CN104645433A - Warming arrangement and a method, continuous renal replacement therapy system and disposable kit - Google Patents
Warming arrangement and a method, continuous renal replacement therapy system and disposable kit Download PDFInfo
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- CN104645433A CN104645433A CN201410652656.1A CN201410652656A CN104645433A CN 104645433 A CN104645433 A CN 104645433A CN 201410652656 A CN201410652656 A CN 201410652656A CN 104645433 A CN104645433 A CN 104645433A
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- 238000000034 method Methods 0.000 title claims abstract description 126
- 238000012959 renal replacement therapy Methods 0.000 title claims abstract description 14
- 238000010792 warming Methods 0.000 title abstract description 7
- 239000012530 fluid Substances 0.000 claims abstract description 342
- 238000010438 heat treatment Methods 0.000 claims abstract description 164
- 239000008280 blood Substances 0.000 claims abstract description 160
- 210000004369 blood Anatomy 0.000 claims abstract description 157
- 238000011282 treatment Methods 0.000 claims abstract description 45
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- 238000006073 displacement reaction Methods 0.000 claims description 175
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- 238000010276 construction Methods 0.000 claims description 10
- 239000000463 material Substances 0.000 claims description 7
- 230000000694 effects Effects 0.000 claims description 5
- 230000036760 body temperature Effects 0.000 abstract description 7
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1654—Dialysates therefor
- A61M1/1656—Apparatus for preparing dialysates
- A61M1/166—Heating
- A61M1/1662—Heating with heat exchange between fresh and used dialysate
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1654—Dialysates therefor
- A61M1/1656—Apparatus for preparing dialysates
- A61M1/166—Heating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
- A61M1/36223—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit the cassette being adapted for heating or cooling the blood
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
- A61M1/36225—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit with blood pumping means or components thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
- A61M1/36226—Constructional details of cassettes, e.g. specific details on material or shape
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
- A61M1/36226—Constructional details of cassettes, e.g. specific details on material or shape
- A61M1/362266—Means for adding solutions or substances to the blood
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3623—Means for actively controlling temperature of blood
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit
- A61M2205/127—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit with provisions for heating or cooling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3368—Temperature
Landscapes
- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
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- General Health & Medical Sciences (AREA)
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- Urology & Nephrology (AREA)
- Emergency Medicine (AREA)
- External Artificial Organs (AREA)
Abstract
The invention discloses a warming arrangement and method, a continuous renal replacement therapy system and a disposable kit. The system comprises a blood treatment unit and a heat exchanger configured to be fluidly coupled to an effluent fluid line to transfer heat to at least one treatment fluid and/or blood. The warming arrangement further comprises a heating element configured to transfer heat to the effluent fluid, wherein the heating element is located downstream the blood treatment unit and upstream the heat exchanger. The method includes determining a control parameter based on an indicated temperature and/or flow rate, and to control the temperature of, or the power delivered to, the heating element based on the control parameter. The continuous blood heating temperature of a blood line outside a human body should be set to a temperature close to a normal body temperature without bringing any risk.
Description
Technical field
Relate generally to extracorporeal blood treatment of the present invention.More particularly, the present invention relates to a kind of heating apparatus (warming arrangement), system, disposable external member and the method for displacement fluids of heating (effluentfluid).
Background technology
In dialysis treatment, the blood that some heats circulate usually from loop is in vitro lost in environment.This extracorporeal circuit comprises the blood treatment unit of blood line and wherein processing blood.After after a while, the heat loss of the blood circulated in extracorporeal circuit causes the health of the patient when blood being turned back to patient to turn cold.There is different types of blood warmer, but they are often difficult to, this is because it is very important for extracorporeally circulating blood not being exposed to any too high temperature enough effective.The temperature of extracorporeally circulating blood should more than 41 DEG C, otherwise may cause blood and to have a strong impact on and/or bubble may be introduced in blood.
Heat loss in extracorporeally circulating blood causes to ambient air and/or to displacement fluids due to heat diffusion.Displacement fluids is made up of the dialysis fluid used in the process under hemodialysis (HD) pattern and the fluid that extracts in hemodiafiltration (HDF) or blood filtration (HF) pattern.Displacement fluids is sent to outlet, thus diffuses to the heat loss of displacement fluids from blood.
Under continuous renal replacementtherapy (hereinafter referred to as CRRT) must be stored in the temperature relatively cold relative to the body temperature of patient usually to the process fluid needed for the process of patient.This fluid be usually stored in scope be from 2 DEG C to 20 DEG C temperature, under fluid be kept at maintain the function of this fluid and the state of integrity.The seriality of CRRT increases the potentiality of the heat loss in the blood circulated in extracorporeal circuit, and patient may experience body temperature reduction in certain circumstances.This is especially obvious when the temperature of process fluid is lower than extracorporeally circulating blood.For this reason, usually wish process fluid be introduced in patient body before by process fluid heating to suitable temperature, decline fast to prevent the body temperature of patient.Process fluid can be any fluid of use in CRRT process, namely for dialysing, infusion, displacement or anticoagulant fluid.
Compared with the medium blood flow period within the scope of 100-200 ml/min or the high blood flow period within the scope of 200-300 ml/min, during the low blood flow period of about 50 ml/min, temperature reduces more.For this reason, the heat loss compensating or reduce extracorporeally circulating blood is desirably in some CRRT process.
In order to save some heats diffusing to displacement fluids from blood from damage, develop the heat exchanger disclosed in WO2010/040819.This heat exchanger by the exchange heat of displacement fluids to one or more process fluid, or exchange to clean after extracorporeally circulating blood.
But, utilize as device disclosed in WO2010/040819, because the limited efficacy of heat exchanger and the heat loss to surrounding air, the blood heat whole process in extracorporeal circuit may be difficult to turn back to normal body temperature.
JP2004313303 discloses a kind of discontinuous CRRT blood processor worked within two cycles, wherein, during the period 1, in blood treatment unit not pump blood or process fluid, and fresh process fluid be transported in housing close equalizing chamber.During second round, these fresh process fluids by the fluid compartment of blood treatment unit and blood pump run.During second round, before entering the housing on outside equalizing chamber, displacement fluids is heated.The shortcoming that this device has is, during second round, only has the time of half to provide process.In addition, the heat being delivered to fresh process fluid from displacement fluids will be completely adiaphorous, because fluid moves considerably less in the housing and in equalizing chamber.In addition, when excavationg pump runs, the heating of displacement fluids may only occur during second round.
