It is thus a feature of at least one embodiment of the invention to provide a simple method of monitoring two different fluid flows. 
         [0023]    The IV line management apparatus may include display elements that may be colored lights indicating a state of flow as one of open, closed, or metered and further may provide the colors and organization of a standard traffic light. 
         [0024]    It is thus a feature of at least one embodiment of the invention to provide a simple intuitive display of multiple states of flow for different IV lines. 
         [0025]    The IV line management apparatus may further include additional sensors sensing solution in the primary and secondary IV tubing, the sensors selected from the group consisting of air-in-line sensors, pressure sensors, and tubing-in-place sensors. 
         [0026]    It is thus a feature of at least one embodiment of the invention to permit the line management apparatus to be used as a precise gravity feed IV system without an infusion pump. 
         [0027]    One embodiment of the flow rate sensor is infrared sensor sensing drips passing through a drip chamber. 
         [0028]    It is thus a feature of at least one embodiment of the invention to permit use with a variety of flow sensing techniques. 
         [0029]    The housing may include a cover closing over the piggyback tubing assembly when received within the housing to retain the tubing within the housing. 
         [0030]    It is thus a feature of at least one embodiment of the invention to provide a positive retention of the piggyback tubing assembly that preserves its integrity and engagement in the housing. 
         [0031]    The cover may include a window positioned to allow visual inspection of the tubing. 
         [0032]    It is thus a feature of at least one embodiment of the invention to provide the ability to continuously visually monitor the piggyback tubing assembly. 
         [0033]    The IV line management apparatus may further include a lock for holding the cover closed against the housing. 
         [0034]    It is thus a feature of at least one embodiment of the invention to permit a tamperproof control of multiple IV lines. 
         [0035]    It should be understood that the invention is not limited in its application to the details of construction and arrangements of the components set forth herein. The invention is capable of other embodiments and of being practiced or carried out in various ways. Variations and modifications of the foregoing are within the scope of the present invention. It also being understood that the invention disclosed and defined herein extends to all alternative combinations of two or more of the individual features mentioned or evident from the text and/or drawings. All of these different combinations constitute various alternative aspects of the present invention. The embodiments described herein explain the best modes known for practicing the invention and will enable others skilled in the art to utilize the invention. 
     
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         [0036]      FIG. 1  is a simplified perspective representation of an example line management apparatus per the present invention used in conjunction with a piggyback tubing assembly and an infusion pump; 
           [0037]      FIG. 2  is a front elevational view of the line management apparatus of the present invention with the cover open showing various sensors, actuators, displays and annunciators; 
           [0038]      FIG. 3  is a block diagram of the principal elements of the pump including a processor for monitoring the sensors of the present invention using a stored program and for controlling actuators; 
           [0039]      FIG. 4  is a cross-sectional view of metering clamp actuators showing their operation on a contained tubing element; 
           [0040]      FIG. 5  is a fragmentary front elevational cross-sectional view through a flow rate sensor having a chamber providing falling drops positionable between capacitor plates flanking the flow rate sensor chamber when the flow rate sensor chamber is inserted into the pump; 
           [0041]      FIGS. 6   a  and  6   b  are a fragmentary front cross-sectional view and a top plan cross-sectional view, respectively, of a second embodiment of the flow rate sensor providing a chamber with a contained turbine wheel and flanking capacitive sensors when the flow rate sensor chamber is inserted into the pump; 
           [0042]      FIG. 7  is a simplified flowchart of a program executing on the processor  FIG. 3 ; and 
           [0043]      FIG. 8  is a figure similar to  FIG. 2  showing an embodiment using a multi-way connection system. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0044]    Referring now to  FIG. 1 , a line management apparatus  10  of the present invention may receive IV lines  12  and  14  from a primary IV bag  16  and a secondary (“piggyback”) IV bag  18  through a top surface of the line management apparatus  10 . Generally the secondary IV bag  18  may be mounted higher than the primary IV bag  16  on an IV pole  19 ; however, this is not required in the present invention. The IV lines  12  and  14  may be joined by a Y-connector  20  leading to an outlet line  22 , the latter of which may be received by a standard infusion pump  24 . Generally the IV lines  12  and  14 , Y-connector  20 , and outlet line  22  provide a piggyback tubing assembly  25 . 
