DE102015107269B4 - dialysis facility - Google Patents

Abstract

A dialysis machine having a blood circulation through which blood can flow and which from an inlet (3) through an arterial line (4) to a first dialyzer (7), through a first flow in the first dialyzer (7) along a first side of a toxin semipermeable membrane and from the first dialyzer (7) through a venous line (8) to an outlet (9) leads, with a Dialysatkreislauf, through which a dialysate is flowable and having a first part (13) of a dialysate line, of a Pressure port (12) of a Dialysatpumpe to the first dialyzer (7), by a second flow in the first dialyzer (7) along a second side of the semipermeable membrane and of the first dialyzer (7) through a second part (17, 17 ') of a Dialysate leads to a suction port (18) of the dialysate, wherein in the first part (13) or the second part (17, 17 ') of the dialysate an adsorber (14) for adsorbing T contained in the dialysate is arranged oxine through which the dialysate cycle is passed, wherein in the arterial line (4) a blood pump is arranged and wherein the dialysate a first pump unit and the blood pump, a second pump unit of a reversibly driven double pump unit are and as a double-tube roller pump (2) are formed, with one or more sensors for detecting contained in the dialysate of the dialysate toxins, characterized in that in the bloodstream one or more further sensors (26) for detecting contained in the blood of the bloodstream The dialysis machine is arranged with a display unit for displaying the operating data of the dialysis device and / or the measured values of the toxins contained in the dialysate of the dialysis circuit and the data of the toxins contained in the blood of the blood circulation detected by the further sensor systems (26) can be displayed on the display unit, wherein the first part (13) and / or the second part (17, 17 ') of the dialysate at least one flushing port (29, 30), to which a rinsing liquid container (31) can be connected and to the inlet (3) the arterial line (4) and / or the outlet (9) of the venous line ng (8) a rinsing liquid container (32) can be connected, wherein rinsing liquid for cleaning the dialysis circuit and / or for cleaning the blood circulation through the double-tube pump in both directions of blood circulation and / or dialysate is conveyed.

Description

The invention relates to a dialysis machine having a blood circulation through which blood is flowable and from an inlet through an arterial line to a first dialyzer, through a first flow in the first dialyzer along a first side of a toxin-semipermeable membrane and from the first Dialyser leads through a venous line to an outlet, with a Dialysatkreislauf, through which a dialysate is flowable and having a first part of a dialysate, which from a pressure port of a dialysate pump to the first dialyzer, through a second flow in the first dialyzer along a second Side of the semipermeable membrane and from the first dialyzer through a second part of a dialysate leads to a suction port of Dialysatpumpe, wherein in the first part or the second part of the dialysate an adsorber for adsorbing toxins contained in the dialysate is arranged, through which the Dialysatkrei slauf is passed, wherein in the arterial line, a blood pump is arranged and wherein the dialysate pump is a first pump unit and the blood pump, a second pump unit of a reversibly driven double pump unit and are designed as a double tube roller pump, with one or more sensors for detecting in the dialysate of the dialysate contained toxins.

In such a dialyzer, it is known to add an accessory with an albumin circulation to a device of a renal dialysis circuit, so that not only hydrophilic but also hydrophobic substances can be removed from the patient's blood. The construction and combining of these two devices is demanding and requires a large amount of time to operational readiness and long lengths of tubing of the dialysate and blood circulation. In addition, these two devices must also have a combinable structure.

Dialysis facilities of the type mentioned are from the US 2007/0179425 A1 , the US 2014/0175010 A1 and the WO 2014/072875 A1 known.

From the DE 10 2006 022 122 A1 is an extracorporeal blood treatment system with integrated Substituataufbereitung with a Sustituatport and a Rinseport is known in which on the substituate port in the blood tubing fresh substituate is released, while on the Rinseport used Substituate is discharged and processed again.

From the US 5 114 580 A a dialysis device with the features of the preamble of the new claim 1 is known. In this case, the dialysis device has a blood circulation, flows through the blood flowing from a reversible blood pump to an inlet of an arterial line and a first dialyzer, through a first flow in the first dialyzer along a first side of a toxin semipermeable membrane and of the first Dialyzer is conveyed through a venous line to an outlet. Furthermore, the dialyzer has a dialysate circuit, through which a dialysate can be flowed. One or more sensory devices are arranged in the blood circulation.