Summary of the invention
The object of this invention is to provide a kind of heating apparatus, comprise the system of this heating apparatus, be suitable for heating apparatus with the use of disposable accessory and the method for heating for displacement fluids in continuous renal replacementtherapy system, by the blood laser heating in extracorporeal blood line to normal body temperature, and any security risk can not be introduced.
According to first scheme, this object is realized at least in part by the heating apparatus for CRRT system.This system comprises: blood treatment unit, connects the blood line being used for extracorporeally circulating blood; And fluid distributed lines, comprise at least one process fluid line for making process fluid pass through, and the displacement fluids line for making displacement fluids pass through.Described heating apparatus also comprises heat exchanger, described heat exchanger is configured to fluid and is connected to described displacement fluids line, and be set to process fluid line with described at least one there is hot relation, thus at treatments period, heat is delivered to the process fluid of at least one uninterrupted pumping from the displacement fluids of uninterrupted pumping, and/or be set to, with described blood line, there is hot relation, thus heat is delivered to the blood of uninterrupted pumping from the displacement fluids of described uninterrupted pumping at treatments period.Described heating apparatus also comprises the heating element heater being configured to heat is delivered to described displacement fluids, and wherein, described heating element heater is positioned at the downstream of described blood treatment unit, the upstream of described heat exchanger.
By this heating apparatus, carry out the situation of heating compared to only using heat exchanger, displacement fluids can reach higher temperature, thus process fluid and/or blood can be warmed to higher temperature.Because to heat to process fluid and/or blood by indirectly to heat, so cause the risk introducing undesired bubble very low due to sharply thermal change.Before heat arrives fluid and/or blood, middle heat medium and then displacement fluids reach stable by making any variations in temperature sharply of heating element heater.
Indirectly heat and refer to and to heat via middle heat medium (being displacement fluids here).Thus, first displacement fluids is heated, and after this, the displacement fluids of heating is heated to one or more process fluid and/or blood.
According to an embodiment, described heating apparatus comprises the control unit being configured to the temperature controlling described heating element heater based on controling parameters.
According to another embodiment, described control unit is configured to receive at least one measuring-signal of the temperature of at least one in instruction described displacement fluids, at least one process fluid and described blood line in blood and/or flow velocity, and determines described controling parameters based on described temperature and/or flow velocity.
According to another embodiment, described controling parameters is the parameter making described heating element heater produce an effect, or described at least one process fluid is warmed to preferred temperature T
setand/or blood is warmed to preferred temperature T
setBthe temperature value T of required heating element heater
he.
According to an embodiment again, described control unit is configured to calculate described controling parameters based on the model of described heat exchanger.
According to an embodiment again, described in heat and be configured at least one process fluid to heat to preferred temperature T
set, this preferred temperature T
setin interval between 35 DEG C and 45 DEG C, be preferably in the interval between 37 DEG C and 43 DEG C.This can by before entering heat exchanger at displacement fluids, and the temperature (being preferably 40 DEG C to 50 DEG C) be warmed to by displacement fluids between 37 DEG C and 55 DEG C has been come.
According to an embodiment, described heating element heater comprises at least one hot plate being configured to the displacement fluids of heating in described displacement fluids line.Thus, described heating element heater can be electric heater.The heating element heater of other application type can be infrared heater or induction heater.
According to alternative plan, this object is realized at least in part by the system for continuous renal replacementtherapy.This system comprises: Continuous renal replacement therapy watch-dog, the excavationg pump having at least one blood pump for uninterrupted pumping blood, the process fluid pump of at least one for uninterrupted pumping process fluid and comprise alternatively for uninterrupted pumping displacement fluids.This system also comprises blood line, associates with described watch-dog, for passing through described blood pump extracorporeally circulating blood; Fluid distributed lines, associates with described watch-dog, comprises at least one process fluid line and the displacement fluids line for making displacement fluids pass through for making process fluid pass through by described process fluid pump; And blood treatment unit, be arranged between described blood line and described fluid distributed lines.Described fluid distributed lines also comprises according to any one heating apparatus in embodiment described herein.
According to an embodiment, the displacement fluids line of this system has the part being designed to coordinate the heat exchange increased between described heating element heater and described displacement fluids with heating element heater, and wherein, described part is positioned at the upstream of described heat exchanger.
According to third program, this object is realized at least in part by disposable external member.This disposable external member comprises supporting construction, blood line and fluid distributed lines.Described fluid distributed lines comprises displacement fluids line and at least one process fluid line, and the wired and described supporting construction of institute associates, and described at least one process fluid line has the U-shaped portion being designed to coordinate with respective pump divides.Described fluid distributed lines also comprises heat exchanger, described heat exchanger is configured to fluid and is connected to described displacement fluids line, and be set to, with described process fluid line, there is hot relation, heat to be delivered at treatments period the process fluid of uninterrupted pumping from the displacement fluids of uninterrupted pumping, and/or be set to described blood line, to there is hot relation, heat is delivered to the blood of uninterrupted pumping from the displacement fluids of described uninterrupted pumping at treatments period.Described displacement fluids line also has the part being designed to coordinate with heating element heater, and described heating element heater is configured to heat is delivered to the displacement fluids in described displacement fluids line, and wherein, described part is positioned at the upstream of described heat exchanger.
According to an embodiment, described part have flat, heave shape, to increase the heat exchange between described heating element heater and described displacement fluids.According to another embodiment, described part has spiral-shaped, and is designed to around described heating element heater.According to an embodiment again, described part comprises the material being configured to the heat exchange increased between described heating element heater and described displacement fluids.
According to fourth program, this object is passed through for utilizing the method for the displacement fluids of heating in displacement fluids line at heating apparatus disclosed herein to realize at least in part in continuous renal replacementtherapy system, and this device comprises the control unit being configured to the temperature controlling described heating element heater.The method comprises: the temperature of at least one in reception instruction described displacement fluids, at least one process fluid and described blood line in blood and/or at least one measuring-signal of flow velocity; Controling parameters is determined based on indicated temperature and/or flow velocity; And control the temperature of described heating element heater based on described controling parameters or be sent to the power of described heating element heater.
According to an embodiment, described method comprises: the model based on described heat exchanger calculates described controling parameters.
According to another embodiment, described method comprises heats described at least one process fluid to preferred temperature T
set, this preferred temperature T
setin interval between 35 DEG C to 45 DEG C, be preferably in the interval between 37 DEG C to 43 DEG C.