         [0045]    The infusion pump  24 , as is understood in the art, provides a peristaltic pump element that accurately meters liquid through the outlet line  22  and to a needle  26  or the like that may be inserted into a patient (not shown). As is understood in the art, the infusion pump  24  may further provide sensors such as air-in-line sensors and pressure sensors for monitoring the flow through outlet line  22  and a tubing in-place sensor for ensuring the tubing of outlet line  22  is properly seated in the pump  24 . The infusion pump  24  may further provide for a time control of the flow through outlet line  22  as well as alarms indicating problems with that flow. 
         [0046]    Referring now to  FIG. 2 , the line management apparatus  10  may provide for a housing  30  having a front face  32  that may receive the piggyback tubing assembly  25  within channels and sockets in the front face  32 . In particular, each of the IV lines  12  and  14  may pass downward through left and right air-in-line sensors  33 , left and right tubing loaded sensors  34 , and left and right metering clamps  36 . 
         [0047]    The air-in-line sensors  33  may consist of two ultrasonic transducers: one serving as an actuator to convert electrical energy into mechanical energy, and the other serving as a receiver to convert mechanical energy into electrical energy. In one embodiment, the actuator is implemented with a piezoelectric actuator. When an electrical signal is applied to the piezoelectric actuator, cyclic deformation of piezoelectric material inside the actuator produces a stress wave that travels across the tubing of IV lines  12  and  14 . Due to the significant difference of attenuation factor from liquid to air, the stress wave detected by the receiver varies significantly depending upon whether liquid or air is within the tubing adjacent to the receiver. Therefore, air can be differentiated from liquid, and an indication of the presence of air bubbles or line empty state may be made. 
         [0048]    The tubing-loaded sensors  34  detect the presence of tubing of IV lines  12  and  14  and outlet line  22  properly seated in the channels in the housing  30 . The seated tubing can be with or without liquid in it. In one embodiment, the tubing-loaded sensors  34  consist of a magnet and a Hall sensor. When tubing is loaded, the magnet is pushed closer or father away from the Hall sensor, depending upon the chosen implementation. Therefore, the signal obtained from the Hall sensor can be used to determine whether the tubing is loaded. In another embodiment, the tubing-loaded confirmation sensor consists of a LVDT (Linear Variable Displacement Transducer). When a tube is loaded, movement of the ferromagnetic core results in a transducer voltage change due to mutual inductance change. The resulting voltage is used to determine the tubing loading condition. In another embodiment, the tubing loading condition can be determined by analyzing a signal from the air-in-line sensor  33  receiver due to observable differences among tube not loaded, empty tube, and liquid filled tube states. 
         [0049]    An upstream occlusion condition can also be detected by the same type of sensors that detect the presence of tubing. 
         [0050]    Positioned below the metering clamps  36  are the operators of left and right electrical switches  38 , and left and right indicator banks  40 , each positioned near a respective IV line  12  and  14  to be clearly associated with one of those IV lines  12  and  14 . Each indicator banks  40  may comprise three LEDs providing red, yellow, and green lights and ordered from top to bottom in the manner of a standard traffic signal to accommodate a color blind user. The LEDs may indicate conditions such as liquid flowing, standby (tubing filled with liquid, but liquid is not flowing), or no flow (no tubing loaded, air in tubing, or tubing closed by flow regulator). 
         [0051]    Outlet line  22  leading from the Y-connector  20  passes through a flow rate sensor  42  after which outlet line  22  may exit the line management apparatus  10 . 
         [0052]    The front face  32  also provides a baffle for a speaker  44 . The speaker  44  can be used to generate an alarm sound when a preset condition is met, such as flow rate out of range, line empty/air in line, tube not loaded, both line switches at off position when flow is expected, as well as for other conditions that will be described below. 
         [0053]    A screen  46  for displaying alphanumerics or text may also be provided, for example, to indicate flow rate. Line condition can also or alternatively be indicated by the screen  46  which may be provided as an LCD, LED or other commonly known type of display screen. 
         [0054]    The housing may further provide a support tab  48  at its top edge for attachment to the IV pole  19  and may have a hinging cover  50  pivoting about one vertical edge of the housing  30  to open and close over the front face  32  of the housing  30 . The cover  50  may provide for a central transparent window  52  and a lock hasp  54  engaging with a corresponding lock hasp  56  on the housing that allows locking of the cover  50  in a closed position on the housing  30 . When the cover  50  is closed over the front face  32 , it retains the piggyback tubing assembly  25  therein and the window  52  allows visual inspection of each of the elements on the front face  32 . 