The object of the invention is therefore to provide a dialysis device of the type mentioned, which is suitable in a simple and compact structure for the removal of both hydrophilic and hydrophobic substances from the blood, is operational without significant time and in the simple rinse liquid for cleaning by the dialysate and / or blood circulation is funded.

This object is achieved according to the invention in that one or more further sensor systems for detecting toxins contained in the blood of the blood circulation are arranged in the blood circulation, wherein the dialysis machine comprises a display unit for displaying the operating data of the dialysis device and / or the measured values of the dialysis device detected by the sensor systems in the dialysate of the dialysis cycle toxins contained and detected by the other sensor data of the toxins contained in the blood of the circulatory system can be displayed on the display unit, wherein the first part and / or the second part of the dialysate has at least one flushing port to which a rinsing fluid container connected and at the inlet of the arterial line and / or at the outlet of the venous line, a rinsing fluid container is connectable, wherein rinsing fluid for cleaning the dialysis circuit and / or for cleaning the blood circulation through the double-tube pump in both Flow directions of blood circulation and / or dialysate can be conveyed.

Due to the arrangement of the double tube roller pump, the adsorber, the sensors and the display unit in a device no construction work to combine these components are required but the device is already in an operational state and thus easy to use.

The sensor systems form an integrated analysis unit for detecting toxins in the blood, wherein the detected measured values can be immediately and permanently displayed on the display module. With this information, the user of the dialysis device can be used at an early stage to review therapy decisions and, if necessary, adapt them.

The display unit is preferably designed as an optoelectronic display unit such as a liquid crystal display and displays its information as alphanumeric representation.

Through the dialysis device can be done in one operation, a blood purification and detection of toxins in the blood.

In a simple and easy to clean by flushing training, the double pump unit can be a double hose roller pump.

An effective blood purification is achieved, the flow directions of blood circulation and dialysate in the dialyzer are directed opposite.

Preferably, the dialysate is an albumin by which both hydrophilic and hydrophobic substances can be removed from the blood.

The sensors for detecting the toxins contained in the dialysate flowing through the dialysate circuit can be a bilirubin sensor system and / or a bile acid sensor system and / or a sepsis parameter sensor, by means of which the respectively existing proportion of toxins of the first type in the dialysate can be detected.

The toxins of the first type may be liver toxins.

For simultaneous detection of different toxins, the adsorber can adsorb a first type of toxin contained in the dialysate and be arranged in the second part of the Dialysatleitung a second dialyzer having a first flow area along a first side of a second semipermeable membrane for a second type of toxins and the second side of the second semipermeable membrane can be flowed through by a second dialysate.

The toxins of the first type can be liver toxins and the second type of toxins can be kidney toxins.

A second pump unit of the double pump unit according to the invention is a blood pump arranged in the arterial line.

The design is simple and compact through the use of a double pump unit instead of two separate pumps for two different circuits as well as the short line lengths of the dialysate circuit and the blood circuit.

One or more further sensor systems for detecting toxins contained in the blood of the bloodstream can be arranged in the blood circulation, wherein the data of the toxins contained in the blood of the bloodstream can be displayed on the display unit by the further sensor systems.

These sensor systems are also part of the integrated analysis unit for the detection of toxins in the blood, wherein the detected measured values can be immediately and permanently displayed on the display module, so that therapy decisions can be checked by the user of the dialysis unit at an early stage and, if necessary, adjusted.

The sensor system for detecting the toxins contained in the blood flowing through the bloodstream can be a bilirubin sensor system and / or a bile acid sensor system and / or a sepsis parameter sensor system.

With this information, the user of the dialysis device can already during the dialysis procedure and thus early check therapy decisions and adjust if necessary.

If one or more of the sensors are designed as interchangeable sensor modules, it is easy to replace a defective sensor module with an intact sensor module.

However, it is also possible to use sensor modules with different sensor systems in one and the same receptacle for a sensor module. Thus, the size of the dialysis machine can be kept low.

If the first part and / or the second part of the dialysate line has at least one flushing connection to which a flushing liquid container can be connected, then flushing liquid can be conveyed from the double pump unit through the dialysate circuit in a simple manner and this cycle can be cleaned.

Also, a rinsing fluid container may be connectable to the inlet of the arterial line and / or to the outlet of the venous line.

For cleaning, a blocking element blocking the flow of the dialysis line is arranged in a simple manner between a first flushing connection and a second flushing connection, wherein the first flushing connection can be connected to a first container connection and the second flushing connection can be connected to a second container connection of the flushing liquid container.

