DE1964735A1 - Peritoneal dialysis machine - Google Patents

Description

1984735

Bergedorf, February 4th, 1970 Patent Hi / Sch

Stw .: Peritoneal Dialysis Dosage - Hauni File 1084 · Alctz ,; G 69 49 786.5

Peritoneal dialysis device

invention
The chain »ttög relates to a peritoneal dialysis device with a metering device for the dialysis fluid with a perier device for the dialysis fluid and with a device for conveying dialysis fluid from the metering device to the body of the patent. Artificial kidneys have the task of eliminating toxins from endogenous or exogenous poisoning via natural (peritoneal | dialysis) or artificial (hemodialysis) membranes from the patient's body. While hemodialysis using artificial membranes is very expensive in terms of apparatus and its implementation with correspondingly complicated apparatus requires special forces, the peritoneal membrane of the patient is used in peritoneal dialysis. The preheated dialysis fluid, the temperature and quantity of which must be strictly adhered to, is introduced into the patient's abdomen with the help of a stylet catheter (Bauoheinlauf) and after a certain dwell time (between 10 and 40 minutes) is pumped out again (Bauohauslauf). The toxins pass into the dialyser fluid and are removed with it. Peritoneal dialysis is therefore all medically borne and can be carried out without special personnel.

The previously known devices for performing peritoneal dialysis are with regard to the observance of important conditions such as keeping the temperature and quantity of the Dialyeierflüfligkeit unreliable, although it is difficult to use are.

The task of the invention is to identify the important preconditions for a successful and not harmful to the patient

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Stw .: Peritoneal Dialysis Dosage - Hauni File 1084 File number: G 69 49 786.5 - Bergedorf, February 4, 1970

Peritoneal dialysis, nänilioh the precise maintenance of temperature and i-lenge of dialysis fluid, with simultaneous Reduction of the operating and monitoring effort, auoh in the case of one of several consecutive individual dialyses existing dialysis cycle.

Invention According to the MeÄSKUÄg; solved in that a measuring vessel with a temperature-controlled hot liquid is provided, which has a left order for the liquid level is provided and by at least one arranged between the dialysis fluid to be dosed and the measuring fluid Partition from which when dialy-

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Stw .: Peritoneal Dairy Dosage - Hauni-Ake 1084 Bergedorf, December 11, 1969

liquid measuring liquid displaceable in the measuring vessel is. A particularly safe and structurally inexpensive dosage, in which a very good heat transfer to the dialysis fluid is guaranteed, can be achieved according to a further embodiment of the invention in that the Partition is flexible and that of the dialysis fluid to be dosed occupied space completely closes off from the space occupied by the measuring liquid. Of the Heat transfer from the measuring liquid to the dosing liquid should be as good as possible with regard to rapid temperature control. In addition, the actual dialysis fluid " space taken up when changing patient if possible Preparing for a new dialysis session is quick and easy, i.e. without laborious cleaning or sterilization. This requirement corresponds to a particularly advantageous development of the invention, in which the partition wall from a The bag consists of flexible material for receiving dialysis fluid, which is arranged in the measuring vessel in such a way that that it is surrounded by measuring liquid at least over the largest part of its surface. A good observation of the dosage is possible if at least the measuring vessel is made of transparent material, e.g. plexiglass. An even better one Observation is made possible by an additional, transparent i flexible plastic, e.g. made of transparent plastic film, Existing bag for holding the dosing liquid. The measuring vessel can have a line to heat the measuring liquid for the heating medium, preferably also a liquid (heating liquid), which in particularly advantageous Embodiment of the invention fixed the bag in its spatial position. Is the line as a hose coil surrounding the bag formed, so there is also good heat transfer to the dialysis fluid in the bag.

This for the exact temperature of the dialysis fluid to be maintained required exact tempering of the measuring liquid

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Stw .: Peritoneal Dialysis Dosage - Hauni File 1084 Bergedorf, December 11, 1969