         [0055]    Referring now to  FIG. 3 , the line management apparatus  10  may include a controller  60  (which may be a processor  61  based system) having a memory  62  for holding a stored operating program and data  64  controlling operation of the line management apparatus  10  as will be described below. In particular, the controller  60  may use the data in the memory  62  to control metering clamps  36  to ensure the desired dose and delivery rate to the patient. The controller  60  may further communicate with the flow rate sensor  42  of the present invention for receiving a signal therefrom as will be described. Further, the controller  60  executing the stored program  64  may read a signal from the air-in-line sensors  33  and the tubing loaded confirmation sensors  34 . 
         [0056]    Referring still to  FIG. 3 , the controller  60  may also communicate with a screen  46  for displaying and/or inputting various programming and operating parameters, a speaker associated with speaker  44  for providing audible alarm signals, and switches  38  for inputting data to the controller  60 , for example, for selecting among solution delivery through IV lines  12  and  14 . The controller  60  may also provide for signals to the indicator bank  40  to control their illumination. This communication may be through standard interfaces  70  understood in the art Referring now to  FIG. 4 , the metering clamps  36  may provide for opposed stationary jaw  72  and movable jaw  74  that may flank each of IV lines  12  and  14 . Movable jaw  74  may communicate through a lead screw  76  with a motor  78 , for example a servo or stepper motor, that may rotate the lead screw  76  to move the jaws  72  and  74  to various degrees of separation. As such, the jaws  72  may close to fully block flow through the IV lines  12  and  14 , or open fully for free flow through IV lines  12  and  14  or may be positioned in between open and closed to provide for a metering of flow. In an alternative embodiment, where only full or no flow is required, the metering clamps  36  may be actuated by solenoids replacing the servo or stepper motors. 
         [0057]    Referring now to  FIG. 5 , in the first embodiment of the invention, the flow rate sensor  42  may provide for a generally cylindrical housing  82  receiving a flexible tube of the IV line  12  or  14  and having a diameter substantially larger than the diameter of the tube of IV lines  12  and  14 . A connection between the tube and the housing  82  provides an orifice opening into an air space  84 , the orifice forming liquid from the IV bag  16  or  18  into drops  86  that may fall through the air space  84  into a pool  89  at the bottom of the cylindrical housing  82 . The pool  89  may communicate with a second tube providing a drain therefrom and a continuation of the IV line as outlet line  22 . 
         [0058]    When the flow rate sensor  42  (formed with the piggyback tubing assembly  25 ) is placed within a socket in the front face  32  of the housing  30 , it will be flanked by first and second plates  90   a  and  90   b  positioned across a diameter of the cylindrical housing  82  and accordingly across the air space  84 . Drops  86  passing through the air space  84  thereby create a change in capacitance between the plates  90   a  and  90   b  caused by the increased dielectric constant of the material of the drop  86 . For example, the dielectric constant of water is approximately 34 to 78 times that of air. This capacitance may be measured by a number of techniques including, for example, measurement of changes in a frequency of the oscillator incorporating the capacitance between the plates  90   a  and  90   b  into a resonant circuit or by use of the capacitance between plates  90   a  and  90   b  as part of an integrator and measuring a time constant of a ramping up of the integrator after periodic reset. These fluctuations in capacitance may be used to count the drops  86  and deduce a flow rate. Alternatively an infrared light beam may be used to count drops in the situation. 
         [0059]    Referring now to  FIGS. 6   a  and  6   b , in a second embodiment the flow rate sensor  42  may also provide for a cylindrical housing  100 . In this case the cylindrical housing  100  holds suspended therein a free spinning turbine  102  having a rotational axis  104  generally along the direction of flow and along the axis of the cylindrical housing. The cylindrical housing  100  may be attached at its upper and lower ends to outlet line  22  leading from the Y-connector  20  to be placed in series with the outlet line  22 . Generally, the turbine  102  provides for one or more canted blades  106  having a known pitch to cause a predetermined rotational rate of the turbine  102  with flow of the liquid within the cylindrical housing  100  along axis  104 . 