Similarly, the inlet of the arterial line with a first container port of a second rinsing fluid container and the outlet of the venous line with a second container port of the second rinsing fluid container be connected, so that in a simple way rinsing fluid promoted by the double pump unit through the blood circulation and this cycle can be cleaned.

In order to increase the cleaning effect even further, the double pump unit according to the invention is reversibly drivable and thus rinsing fluid in both directions of blood circulation and / or dialysate can be conveyed.

For detecting and controlling the blood pressure, a pressure sensor may be arranged in the arterial line upstream of the double pump unit and / or in the arterial line downstream of the double pump unit and / or in the venous line downstream of the dialyzer, the measured values of which can be displayed by the display unit as operating data.

To record and control the dialysate pressure, at least one pressure sensor can be arranged in the dialysate line, the measured values of which can be displayed by the display unit.

For separating air from the venous line and / or the dialysis line, a bubble catcher may be arranged in the venous line and / or in the dialysate line.

• 1 eine Prinzipdarstellung einer Dialyseeinrichtung in einem ersten Arbeitsmodus
• 2 eine Prinzipdarstellung der Dialyseeinrichtung nach 1 in einem zweiten Arbeitsmodus
• 3 die Dialyseeinrichtung nach 1 in einer ersten Perspektivansicht
• 4 die Dialyseeinrichtung nach 1 in einer zweiten Perspektivansicht.

An embodiment of the invention is illustrated in the drawing and will be described in more detail below. Show it

• 1 a schematic diagram of a dialysis device in a first working mode
• 2 a schematic diagram of the dialysis device according to 1 in a second working mode
• 3 the dialysis device after 1 in a first perspective view
• 4 the dialysis device after 1 in a second perspective view.

The 1 shows a dialysis device in a first working mode with a housing 1 , in which a reversible drivable and variable in their capacity adjustable double hose roller pump 2 is arranged. From an outside entrance 3 leads in the housing 1 an arterial line 4 to the suction port 5 a second pump portion of the double tube roller pump forming a blood pump 2 , From a pressure connection 6 the second pump section carries the arterial line 4 out of the case 1 on to a dialyzer inlet 10 a first dialyzer having a flow along a first side of a semipermeable membrane (not shown) 7 , From the dialyzer outlet 11 of the first dialyzer 7 leads a venous line 8th at one point back into the housing 1 to get out of the case at another point 1 to emerge and an outlet 9 to build. This one from the inlet 3 to the outlet 9 Leading circle is a bloodstream in which a patient's blood enters from the inlet 3 to the outlet 9 is encouraged.

From a pressure connection 12 of the first pumping area of the double hose roller pump forming a dialysate pump 2 leads a first part 13 a dialysate line to an inlet 15 an adsorber 14 and further from the outlet 16 of the adsorber 14 to the first dialyzer 7 to enter another passage of the dialyzer 7 near the dialyzer outlet 11 on a second side of the semipermeable membrane.

From near the dialyzer inlet 10 then leads from the further passage of the first dialyzer 7 from a second part 17 the dialysate line back into the housing 1 and to a suction port 18 of the dialysate pump forming second pump portion of the double tube roller pump 2 ,

This from the pressure port 12 to the suction connection 18 the second pump portion of the double tube roller pump forming a dialysate pump 2 leading circle is a dialysate cycle in which is promoted as a dialysate albumin.

The albumin flows in the first dialyzer 7 on the one side along the semipermeable membrane in countercurrent to the blood on the other side of the semipermeable membrane and absorb toxins contained in the blood through the semipermeable membrane. These toxins then pass through the adsorbent formed as a carbon adsorber 14 adsorbed.

The housing 1 still has a display 19 a display unit, the operating data of the dialysis device as well as data recorded by sensors are displayed.

In the case 1 is in the arterial line 4 near the inlet 3 a first locking device 20 for blocking the flow from the inlet 3 to double hose roller pump 2 arranged.

Furthermore, in the housing 1 in the first part 13 the dialysate line between the Double hose roller pump 2 and the adsorber 14 a second locking device 21 to block the flow through the first part 13 arranged the dialysate line.

In the arterial line 4 in the flow direction in front of the double hose roller pump 2 is a first pressure sensor 22 in the venous line 8th in the flow direction behind the dialyzer 7 is a second pressure sensor 23 and in the first part 13 the dialysate line between the double tube roller pump 2 and the adsorber 14 is a third pressure sensor 24 arranged.