According to the 5th scheme, this object is realized at least in part by the computer program in system, and wherein, described computer program comprises the computer instruction impelling control unit to perform the method for asking disclosed arbitrary steps or embodiment according to root.
According to the 6th aspect, this object is realized at least in part by computer program, and described computer program comprises storage on a computer-readable medium for performing the computer instruction of any step of described method.
The disclosure provides the Continuous Flow of displacement fluids by heat exchanger and fresh process fluid or multiple fresh process fluid and/or blood.Heat exchanger can be arranged as with counter-flow pattern (countercurrent mode) work, that is, heat exchanger is arranged such that displacement fluids stream flows along the rightabout of at least one with process fluid or blood stream during heat exchange.Described heating element heater is also arranged to displacement fluids of heating continuously, and this is more effective than the solution of prior art.In addition, due to fluid continuous-flow, thus temperature controls to become more accurate.
Accompanying drawing explanation
Illustrate in greater detail the present invention by the following examples with reference to appended accompanying drawing now, wherein:
Fig. 1 schematically shows the CRRT flow graph comprised for processing the heating apparatus carrying out heat exchange between fluid at displacement fluids and two or three.
Fig. 2 A to Fig. 2 D shows the different embodiments of the mating part of heating element heater and displacement fluids line.
Fig. 3 diagrammatically illustrates the CRRT flow graph of the heating apparatus comprised for carrying out heat exchange between displacement fluids and blood.
Fig. 4 schematically shows the embodiment of the disposable external member (disposable kit) for CRRT watch-dog, and it comprises heat exchanger and the displacement fluids line being configured to be heated by heating element heater.
Fig. 5 diagrammatically illustrates the external member according to Fig. 4 be arranged on CRRT watch-dog.
Fig. 6 shows the flow chart of the method according to an embodiment.
Detailed description of the invention
Fig. 1 shows the exemplary system for continuous renal replacementtherapy (CRRT).This system comprises blood circuit or blood line 1a, its for by least one blood pump 1b (blood pump is only shown by way of example) from the first compartment 2a in vitro blood circulation of patient P via blood treatment unit 2.Device also comprises displacement fluids line 3a, and it is for being sent to displacement fluids container 4 by displacement fluids from the second compartment 2b of blood treatment unit 2 by displacement fluids pump 3b.First compartment 2a and the second compartment 2b is separated by the semipermeable membrane 2c of such as hollow fiber type.This device comprises one or more process fluid line, as the line for passing through fresh dialysis liquid and/or displacement fluid and/or anticoagulation fluid.This CRRT treatment carrys out monitor and forecast by CRRT watch-dog (not shown).This watch-dog can based on microprocessor.This watch-dog can be comprised all logics and be received and processing command by control valve (not shown) and pump, resolves sensor (not shown), activates the operation of all aspects of alarm and guiding treatment system.
CRRT can perform under three kinds of different modes according to Solute removal principle: hemodialysis (HD) pattern, blood filtration (HF) pattern and hemodiafiltration (HDF) pattern.Under all patterns, CRRT is continuous print.This means, blood is continuously pumped and without any intentional interruption in processing procedure.Thus process becomes more effective, and its persistent period can be shortened.Continuous process is also included in the process fluid of one or more uninterrupted pumpings of treatments period and the displacement fluids stream of uninterrupted pumping, and without any intentional interruption.Thus, at treatments period, can be implemented in treatments period and heat is delivered at least one process fluid continuously from displacement fluids and/or heat is delivered to blood continuously from displacement fluids.Such as, but this continuous process is not got rid of process and is stopped, during alarm condition or between the stage of replacement of bag with fluid solution.
In HD pattern, the Solute removal wherein in blood treatment unit 2 carries out based on diffusion, and fresh dialysis fluid is sent to the second compartment 2b of blood treatment unit 2 via dialysis fluid line 6a from dialysis fluid source 5 by dialysis fluid pump 6b.The dialysis fluid used in blood treatment unit 2 is sent to amount discharge container 4 by excavationg pump 3b via displacement fluids line 3a.
In HF pattern, Solute removal wherein in blood treatment unit 2 carries out based on convection current, filtrate (that is, by liquid that semipermeable membrane filters from patient blood) is sent to amount discharge container 4 from the second compartment 2b of blood treatment unit 2 via displacement fluids line 3a by excavationg pump 3b.In order to replace some filtrate and recover the normal body fluid state of patient, the infusion point that displacement fluid is being arranged in blood treatment unit 2 upstream from replacement fluid source 7 is infused in blood line 1a.Displacement fluid to be sent to the infusion point 1c in blood line 1a via displacement fluid line 8a by displacement fluid pump 8b.Alternatively, the infusion point 1d in blood treatment unit 2 downstream is infused into from the displacement fluid of replacement fluid source 7.Then, displacement fluid is sent to infusion point 1d by displacement fluid pump 8b via displacement fluid line 8a, 8e.
The volume of displacement fluid is controlled by CRRT watch-dog, makes it be less than the volume of filtrate.In alternative CRRT structure, displacement fluid is made up of the dialysis fluid in dialysis fluid source 5, and to be sent to the infusion point 1d in blood line 1a via dialysis fluid line 6a, 6e by dialysis fluid pump 6b.
In HDF pattern, wherein Solute removal carries out based on diffusion and convection current, and fresh dialysis fluid and displacement fluid are used with the principle of HD and HF pattern associated description according to above-mentioned.
In this Three models all, alternatively, the anticoagulation fluid from anticoagulation fluid source 9 is infused in the blood line 1a at the infusion point 1e place being arranged in blood pump 1b upstream.Anticoagulation fluid is passed to infusion point 1e by anticoagulation fluid pump 10b via anticoagulant line 10a.
The respective source of dialysis fluid 5, displacement fluid 7 and anticoagulation fluid 9 can be all the form of container, and this container is sterilized and is ready for previously prepared fluid.Fluid 5,7,9 is all called as the process fluid for the process in CRRT system.Each container can comprise volume and rise process fluid in scope at 1-10.This container can be flexible, rigidity or semirigid.
Process fluid in container can be the cold fluid relative to displacement fluids.As will be explained hereinafter, temperature difference is used to the process fluid of heating colder.Therefore, comparatively warm displacement fluids is used to one or more fluids of heating colder, such as dialysis fluid, displacement fluid, anticoagulation fluid and/or blood.Heat in the heat exchanger 12 that occurs in and be arranged to there is with displacement fluids hot relation, so as by heat from displacement fluids be delivered to treat by heat compared with cold treatment fluid or multiple comparatively cold treatment fluid or blood.