According to a further development of the invention, speed can be achieved by a temperature sensor in at least one of the liquids (measuring liquid, heating liquid), which is connected to a control arrangement for controlling the supply of heat to a liquid in order to keep the liquid temperature constant. A temperature measurement of both fluids, which requires two thermal control loops and thus a certain additional effort, results in a particularly good temperature constancy of the dialysis fluid, since the temperature of the heating fluid heating the measurement fluid is already monitored and regulated to an at least approximately constant measured value. The temperature constancy of the heating fluid is not subject to high requirements, so that simple temperature regulators such as bimetal regulators are sufficient for regulating the temperature. The temperature of the liquid to be measured should, however, be measured with high accuracy, for example by means of a very sensitive semiconductor resistor (PTC or NTC resistor), which is then advantageously followed by an electronic actuator, for example a transistor or thyristor actuator. In peritoneal dialysis, in which dialysis fluid is supplied directly to the patient's abdomen, it must be excluded with particular certainty that the dialysis fluid is supplied to the patient too hot, since this can have life-threatening consequences. In particular, it must be prevented that the duration of the metering and temperature control or the speed at which the dialysis fluid is conveyed from the metering chamber into the patient's body does not have any influence on the dialysis fluid temperature. According to a further development of the invention, this is excluded if at least the measuring liquid is assigned a temperature sensor which switches off the supply of heat to the measuring liquid as soon as the measuring liquid has - at least approximately - reached body temperature. One gets an even higher security against overheating of the dialysis liquid when the heating fluid is associated with a temperature sensor in addition, the supply of

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Stw .: Peritoneal Dialysis Dosage - Hauni File 1084 Bergedorf, December 11, 1969

Heat to the heating fluid switches off as soon as this - at least approximately - has reached body temperature. The dosage can only be as precise as the measurement of the weight. is the displacement of the measuring liquid. As an exact measuring arrangement for the measuring liquid level, an electrode is particularly suitable which is connected in an electrical control circuit that it causes a Circuit closes. An electrode that is characterized by its particular accuracy, safety and small dimensions net, is characterized in that the electrode is provided with a flexible metal strip that can be wound on a roll, is connected and is guided in a slotted tube connected to the other pole of the voltage source, which is connected to a Insulating layer is lined and in which the measuring liquid is.

To control the dosing, the measuring arrangement is expediently connected to a control arrangement for a dosing conveyor for supplying dialysis fluid to be dosed in such a way that the dosing conveyor is inactivated when the measuring fluid reaches the electrode. In a further development of the invention, the dosing conveyor, preferably a hose pump, can, in addition to supplying dialysis fluid for the purpose of dosing, also take over a subsequent circulation of the dialysis fluid in the hose system so that this dialysis fluid, which has not yet been heated in the hose system, does not reach the patient's body unheated » Finally, this tube pump may advantageously additionally promoting the metered and tempered dialysis fluid from the bag to the patient (belly enema) assume ,, Eiu admixing non-sterile Meßflüsslgkeit with sterile dialysis fluid must, as the Dialysierfltissigkeit the abdominal cavity dee patient is immediately fed prevented under all circumstances will. A solution to this problem is offered by a further development of the invention with a • in signal when the heating fluid and sialysis

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liquid-emitting signal arrangement.

A peritoneal dialysis machine that is portable and for example to be used in mobile clinics must have small dimensions. According to a further embodiment the invention can meet this requirement in that the metering and temperature control device structurally with each other are united.

A dialysis cycle generally consists of a sequence of individual dialyses, in which dialysis fluid is dosed and tempered, then the patient's body is supplied, is removed from this again and is measured with regard to its amount. Because a dialysis cycle The operating personnel say that a single dialysis session can take 12 to 24 hours to last up to an hour relatively often occupied with controlling the individual dialysis sections and the entire dialysis cycle. Around To remedy this evil is according to a further training the invention a control arrangement for automatic Controlling the dosage and temperature control of one or more individual amounts of dialysis fluid provided within of a dialysis cycle can be successively supplied to and removed from the patient's body. The for this required residence time of the dialysis fluid in the body of the patient can, in particular with an automatic control of the sequence of the individual dialyses and the whole Dialysis cycle, to take advantage of the individual amounts of dialysis fluid, which will be used in the following dialysis procedure.

So far, dialysis fluid has been supplied by the manufacturer, im general alsg from a pharmaceutical company, already assembled in its factory and shipped in sterile containers. As the main volume of the dialysis fluid is out distilled water, the transport of the relatively large amounts required for dialysis causes

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finished dialysis fluid considerable costs. Around To reduce costs, according to a development of the invention, the metering device can be a device for merging of individual components forming the dialysis fluid.

For the transport of distilled water, which is generally produced in hospitals themselves, are at this Embodiment of the invention no longer incur any costs.

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Stw.t peritoneal dialysis dosage. - Hauni file 1084 Bergedorf, December 11, 1969

The invention is illustrated by means of an exemplary embodiment Drawing explained in more detail. It shows:

Figure 1 shows the structure of a peritoneal dialysis machine according to the invention,

FIG. 2 shows an electrode for signaling when a certain adjustable liquid level is reached,

Figure 3 a peristaltic pump,

FIG. 4 shows an electromagnetic valve for shutting off a hose line,

FIG. 5 a monitoring device for a hose line

FIG. 6 shows the hose system of the peritoneal dialysis machine according to the invention drawn by itself,

FIG. 7 shows a central control arrangement for an automatic sequence of one consisting of individual dialyses Dialysis cycle,

FIG. 8 shows the peritoneal dialysis machine according to the invention together with its control arrangement as a mobile one Unit,

FIG. 9 shows a variant of the measuring arrangement for dialysis fluid withdrawn from the patient's body,

FIG. 10 shows a mixing arrangement for bringing together components to form the dialysis fluid in the case of Dosage.