By the pressure sensors 22 . 23 and 24 The pressures are detected at the locations mentioned and passed corresponding measurement signals to a control unit, not shown, the control signals from there to drive the display 19 forms. Based on the displayed values displayed there, the correct function of the dialysis device can be monitored.

In the second part 17 the dialysate line is a first sensor 25 for detecting one of the albumin in the first dialyzer 7 arranged toxin arranged. Furthermore, in the venous line 8th a second sensor 26 for detecting one in the blood of the bloodstream after the first dialyzer 7 contained toxins arranged.

According to the first sensor 25 and the second sensor 26 detected values are fed to the control unit, the control signals from there to drive the display 19 forms.

A first bubble catcher 27 is in the first part 13 the dialysate line to the adsorber 14 arranged to separate air from the albumin.

In the venous line 8th is also a second bubble catcher 28 arranged to separate air from the blood of the bloodstream.

In the flow direction in front of the barrier device 21 is at the first part 13 the dialysate a first flushing connection 29 and after the locking device 21 a second flushing connection 30 arranged. The first flushing connection 29 and the second purge port 30 lead to a rinse liquid filled with rinse liquid container 31 ,

The inlet 3 the arterial line 4 and the outlet 9 the venous line 8th are filled with a second rinsing liquid container also filled with a rinsing liquid 32 ,

If the dialysate circuit and the blood circulation are to be cleaned, these are first emptied, the blocking device 21 locked and the double hose pump 2 put into operation. This is preferably done with some changes of direction of the double hose pump 2 , so that the two circuits are flushed out and cleaned with it.

After completion of the cleaning, the circuits are emptied again of the rinsing liquid, the dialysate filled with albumin and the locking device 21 opened again. Now the dialysis machine is ready for use again.

2 shows a dialysis device in a second working mode. In this case, the components of the in 1 shown with the same reference numerals.

Now leads the arterial line 4 from a patient, not shown, directly to the lower end of the first dialyzer 7 and the venous line 8th leads from the top of the first dialyzer 7 back to the patient.

From a pressure connection 12 of the first pumping area of the double hose roller pump forming a dialysate pump 2 leads a first part 13 a dialysate line to an inlet 15 an adsorber 14 in which a first type of toxins, namely liver toxins, are adsorbed and farther from the outlet 16 of the adsorber 14 to the first dialyzer 7 to enter another passage of the dialyzer 7 near the dialyzer outlet 11 on a second side of the semipermeable membrane.

From near the dialyzer inlet 10 then leads from the further passage of the first dialyzer 7 from a second part 17 ' the dialysate line through the housing 1 and after exiting the housing 1 to a dialyzer inlet 34 a second dialyzer 33 having a flow area on one side of a second semipermeable membrane, from the other end thereof to a dialyzer outlet 35 of the second dialyzer 33 the second part 17 ' the dialysis line to double hose pump 2 returns.

On the other side of the membrane flows another dialysate, namely water, which absorbs and removes the renal toxins contained in the albumin through the second membrane.

It will thus be with a single dialysis device on the adsorber 14 the liver toxins and on the second dialyzer 33 the kidney toxins are taken from the albumin.

The rinsing process and the required components of Dialysatkeislaufs in the second working mode correspond to those of the first working mode.

According to the first mode of operation, the second mode of operation also includes a second pressure sensor 23 in the first part 13 the dialysate line and in the second part 17 the dialysate line a first sensor 25 for detecting one of the albumin in the first dialyzer 7 recorded toxin present, the measured values fed as signals to the control and the display is controlled accordingly for display.

LIST OF REFERENCE NUMBERS

1

casing

2

Double hose roller pump

3

Inlet

4

arterial line

5

suction

6

pressure connection

7

first dialyzer

8th

venous line

9

outlet

10

Dialysatoreinlaß

11

Dialysatorauslaß

12

pressure connection

13

first part dialysate line

14

adsorber

15

Inlet adsorber

16

Outlet adsorber

17

second part dialysate line

17 '

second part dialysate line

18

suction

19

display

20

first locking device

21

second locking device

22

first pressure sensor

23

second pressure sensor

24

third pressure sensor

25

first sensor

26

second sensor

27

first bubble catcher

28

second bubble catcher

29

first flushing connection

30

second flushing connection

31

first rinsing liquid container

32

second rinse tank

33

second dialyzer

34

Dialysatoreinlaß

35

Dialysatorauslaß

Claims (12)