The heating apparatus 11 of CRRT system is shown in Fig. 1.Heating apparatus 11 comprises heat exchanger 12, and it is configured to fluid and connects (couple) to displacement fluids line 3a and be set to process fluid line 6a, 8a, 10a with at least one and have hot relation.Heating apparatus 11 also comprises heating element heater 13, and heating element heater 13 is configured to heat to be passed to displacement fluids, and wherein heating element heater 13 is positioned at the downstream of blood treatment unit 2 and is positioned at the upstream of heat exchanger 12.Heating element heater 13 can be positioned at upstream or the downstream of excavationg pump 3b (if present).
According to an embodiment, heating apparatus 11 comprises control unit 14, and control unit 14 is configured to the temperature such as controlling heating element heater 13 based on controling parameters.Control unit 14 can be a part for the CRRT watch-dog of system.Heating element heater 13 is configured to be connected to control unit 14 for supply of electric power and/or data transmission.According to an embodiment, control unit 14 comprises computer-readable memory 31 and processor or processing unit 32, and this processor or processing unit 32 are configured to perform the computer instruction be stored on control unit 14.Heating element heater 13 can provide heating continuously to displacement fluids.This heating element heater 13 is controlled by rights by control unit 14, to heat continuously to displacement fluids.This control suitably of heating element heater 13 can comprise on-off (on-off) control of standard, and the heat wherein come from heating element heater 13 transmission may slightly fluctuate.The suitable control of other kind can comprise ratio control (P) and/or integration control and differential and control (PID).
Heat exchanger 12 is adapted to pass through displacement fluids and heats at least one fluid continuously, and the fluid of two kinds, three kinds, four kinds or more of can being configured to heat.In FIG, heat exchanger 12 is shown as heating two kinds of liquid, the displacement fluid in the fresh dialysis liquid namely in dialysis fluid line 6b and displacement fluid line 8a.Alternatively, heat exchanger 12 can heat the 3rd fluid, the displacement fluid namely in anticoagulation fluid line 10a, as shown in the dotted line of the anticoagulation fluid line 10a in figure.Heat exchanger 12 can be template or hollow fiber type, and wherein doughnut can be semi-permeable or impermeable type.An example of suitable heat exchanger is open in WO2010/040819A1.Heat exchanger 12 can operate under counter-flow pattern.Counter-flow pattern refers to and is arranged to rightabout flowing along at least one fluid (this fluid during heat exchange in heat exchanger 12 exchanged heat) by the displacement fluids of heating.
According to an embodiment, heating element heater 13 has following design: between heating element heater 13 and displacement fluids line 3a, provide effective heat trnasfer.In Fig. 2 A-Fig. 2 D, show the multiple different embodiment of the heating element heater 13 of cooperation (mating) part 20 with displacement fluids line 3a.Heating element heater 13 can be such as electric heater, infrared heater, induction heater or another kind of thermal source.Displacement fluids line 3a can be provided with the part 20 being positioned at heat exchanger 12 upstream, and it is designed to provide effective heat trnasfer between heating element heater 13 and displacement fluids.This part 20 can be designed to coordinate with heating element heater 13 and/or be made up of the material being configured to the heat exchange improved between heating element heater 13 and displacement fluids.
In fig. 2, the embodiment that heating element heater 13 comprises two hot plates 23a, 23b is shown.Fig. 2 A shows the expanded view of heating element heater 13 and part 20.In operation, heating element heater 13 is placed with and mating part 20 compact siro spinning technology, makes this mating part 20 be placed between two hot plates 23a, 23b of heating element heater 13.At least side 25 of hot plate 23a, 23b is intended in the face of mating part 20 is so that transferring heat, and can have flat rectangular shape as shown in Figure 2 A.Mating part 20 herein has bag-shaped, such as flat, bloat shape, there is upper and lower relative flat side 26a, 26b.The cross section of mating part 20 is herein greater than the cross section of remaining displacement fluids line 3a.Each hot plate 23a, 23b are positioned as making to be intended in the face of the side 25 of hot plate 23a, 23b of mating part 20 in the face of the upper or lower flat sides 26 of mating part 20.If only have hot plate 23a, a 23b, then hot plate 23a, 23b orientates upper or lower flat sides 26a, the 26b in the face of mating part 20 as.Part 20 can also have internal channel 24 in part 20, for carrying displacement fluids.Thus the displacement fluids dirty longer route of situation flowed by part 20 more direct than displacement fluids is forced, and can heating element heater 13 in augmenting portion 20 and the heat trnasfer between displacement fluids.Displacement fluids is represented with hatched arrows by the flow direction of passage 24.Can instead, mating part 20 only can comprise and has the flat major path (not shown) bloating shape.Inner at this major path, displacement fluids scatters when flowing through part 20, with the heat trnasfer between the one side or the multi-lateral 25 increasing displacement fluids and heating element heater or multiple element 23a, 23b.Control unit 14 is illustrated as being connected to heating element heater 13, i.e. hot plate 23a, 23b.
According to another example shown in Fig. 2 B, heating element heater 13 comprises at least one infrared heater 27a, 27b.The shape of part 20 can be identical with any embodiment described with reference to figure 2A.Infrared heater or heater 27a, 27b are configured to relative flat side 26a, 26b above and/or under mating part 20.Control unit 14 is illustrated as being connected to heating element heater 13, i.e. infrared heater 27a, 27b.
In another embodiment in fig. 2 c, mating part 20 has spiral-shaped, and is designed to around heating element heater 13.Thus, heating element heater 13 can have shaft-like, such as, have the corresponding matching recess 28 for spiral type mating part 20 or vestige (trace).Spiral type mating part 20 can partially or completely by accommodating or be integrated in bar.According to an embodiment, spiral type mating part 20 is placed in bar, makes the surface contact of half periphery of spiral type mating part 20 and the recess 28 of bar or vestige.Displacement fluids is represented by arrow by the flow direction of mating part 20.Control unit 14 is illustrated as being connected to heating element heater 13, i.e. bar.