The peritoneal dialysis machine of Figure 1 consists essentially of a metering and temperature control circuit 1, which at the same time the conveyor for the dialysis fluid to the patient contains, a withdrawal circuit 2 for withdrawing the dialysis fluid from the patient's body and a measuring circuit 3 for the automatic determination of the patient's body again withdrawn amount of dialysis fluid.

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Stw .: Peritoneal Dialysis Dosage - Hauni File 1084 Bergedorf, December 11th 19β9

The dosing and temperature control circuit 1 has two or more storage tanks 6 and 7 for receiving a supply of dialysis fluid 5 for a dialysis cycle via a hose line 8 are connected to a bag 9 made of flexible transparent plastic. In the course of the hose line 8 is located a controllable solenoid valve 11 (details in Figure 4) and a feeder for dialysis fluid to the dosing device or to the patient in the form of a hose pump 12 (details in Figure 3) with controllable electric drive motor 13. The solenoid valve

11 and the drive motor 13 receive control voltages via | lines 14 and 15 from a central control arrangement 16 for the independent control of the individual dialysis processes of a dialysis cycle. The drive motor 13 is a DC motor, since its speed and direction of rotation must be controllable. The direction of rotation can be controlled by the Polarity, the control of the speed can be set via the size of the supplied control voltage. The drive motor 13 can be used as a control device for the feed conveyor

12 can be understood.

The bag 9 is located in a partially filled with measuring liquid 17 (water), also made of transparent plastic existing measuring vessel 18 with a measuring arrangement 19 for a lower level and an upper level (level) of Measuring liquid 17 in the form of electrodes 21 and 22 (details shows Figure 2) is provided, each in front of a Scale 23 for setting the individual amount of dialysis fluid to be dosed 5 can be moved up and down. Those of the electrodes 21 and 22 when they come into contact with the measuring liquid 17 The measurement signals output are sent to cter via lines 24 and 26, respectively central control arrangement 16 out. The bag 9 provides a partition between the dosing liquid 5 in that of the Bag 9 enclosed space and the measuring liquid 17 in the measuring vessel 18, which when dialysis liquid is supplied displaced measuring liquid to the bag 9.

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In an immersion body 27, which is thermally insulated from the measuring liquid 17 by an insulating layer 28, is located a heating fluid 29, which is from an electrical Heating resistor 31 can be heated and via hose lines 32 and 33 is guided to a hose coil 34 which surrounds the bag 9 and holds it mechanically in its position. In the measuring vessel 18 there is a temperature sensor 36 such that that it detects the temperature of the measuring liquid 17. This temperature sensor 36, which is an actual value transmitter of a first thermal control circuit 35 for keeping the temperature of the measuring liquid 17 constant, is with a comparator 37 connected, which also has a setpoint generator designed as an adjustable electrical resistor 38 is connected.

The comparator 37 is used to generate the system deviation (difference between setpoint and actual value) and controls via an amplifier 47 an actuator of the thermal control circuit 35 in the form of an electric motor 39 of a pump 41 in the circuit of the heating fluid 29. The controller can be an on-off controller. But it can also be a pump with continuously variable Find funding volume use.

A temperature sensor 42 is located in the displacement body 27 in such a way that it measures the temperature of the heating fluid 29 recorded. This temperature sensor, which is an actual value transmitter of a second thermal control circuit 40 to keep the Represents the temperature of the heating fluid is with a comparator 43 connected, which is also connected to a setpoint generator 44 connected is. The comparison element 43 forms the control deviation of the second thermal control loop and controls over a switching amplifier 48 an actuator 46 for controlling the heating current through the heating resistor 31. The actuator 46 can, in the simplest case, be designed as a switch for the heating current. But it can also be a continuously controllable actuator, for example an electronic transistor or thyristor

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amplifier, to continuously adjust the heating power in the electrical heating resistor 31, be connected downstream of the comparison element 43. A single thermal control circuit is sufficient, for example the second thermal control circuit 40, solely for keeping the temperature of the measuring liquid 17 constant at least approximately; If the temperature of the heating fluid 29 is selected, for example, in the order of magnitude of the body temperature, i.e. is set to approximately 38 degrees Celsius, the dialysis fluid also reaches this end temperature after the heating time, so that - after heat losses in the hose lines to the patient - the dialysis fluid in these patients - λ speed arrives with body temperature. In the case of higher demands on the constant temperature of the dialysis fluid 5 in the bag 9, however, two thermal control circuits, one for the heating fluid 29 and the other for the measuring fluid 17, are advantageous.