         [0060]    Plates  90   a  and  90   b  may flank the cylindrical housing  100  when the flow rate sensor  42  is placed within the socket in the front face  32  of the housing  30  as described above with respect to the embodiment of  FIG. 5 . One or more blades  106  of the turbine  102  may include high conductivity or dielectric inclusions  108 , for example aluminum inserts or metal plating, that change the effective spacing of the capacitor plates  90   a  and  90   b  with rotation of the turbine  102 . Alternatively, the dielectric material of the turbine blade  106  may provide for the necessary variations in capacitance between the plates  90   a  and  90   b  causing a variation in capacitance as a function of rotation of the turbine  102 . It will be understood that the change in capacitance signal between the plates  90   a  and  90   b  may be used to deduce rotation of the turbine  102  and thus the total flow of liquid through the outlet line  22 . It will be appreciated that other sensing techniques such as Hall effect sensing may also be used. 
         [0061]    Although two flow rate sensors have been described above, it will be appreciated that other flow rate sensors may also be used in this capacity including, for example, thermal time of flight sensors, ultrasonic sensors and the like. 
         [0062]    For example, in another embodiment, the flow rate sensor  42  for outlet line  22  may consist of an ultrasonic flow meter and the supporting circuits. The ultrasonic flow meter may have two piezoelectric transducers and a tubing section between the two transducers. Mechanical stress waves can be generated by applying an electrical signal to either transducer. Velocity of stress wave propagation along and against the flow direction within the tube is affected by the velocity of the liquid. By knowing the cross section of the tubing section and the length of the tubing section, flow rate can be calculated using time difference between the stress wave propagation directions. 
         [0063]    In another embodiment, the flow rate sensor  42  for the outlet line  22  may consist of a laser based flow meter and the supporting circuits. Liquid inside a tubing section with a specific cross section can be heated with a heating laser, and the change in fluid reflectivity and/or diffractivity due to added thermal energy can be utilized to measure flow rate. The change in reflectivity and/or diffractivity can be detected by a sensing laser, photo diode, and corresponding optical components such as mirrors and apertures. 
         [0064]    In another embodiment, the flow rate sensor  42  for the outlet line  22  may consist of a thermal time-of-flight based flow meter and the supporting circuits. Fluid flowing through the tubing is heated up by a certain amount of thermal energy. A thermal probe(s) at a downstream location measures the temperature change of the fluid. The flow rate can be calculated from temperature change data. 
         [0065]    In another embodiment, the flow rate sensor  42  for the outlet line  22  may consist of two pressure sensors and the supporting circuits. The two pressure sensors are positioned at a certain distance along the flow direction. Differential pressure can be calculated from pressure values measured by the two pressure sensors. By knowing the cross section of the tubing, distance between two differential pressure sensors, and the differential pressure, flow rate can be calculated. Any of various pressure sensors known to one skilled in the art may be employed. 
         [0066]    In another embodiment, the flow rate sensor  42  for the outlet line  22  may be a differential pressure sensor, using a piezoresistive monolithic silicon pressure sensor and supporting circuitry. Commercially available piezoresistive sensing element (such as part #MPVZ4006G from Freescale Semiconductor, Inc) can be utilized to sense the differential pressure at two different locations along the flow direction. Deformation of the diaphragm results in resistance change, which can be used to directly calculate the differential pressure. Once differential pressure is obtained, with known cross section of tubing and distance between two pressure ports along the line, flow rate can be measured. 
         [0067]    Referring now to  FIGS. 1 ,  3  and  7 , the program  64  executed by the processor  61 , as indicated by process block  110 , may receive a state setting by the user indicating in which of IV lines  12  and  14  initial flow is desired. The state setting signal may come from switches  38  which when pressed indicate that the IV line  12  or  14  closest to the switch  38  is to be the line that will have flow and the remaining line will be clamped off for no flow by adjustment of the appropriate metering clamps  36 . At this time, indicator bank  40  shows a green light if flow is occurring in the particular tube and a red light if no flowing is occurring. 
         [0068]    As indicated by decision block  112 , as material flows through outlet line  22 , the flow is monitored by flow rate sensor  42  to make sure it is below a predetermined limit that should be provided to the patient. This first predetermined limit enforces a degree of safety in the event that the infusion pump  24  fails in an open state or may be a routine monitoring used when the line management apparatus  10  is used without an infusion pump  24 . 
         [0069]    If the flow exceeds the indicated limit, then the processor  61  may close the metering clamp  36  associated with the active IV line  12  or  14  as indicated by process block  114  and provide an output alarm as indicated by process block  116 . The alarm will typically be an audible alarm demanding immediate attention. 