In an embodiment again in figure 2d, heating element heater 13 has the shape of the shell 29 being configured to surrounding mating part 20.This shell 29 can have opening 34, and shell can be contained on (dressover) mating part 20.Shell 29 comprises heater, as heater strip 30.This heater strip 30 is arranged to shell 29, and the displacement fluids in mating part 20 can be heated effectively by the heat of heater strip 30.Heater strip 30 can be arranged on shell 29 with rule or irregular pattern.According in an embodiment, heater strip 30 is arranged between the lining of shell 29 at least in part.According to another embodiment, heater strip 30 is arranged on the surface of shell 29 at least in part, on the surface of such as, faced by being arranged in when being contained on mating part 20 mating part 20.Heater strip 30 can be arranged to have the extension reciprocal back and forth to the opposite side of shell 29 from the side of shell 29, so that effectively and provide heat to mating part equably.Represented by arrow by the flow direction of the displacement fluids of mating part 20.Control unit 14 is illustrated as being connected to heating element heater 13, i.e. shell 29 and heater strip 30.But other substitutes many of heating element heater 13 and mating part 20 can be considered to provide efficient heat trnasfer.
Fig. 3 illustrates at first and the schematic diagram of the CRRT system of Fig. 1 associated description, and it comprises the heating apparatus 11 being adapted to pass through and carrying out warming blood from the displacement fluids of blood treatment unit 2 extraction.Heat exchanger 12 is configured to be fluidly coupled to displacement fluids line 3a, and is set to have hot relation with blood line 1a, thus for heat is delivered to blood continuously from displacement fluids.Therefore, blood can via displacement fluids in a secured manner by laser heating indirectly.
Heating element heater 13 can have between 40 DEG C to 55 DEG C, the steady temperature preferably between 45 DEG C to 50 DEG C, with displacement fluids of heating before entering heat exchanger 12 at displacement fluids, thus warming blood and/or one or more process fluids.Then, when CRRT system is activated, heating element heater 13 is simultaneously activated by CRRT system power supply.
According to an embodiment, controling parameters heating element heater 13 is produced at least one fluid is warmed to preferred temperature T
setand/or blood is warmed to preferred temperature T
setBthe parameter of required effect.Therefore, this parameter can be performance number Q
h, current value I
h, magnitude of voltage U
h, dutyfactor value or be used for make heating element heater produce needed for any other of controling parameters of effect represent.Thus, control unit 14 is configured to the power Q controlling to be delivered to heating element heater 13 according to dutyfactor value etc.
h, electric current I
h, voltage U
hdeng, or control heating element heater 13.
Or controling parameters is that at least one process fluid is warmed to preferred temperature T
setand/or blood is warmed to preferred temperature T
setBthe temperature value T of required heating element heater 13
he.Thus, control unit 14 is configured to the temperature of heating element heater 13 to control to temperature T
he.This such as can by being delivered to heating element heater 13 or the temperature of heating element heater 13 being controlled to temperature T by certain power
heand complete.
The preferred temperature T of one or more process fluid
setor the preferred temperature T of blood
setBcan be set by the user interface of CRRT system.Or, temperature T
setor temperature T
setBbe predetermined value, and be known for control unit.Typically, temperature T
setbetween 35 DEG C and 45 DEG C, the interval preferably between 37 DEG C and 43 DEG C.Temperature T
setBthe temperature close to normal body temperature should be set to, and usually be set as about 37 DEG C.
Such as, in order to determine suitable controling parameters, performance number Q based on the preferred temperature of one or more process fluids or blood
hor temperature value T
he, control unit 14 is configured to receive instruction displacement fluids, at least one process fluid and blood line 1
athe temperature of at least one in middle blood and/or at least one measuring-signal of flow velocity.Thus, control unit 14 is configured to carry out controling parameters based on temperature and/or flow velocity.
Such as, if CRRT system (namely blood line 1a is on return path of patient P or other destination (such as blood bag)) on blood line 1a is provided with temperature sensor, then the measuring tempeature of blood can be sent to the measuring-signal of control unit 14 as the blood heat measured by instruction.This measuring-signal via line 33, be sent to control unit 14 by wireless transmission, or can exchange via internal data network.Thus, control unit 14 is configured to determine controling parameters based on measured blood heat, thus realizes the preferred temperature T of blood
setB, and correspondingly regulate heating element heater 13.Here, controling parameters can be determined by using general control algorithm (as feedback control) well known by persons skilled in the art.At this, feedback control running is to minimize preferred temperature T
setBand the error between measured blood heat.
According to another embodiment, and when there is not temperature sensor on blood line 1a, the somewhere of temperature in dialysis fluid path or on dialysis fluid path records.The temperature of displacement fluids can in the downstream of heating element heater 13, the upstream of heat exchanger 12 measures.Then, after displacement fluids leaves heating element heater 13, but before entering heat exchanger 12, measure the temperature of displacement fluids.That is, the temperature of displacement fluids be in the downstream of heating element heater 13, the upstream of heat exchanger 12 measures.Equally, the temperature of one or more process fluids can be measured.Thus, CRRT Operation system setting has one or more suitable temperature sensor.Thus, control unit 14 is configured to determine controling parameters based on measured temperature, thus can realize the preferred temperature T of one or more process fluids
set, and correspondingly regulate heating element heater 13.Again state, controling parameters can be determined by using general control algorithm (as feedback control) well known by persons skilled in the art.Here, feedback control running is to minimize preferred temperature T
setand the error between the temperature of the process fluid recorded or multiple process fluid or multiple temperature.
As previously mentioned, controling parameters can be confirmed as quantity of power Q
h, current value I
h, magnitude of voltage U
hdeng, it has been sent to heating element heater 13 to realize the specified temp T of heating element heater 13 or any fluid
set.Temperature sensor is not had to be favourable to measure the temperature of blood or other fluid any.
In the following example, for the sake of simplicity, controling parameters is calculated as and expects performance number Q
h, but the expectation voltage U of heating element heater 13 can be converted into
h, electric current I
hdeng.The efficiency of heating element heater 13 usually close to 100%, but also may be used for more high-precision measurement (such as, shifting to an earlier date), and measures efficiency eta
hcan be included in calculating below.Only there is sub-fraction (fraction) η of the heat being delivered to displacement fluids
xprocess fluid in heat exchanger 14 will be passed to.This sub-fraction η
xto the flow velocity of fluid be depended on, and the model of the heat exchanger 12 for different in flow rate can be previously determined to be.In order to measure the flow velocity of fluid, system can be provided with suitable flow sensor.This flow velocity also can calculate by using the rotary speed of such as pump and their known stroke capacity.Therefore, control unit 14 can be configured to calculate controling parameters based on the model of heat exchanger 12.
Blood and process fluid both can lose some heats Q
ato in surrounding air.This loss also will depend on flow velocity, and it can be used for estimating this loss.This calculating can complete for often kind of process fluid and blood respectively for using often kind of process fluid and blood flow velocity separately, and results added is obtained Q
a.Thus, Q
adepict the total amount of the heat being lost to surrounding air.