A dialysis machine having a blood circulation through which blood can flow and which from an inlet (3) through an arterial line (4) to a first dialyzer (7), through a first flow in the first dialyzer (7) along a first side of a toxin semipermeable membrane and from the first dialyzer (7) through a venous line (8) to an outlet (9) leads, with a Dialysatkreislauf, through which a dialysate is flowable and having a first part (13) of a dialysate line, of a Pressure port (12) of a Dialysatpumpe to the first dialyzer (7), by a second flow in the first dialyzer (7) along a second side of the semipermeable membrane and of the first dialyzer (7) through a second part (17, 17 ') of a Dialysate leads to a suction port (18) of the dialysate, wherein in the first part (13) or the second part (17, 17 ') of the dialysate an adsorber (14) for adsorbing T contained in the dialysate oxinen, through which the dialysate circuit is passed, wherein in the arterial line (4) a blood pump is arranged and wherein the dialysate pump is a first pump unit and the blood pump is a second pump unit of a reversibly drivable double pump unit and are designed as double tube roller pump (2), with one or more sensors for detecting toxins contained in the dialysate of the dialysate cycle, characterized in that one or more further sensor systems (26) for detecting toxins contained in the blood of the blood circulation are arranged in the blood circulation, wherein the dialysis machine is a display unit for Display of the operating data of the dialysis device and / or the measured values of the dialysate of the dialysis circuit and the data of the toxins contained in the blood of the circulatory system can be displayed on the display unit by the further sensor systems (26) d, wherein the first part (13) and / or the second part (17, 17 ') of the dialysate line at least one flushing port (29, 30), to which a rinsing liquid container (31) is connectable and to the inlet (3) of the Arterial line (4) and / or at the outlet (9) of the venous line (8) a rinsing fluid container (32) can be connected, wherein rinsing fluid for cleaning the dialysis circuit and / or for cleaning the blood circulation through the double-tube pump in both directions of blood circulation and / or dialysate cycle is eligible. Dialysis device according to one of the preceding claims, characterized in that the flow directions of the dialysate circuit in the first dialyzer (7) are opposite. Dialysis device according to one of the preceding claims, characterized in that the dialysate is an albumin. Dialysis device according to one of the preceding claims, characterized in that the sensor system (25) for detecting the toxins contained in the dialysate flowing through the dialysate circuit is a bilirubin sensor system and / or a bile acid sensor system and / or a sepsis parameter sensor, by which the respectively existing proportion of the toxins of the first type in the dialysate can be detected. Dialysis device according to one of the preceding claims, characterized in that the adsorber (14) adsorbs a first type of toxin contained in the dialysate and in the second part of the dialysate line a second dialyzer (33) is arranged, which has a first flow area along a first side of a second semipermeable membrane for a second type of toxins and the second side of the second semipermeable membrane can be traversed by a second dialysate. Dialysis device according to one of the preceding claims, characterized in that the sensor system (26) for detecting the toxins contained in the blood flowing through the blood circulation is a bilirubin sensor system and / or a bile acid sensor system and / or a sepsis parameter sensor. Dialysis device according to one of the preceding claims, characterized in that one or more of the sensors (25, 26) are designed as interchangeable sensor modules. Dialysis device according to one of the preceding claims, characterized in that a blocking element (21) blocking the flow of the dialysis line is arranged between the first flushing connection (29) and the second flushing connection (30), the first flushing connection (29) having a first container connection and the second flushing connection (30) can be connected to a second container connection of the flushing liquid container (32). Dialysis device after Claim 8 , characterized in that the inlet (3) of the arterial line (4) with a first container connection of a second rinsing liquid container (32) and the outlet (9) of the venous line (8) with a second container connection of the second rinsing liquid container (32) is connectable , Dialysis device according to one of the preceding claims, characterized in that in the arterial line (4) before the double tube roller pump (2) and / or in the arterial line (4) after the double tube roller pump and / or in the venous line (8) after the dialyzer a pressure sensor (22, 23) is arranged, the measured values of which can be displayed by the display unit. Dialysis device according to one of the preceding claims, characterized in that at least one pressure sensor (24) is arranged in the dialysate line, the measured values of which can be displayed by the display unit. Dialysis device according to one of the preceding claims, characterized in that a bubble trap (27, 28) is arranged in the venous line (8) and / or in the dialysate line.

Images