         [0070]    When the line management apparatus  10  is being used without an infusion pump  24 , then instead, at process block  118 , the metering clamp  36  associated with the open IV line  12  and  14  may be tightened down until proper flow rate is obtained. This metering is indicated by a green or yellow illumination in the corresponding indicator bank  40  and provides closed loop regulation of flow in conjunction with flow rate sensor  42 . 
         [0071]    If the first predetermined flow rate limit has not been exceeded at decision block  112 , then at decision block  120  it is determined whether the active IV line  12  or  14  has a flow below a second predetermined limit indicating depletion of the solution in the associated IV bag  18  or  16 . If this second predetermined flow limit is not maintained, then the program  64  moves to process block  122  and a state-switch occurs in which the open IV line  12  or  14  is fully closed (typically the IV line  12  associated with the piggyback solution) and the other IV line  12  or  14  (typically the primary IV line  14 ) is opened. In this case a visual alarm may be output indicating to a healthcare professional that the secondary solution from IV bag  18  has been exhausted. 
         [0072]    Referring now to  FIG. 8 , it will be appreciated that the principles of the present invention, as described above, may be extended to a system having additional inlet IV lines beyond primary IV line  12  and secondary IV line  14 , for example, to provide for a tertiary IV line  12 ′, and optionally a quaternary IV line  14 ′ and possibly additional IV lines joined by a manifold connector  20 ′ merging the flows from these multiple inlet IV lines into the single outlet line  22 . In this case the air-in-line sensors  33 , tubing loaded sensors  34 , metering clamps  36 , switches  38  and indicator banks  40  may be duplicated for each of these inlet IV lines to provide independent sensing and control of each line. 
         [0073]    Such multi-way systems may be desirable for anesthesiology where additional medications and materials need to be simultaneously administered in a controlled fashion to a patient. Such multi-way systems may also be desirable for staging multiple bags of medications for sequential delivery and may operate, for example, to allow the flow through one inlet IV line at a time until a flow rate drop below a predetermined amount, and then to switch to the next IV line in a predetermined sequence. Generally, it is contemplated that the invention may provide for a wide range of different inlet IV line numbers ranging from 2 to 8 and thus including two inlet IV lines, greater than two inlet IV lines, greater than three inlet IV lines, etc. The extension of the circuitry of  FIG. 3  to include additional control lines will be understood from this disclosure to those of ordinary skill in the art. 
         [0074]    Certain terminology is used herein for purposes of reference only, and thus is not intended to be limiting. For example, terms such as “upper”, “lower”, “above”, and “below” refer to directions in the drawings to which reference is made. Terms such as “front”, “back”, “rear”, “bottom” and “side”, describe the orientation of portions of the component within a consistent but arbitrary frame of reference which is made clear by reference to the text and the associated drawings describing the component under discussion. Such terminology may include the words specifically mentioned above, derivatives thereof, and words of similar import. Similarly, the terms “first”, “second” and other such numerical terms referring to structures do not imply a sequence or order unless clearly indicated by the context. 
         [0075]    When introducing elements or features of the present disclosure and the exemplary embodiments, the articles “a”, “an”, “the” and “said” are intended to mean that there are one or more of such elements or features. The terms “comprising”, “including” and “having” are intended to be inclusive and mean that there may be additional elements or features other than those specifically noted. It is further to be understood that the method steps, processes, and operations described herein are not to be construed as necessarily requiring their performance in the particular order discussed or illustrated, unless specifically identified as an order of performance. It is also to be understood that additional or alternative steps may be employed. 
         [0076]    References to “a microprocessor” and “a processor” or “the microprocessor” and “the processor,” can be understood to include one or more microprocessors that can communicate in a stand-alone and/or a distributed environment(s), and can thus be configured to communicate via wired or wireless communications with other processors, where such one or more processor can be configured to operate on one or more processor-controlled devices that can be similar or different devices. Furthermore, references to memory, unless otherwise specified, can include one or more processor-readable and accessible memory elements and/or components that can be internal to the processor-controlled device, external to the processor-controlled device, and can be accessed via a wired or wireless network. 
         [0077]    It is specifically intended that the present invention not be limited to the embodiments and illustrations contained herein and the claims should be understood to include modified forms of those embodiments including portions of the embodiments and combinations of elements of different embodiments as come within the scope of the following claims. All of the publications described herein, including patents and non-patent publications, are hereby incorporated herein by reference in their entireties.