Process fluid should from their initial temperature T
0(processing the temperature of fluid in such as their bag) is warmed to preferred temperature T
set.Thus, required heat is:
Q
f＝F·C
P·(T
set-T
0) (1)
Wherein, F is flow velocity, C
pthe thermal capacity of process fluid.Usually, C
p, T
setand T
0be assumed that for different process fluids be equal, thus, calculate and F can be used to have come as the flow velocity summation of process fluid.Otherwise, be used alone Q for each process fluid
fequation, then result is added again and obtains total Q
f.
Even if when not having heating element heater 13, some in the heat needed for heating will be provided by heat exchanger 12.This heat Q
xthe decline of the temperature of experience can be calculated according to displacement fluids, this is total usable temp difference (T
e-T
0) sub-fraction η
x(heat exchanger effectiveness), wherein, T
efor the temperature of displacement fluids when arriving heat exchanger 12.Q
xwill be:
Q
x＝F
e·C
P·η
x·(T
e-T
0) (2)
According to following equation, efficiency and loss can be considered now, calculate and need the quantity of power Q being provided to heating element heater 13
h:
Q
h·η
h·η
x＝Q
f+Q
a-Q
x(3)
Process fluid at room temperature uses, and usually stores at a lower temperature.They in use will be heated by surrounding air.Suppose T
0equal 25 DEG C by too high estimation actual temperature, thus avoid due to too high estimation Q
fand convection cell superheated.Displacement fluids goes out from blood filtration, and can experience some temperature losses, but T
ecan be assumed that close to 36 DEG C.Due to loss be calculated in, thus T
setbe not set to the temperature higher than wanting, such as 37 DEG C.
Rated output amount Q
hanother kind of method be by higher T
set(as 40-43 DEG C) replaces estimated heat loss and (that is, sets Q
a=0).
Calculate power demand Q
hanother mode come to be determine which temperature T displacement fluids should have in the upstream of heat exchanger 12
high, to transmit power required in heat exchanger 12.The heat Q then transmitted by heat exchanger 12 will be:
Q＝F
e·C
p·η
x·(T
high-T
0) (4)
Further, this heat Q should heat (multiple) fluid, and covers the loss, and makes:
F
e·C
p·η
x·(T
high-T
0)＝Q
f+Q
a(5)
Consider the efficiency of heating element heater 13, then the power Q needed for heating element heater 13
hcan pass through from T
ebe increased to T
highrequired temperature is determined:
Q
h·η
h＝F
e·C
p·(T
high-T
e) (6)
When heater is used for direct warming blood, control unit 14 can use a model or show to control heating element heater 13 and blood is warmed to preferred temperature.Such as, can be as explained above, the temperature of displacement fluids is measured in the upstream of the downstream of heating element heater 13 and heat exchanger 12.Controling parameters can be used as by this temperature of the ejection (effluent) of heating.If the flow of ejection is known, such as by flowmeter survey or known by excavationg pump speed, and which power makes heating element heater 13 realize the relevant knowledge of the specified temp of displacement fluids as required, the temperature of the displacement fluids of heating element heater 13 upstream can be calculated.By such as knowing velocity of blood flow and rate of flow of fluid by the speed of the pump of pumping different fluid, know the type of the blood processing apparatus that process is used, and the data using above-mentioned calculating and record, the usefulness (effectiveness) of heat trnasfer in blood processing apparatus can be derived according to table or computation model, derive the energy loss of blood thus.When the energy loss of blood is known, displacement fluids should can be calculated, so that blood reaches or regains preferred temperature by controlled preferred temperature.
The principal sketch of the disposable external member in integrated fluid processing module form shown in Figure 4, it comprises: blood line 1a and fluid distributed lines, this fluid distributed lines comprises displacement fluids line 3a, multiple process fluid line 6a, 8a, 10a and heat exchanger 12, this heat exchanger 12 fluid is connected to displacement fluids line 3a and is set to and processes fluid line 6a, 8a, 10a and have hot relation, is delivered to process fluid for by heat from displacement fluids.Alternatively, or in combination, heat exchanger 12 can be set to have hot relation with blood line 1a, is delivered to blood for use in by heat from displacement fluids.All these lines all have formation U-shaped line length 15,16,17,18,19 to coordinate with respective pump, namely coordinate at least partially with blood pump 1b, displacement fluids pump 3b, dialysis fluid pump 6b, displacement fluid pump 8b and anticoagulation fluid pump 10b.Alternatively, disposable external member also comprises the blood treatment unit 2 be associated with blood line 1a and fluid distributed lines.Line 1a, 3a, 6a, 8a, 10a, blood treatment unit 2 and heat exchanger 12 are disposed in the supporting construction 22 that is illustrated by the broken lines, so that line is connected to pump 1a, 3b, 6b, 8b, 10b.Displacement fluids line 3a also comprises the part 20 being designed to coordinate with heating element heater 13, and this heating element heater 13 is configured to heat is delivered to the displacement fluids in displacement fluids line 3a.Heating element heater 13 can be in one of embodiment disclosed herein.This part 20 is positioned at the upstream of heat exchanger 12, the downstream of blood treatment unit 2.In the diagram, this part 20 is positioned at the outside of supporting construction 22, but also can be arranged in supporting construction 22.
Part 20 can be formed to carry out heat exchange between the displacement fluids being convenient to flow in heating element heater 13 and part 20.Explain the multiple different embodiment of part 20 relatively from Fig. 2 A-Fig. 2 D.The wall portion of mating part 20 also can be made for thinner than other wall portion of displacement fluids line 3a, thus improves heat trnasfer.According to an embodiment, part 20 comprises the material being configured to the heat exchange increased between heating element heater 13 and displacement fluids.This material can be metal, such as copper.Remaining displacement fluids line 3a can such as be made up of plastic material.
This disposable external member is designed to use together with the CRRT watch-dog 21 of Fig. 4 shown type.Disposable external member is in use arranged on the front side of watch-dog 21.Disposable external member has blood line 1a, displacement fluids line 3a and multiple process fluid line 6a, 8a, 10a.All lines are all associated with supporting construction 22, and every bar line all has the U-shaped portion being designed to coordinate with respective pump 3b, 6b, 8b, 10b (Fig. 4) divides 15,16,17,18,19 (Fig. 4).Blood treatment unit 2 to be also arranged in supporting construction 22 and to be connected to blood line 1a and dialysis fluid line 6a.In addition, heat exchanger 12 is connected to supporting construction 22, and fluid is connected to displacement fluids line 3a, and is arranged to and processes fluid line 6a, 8a, 10a and have hot relation, heat is delivered to process fluid from displacement fluids.
Thus, when using together with CRRT watch-dog, heat exchanger 12 will vertically be arranged.Vertically being furnished with of heat exchanger 12 is beneficial to dissipation of air bubbles.But it is also feasible for being arranged in any position that other is selected.Further illustrate the bag for comprising displacement fluids 4, dialysis fluid 5, displacement fluid 7 and anticoagulation fluid 9 in Figure 5.
The disclosure also relates to a kind of system for CRRT.This system comprises Continuous renal replacement therapy watch-dog 21 (Fig. 5), and it has at least one blood pump 1b, at least one process fluid pump 6b, 8b, 10b of previously showing and more any alternatively in excavationg pump 3b as shown in Figure 1 and Figure 3.This system also comprise be associated with watch-dog 21 for the blood line 1a by blood pump 1b extracorporeally circulating blood, and the fluid distributed lines to be associated with watch-dog 21, this fluid distributed lines comprises at least one process fluid line 6a, 8a, 10a and the displacement fluids line 3a for making displacement fluids pass through for making process fluid pass through by process fluid pump 6b, 8b, 10b.This system also comprises the blood treatment unit 2 be arranged between blood line 1a and fluid distributed lines.This fluid distributed lines comprises the heating apparatus 11 according to any embodiment as has been described previously.Displacement fluids line 3a can comprise the part 20 (Fig. 4) according to any embodiment as described herein.
The computer instruction be stored on control unit 14 can be computer program P
cform.According to an embodiment, computer instruction is configured to make control unit 14 to perform method for the displacement fluids in displacement fluids line 3a in CRRT system of heating, and wherein this heating apparatus 11 comprises the control unit 14 being configured to control the temperature of heating element heater 13 according to arbitrary described embodiment.With reference to the flow chart in Fig. 6, the method is described.The method comprises at least one measuring-signal (A1) receiving the temperature of at least one in instruction displacement fluids, at least one process fluid and blood line 1a in blood and/or flow velocity.After this, controling parameters (A2) is determined based on indicated temperature and/or flow velocity.Based on this controling parameters, control the temperature of heating element heater 13 or be sent to the power of heating element heater 13.Controling parameters previously described, and can be referenced in the various replacement schemes of this dissimilar controling parameters and calculating thereof, and was determined by the method and/or calculate.
The disclosure also relates to a kind of computer program, comprises storage computer instruction on a computer-readable medium, for performing foregoing method.
The invention is not restricted to embodiment described herein and accompanying drawing, but can freely change within the scope of the claims.Such as, any embodiment measuring the temperature of blood and/or any fluid can combine with the embodiment not needing (if possible) temperature survey to realize the controling parameters verified further.
Claims (18)
1. a heating apparatus (11), for continuous renal replacementtherapy system, wherein, described system comprises: blood treatment unit (2), connects the blood line (1a) being used for extracorporeally circulating blood, and fluid distributed lines, comprise at least one process fluid line (6a for making process fluid pass through, 8a, 10a), and the displacement fluids line (3a) for making displacement fluids pass through, wherein, described heating apparatus (11) comprises heat exchanger (12), described heat exchanger (12) is configured to fluid and is connected to described displacement fluids line (3a), and be set to process fluid line (6a with described at least one, 8a, 10a) there is hot relation, thus at treatments period, heat is delivered to the process fluid of at least one uninterrupted pumping from the displacement fluids of uninterrupted pumping, and/or be set to, with described blood line (1a), there is hot relation, thus at treatments period, heat is delivered to the blood of uninterrupted pumping from the displacement fluids of described uninterrupted pumping, it is characterized in that: described heating apparatus (11) comprises the heating element heater (13) being configured to heat is delivered to described displacement fluids, wherein, described heating element heater (13) is positioned at the downstream of described blood treatment unit (2), the upstream of described heat exchanger (12).
2. heating apparatus according to claim 1 (11), comprises the control unit (14) being configured to control the temperature of described heating element heater (13) based on controling parameters.
3. heating apparatus according to claim 2 (11), wherein, described control unit (14) is configured to receive instruction described displacement fluids, at least one process fluid and described blood line (1
a) at least one measuring-signal of the temperature of at least one in blood and/or flow velocity, and determine described controling parameters based on described temperature and/or flow velocity.
4. the heating apparatus (11) according to Claims 2 or 3, wherein, described controling parameters is the parameter making described heating element heater (13) produce an effect, or described at least one process fluid is warmed to preferred temperature T
setand/or blood is warmed to preferred temperature T
setBthe temperature value T of required heating element heater (13)
he.
5. heating apparatus according to claim 4 (11), wherein, described control unit (14) is configured to calculate described controling parameters based on the model of described heat exchanger (12).
6. the heating apparatus (11) according to claim 4 or 5, is configured to described at least one process fluid to heat to preferred temperature T
set, this preferred temperature T
setin interval between 35 DEG C to 45 DEG C, be preferably in the interval between 37 DEG C to 43 DEG C.
7. the heating apparatus (11) according to arbitrary aforementioned claim, wherein, described heating element heater (13) comprises at least one hot plate of joining and being set to the displacement fluids of heating in described displacement fluids line (3a).
8., for a system for continuous renal replacementtherapy, comprising:
-Continuous renal replacement therapy watch-dog (21), there is at least one blood pump (1b) for uninterrupted pumping blood, the process of at least one for uninterrupted pumping process fluid fluid pump (6b, 8b, 10b) and the excavationg pump (3b) that comprises alternatively for uninterrupted pumping displacement fluids;
-blood line (1a), associates with described watch-dog (21), for passing through described blood pump (1b) extracorporeally circulating blood;
-fluid distributed lines, associate with described watch-dog (21), comprise for by described process fluid pump (6b, 8b, at least one process fluid line (6a 10b) making process fluid pass through, 8a, 10a) and displacement fluids line (3a) for making displacement fluids pass through; And
-blood treatment unit (2), be arranged between described blood line (1a) and described fluid distributed lines, it is characterized in that, described fluid distributed lines comprises the heating apparatus (11) according to any one of claim 1-7.
9. system according to claim 8, wherein, described displacement fluids line (3a) has the part (20) being designed to coordinate to increase the heat exchange between described heating element heater (13) and described displacement fluids with described heating element heater (13), wherein, described part (20) is positioned at the upstream of described heat exchanger (12).
10. system according to claim 9, wherein, described part (20) comprises the material being configured to the heat exchange increased between described heating element heater (13) and described displacement fluids.
11. disposable external members, comprising:
-supporting construction (22);
-blood line (1a);
-fluid distributed lines, comprise displacement fluids line (3a) and at least one process fluid line (6a, 8a, 10a), wired and the described supporting construction (22) of institute associates, and described at least one process fluid line has and is designed to and respective pump (6b, 8b, U-shaped portion 10b) coordinated divides (15, 16, 17, 18, 19), described fluid distributed lines also comprises heat exchanger (12), described heat exchanger (12) is configured to fluid and is connected to described displacement fluids line (3a), and be set to and described process fluid line (6a, 8a, 10a) there is hot relation, heat to be delivered at treatments period the process fluid of uninterrupted pumping from the displacement fluids of uninterrupted pumping, and/or be set to, with described blood line (1a), there is hot relation, heat to be delivered at treatments period the blood of uninterrupted pumping from the displacement fluids of described uninterrupted pumping, it is characterized in that, described displacement fluids line (3a) has the part (20) being designed to coordinate with heating element heater (13), described heating element heater (13) is configured to heat is delivered to the displacement fluids in described displacement fluids line (3a), wherein, described part (20) is positioned at the upstream of described heat exchanger (12).
12. disposable external members according to claim 11, wherein, described part (20) have flat, heave shape, to increase the heat exchange between described heating element heater (12) and described displacement fluids.
13. disposable external members according to claim 11, wherein, described part (20) has spiral-shaped, and is designed to around described heating element heater (12).
14. disposable external members according to any one of claim 11 to 13, wherein, described part (20) comprises the material being configured to the heat exchange increased between described heating element heater (13) and described displacement fluids.
The method of 15. 1 kinds of displacement fluids in displacement fluids line (3a) of being heated in continuous renal replacementtherapy system by heating apparatuss (11) according to any one of claim 1 to 7, described heating apparatus (11) comprises the control unit (14) being configured to the temperature controlling described heating element heater (13), and described method comprises:
The temperature of at least one in-reception instruction described displacement fluids, at least one process fluid and described blood line (1a) in blood and/or at least one measuring-signal of flow velocity;
-determine controling parameters based on indicated temperature and/or flow velocity; And
-control the temperature of described heating element heater (13) based on described controling parameters or be sent to the power of described heating element heater (13).
16. methods according to claim 15, wherein, described controling parameters is the parameter making described heating element heater (13) produce an effect, or described at least one process fluid is warmed to preferred temperature T
setand/or blood is warmed to preferred temperature T
setBthe temperature value T of required described heating element heater
he.
17. methods according to claim 16, the model comprised based on described heat exchanger calculates described controling parameters.
18. methods according to any one of claim 15 to 17, comprise and heat described at least one process fluid to preferred temperature T
set, this preferred temperature T
setin interval between 35 DEG C to 45 DEG C, be preferably in the interval between 37 DEG C to 43 DEG C.
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| Application Number | Priority Date | Filing Date | Title |
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| SE1351389 | 2013-11-22 | ||
| SE1351389-0 | 2013-11-22 |
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| CN104645433A true CN104645433A (en) | 2015-05-27 |
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| CN201410652656.1A Pending CN104645433A (en) | 2013-11-22 | 2014-11-17 | Warming arrangement and a method, continuous renal replacement therapy system and disposable kit |
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| CN (1) | CN104645433A (en) |
| WO (1) | WO2015074999A1 (en) |
Cited By (5)
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| CN108042864A (en) * | 2017-12-23 | 2018-05-18 | 玉林市玉州区万通华信科技服务部 | A kind of blood dialysis solution manufacture modified resin absorber being easily installed with temperature control |
| CN108136093A (en) * | 2015-09-28 | 2018-06-08 | 费森尤斯医疗护理德国有限责任公司 | Dialysis machine |
| CN108289988A (en) * | 2015-11-17 | 2018-07-17 | 费森尤斯医疗护理德国有限责任公司 | Dialysis apparatus with heating and cooling mechanism |
| CN109125830A (en) * | 2018-07-23 | 2019-01-04 | 南京医科大学 | A kind of intelligence auxiliary temperature control device and control method suitable for haemodialysis or purification |
| CN109906095A (en) * | 2016-09-05 | 2019-06-18 | 费森尤斯医疗护理德国有限责任公司 | Method and apparatus for determining the body temperature of patient |
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|---|---|---|---|---|
| CN117919529B (en) * | 2024-02-26 | 2024-07-09 | 南京汉科明德医疗科技有限公司 | Liquid heating device and heating method for blood purification |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SE510026C2 (en) * | 1994-09-23 | 1999-04-12 | Gambro Ab | Disinfection device for dialysis machine |
| JP4259167B2 (en) * | 2003-04-14 | 2009-04-30 | ニプロ株式会社 | Continuous blood purification device |
| WO2010040827A1 (en) * | 2008-10-10 | 2010-04-15 | Gambro Lundia Ab | Heat exchanger and method for heat exchanging |
-
2014
- 2014-11-17 CN CN201410652656.1A patent/CN104645433A/en active Pending
- 2014-11-17 WO PCT/EP2014/074785 patent/WO2015074999A1/en active Application Filing
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| CN108136093A (en) * | 2015-09-28 | 2018-06-08 | 费森尤斯医疗护理德国有限责任公司 | Dialysis machine |
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| CN109906095A (en) * | 2016-09-05 | 2019-06-18 | 费森尤斯医疗护理德国有限责任公司 | Method and apparatus for determining the body temperature of patient |
| US11925479B2 (en) | 2016-09-05 | 2024-03-12 | Fresenius Medical Care Deutschland Gmbh | Method and apparatus for determining the body temperature of a patient |
| CN108042864A (en) * | 2017-12-23 | 2018-05-18 | 玉林市玉州区万通华信科技服务部 | A kind of blood dialysis solution manufacture modified resin absorber being easily installed with temperature control |
| CN109125830A (en) * | 2018-07-23 | 2019-01-04 | 南京医科大学 | A kind of intelligence auxiliary temperature control device and control method suitable for haemodialysis or purification |
| CN109125830B (en) * | 2018-07-23 | 2021-05-11 | 南京医科大学 | Control method of intelligent auxiliary temperature control device suitable for blood purification |
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| Publication number | Publication date |
|---|---|
| WO2015074999A1 (en) | 2015-05-28 |
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