The bag 9 is connected via a further hose line 51 to an inlet hose line 52 which is attached to the stylet catheter 49 is attached in the body of the patient 53. The part of the hose line 51 between the dosing bag 9 and the branch point 54 is denoted by 51a. In the hose line 51 is located shortly before the inlet hose line 52 Via line 50 from the central control arrangement 16 a control voltage can be applied to the solenoid valve 55 { (Details in Fig. 3). From a junction 54 branches off a bend 56, which consists of a bend 57 and a Throttle 58 exists and opens into the hose line 8 at a branch point 59. In the course of the hose line 51 there are two safety electrodes 61 and 62, respectively, connected to T-pieces 55 and 60 (details in Pig. 5) for display of air bubbles in the dialysis fluid that are harmful to the patient, which send their measurement signals to the central control arrangement 16 via lines 63 and 64. aside from that lies in the course of the hose line 51 with a Spring 66 loaded safety valve 67, the dialysis fluid

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only lets through when a certain pressure is exceeded is. In the course of the hose line 8 there is a T-piece 70 connected safety electrode 71 (details in Figure 5), which via a line 72 to a measurement signal the central control arrangement 16 emits when, in particular as a result of a leak in the bag 9, measuring liquid 17 and mix dialysis fluid 5 with one another in the measuring container 18. One executed as an alarm device, described later at B. Signal arrangement in the central control arrangement 16 provides for the alarm or shutdown of the entire device in the Case of danger. In the removal circuit 2 there is a conveyor for dialysis fluid from the patient's body a hose pump 73 (details in Fig. 3) with a controllable electric drive motor 74 and an electromagnetic valve 76 (details in Fig. 4) in the course of a hose line 77, which is at a junction 78 on the inlet hose line 52 connects. The drive motor 74 and the solenoid valve 76 are supplied with control voltages Lines 79 and 81 can be acted upon by the central control arrangement 16. The drive motor 74 is a direct current motor formed, the speed of which is adjustable by the size of the control voltage. It can be used as a control device for the discharge conveyor 73 are taken. A safety hose line is attached to the hose line 77 at a branch point 82 83 connected, in the downstream of a throttle 84 and the junction 82, an electrical vacuum switch 86 and a manometer 87 lie. The upper part 83a of the safety hose line 83, to which the vacuum switch 86 and the manometer 87 are connected, need not be sterile and is connected via a connection piece 89 to the safety hose line belonging to the sterile hose system (186 in FIG. 6) 83 connected. Measurement signals pass from the vacuum switch 86 via line 88 to the central control arrangement 16. The upper end of the safety smart line 83 with the throttle 84, for the sake of clarity, is to be accommodated in the removal circle outlined in dash-dotted lines

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drawn below the arc piece 57 in the realized Execution, however, this upper end is above of the bend 57 »

The tubing 77 leading the dialysis fluid withdrawn from the patient's body 53 to the measuring circuit 3 ends in a collecting vessel 91 which has an electrode 94 which can be moved up and down in front of a scale 92 for setting the desired fluid level in the collecting vessel (details in Jig. 2) is provided, of which the reaching of the set liquid level indicating measuring signals via line 96 of the central control system 16 are supplied * har. A hose 97, in the train of which a solenoid valve 99 (details in Pig a lower liquid level (level) movable up and down electrodes (details in Fig. 2) 102 and 104, which are connected to the central control arrangement 16 via lines 106 and 107 to emit measurement signals when the set liquid levels are reached. Of the measurement container 101, a hose 108 performs, in its train a acted upon via a line 109 from the central control assembly 16 with control voltages solenoid valve 111 and an electric drive motor 112 of a feed pump 113 (for example a gear pump) are, to a drain 114th

The central control arrangement 16 each has an adjusting knob 171 and 172 for the speeds of the drive motors 13 and 74 of the hose pumps 12 and 73. With the adjustment knobs 171 and 172, for example, electrical potentiometers (not shown) in the excitation circuits of all DC motors trained drive motors to change the

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Excitations and thus the speeds can be adjusted. the lines to the excitation windings are also shown nifat, because this control principle for DC motors notorious "is known. The central control arrangement has Furthermore, a timer 173 with an adjustable switching contact 173a for the dwell time of a single amount of dialysis fluid in the patient's body as well as a timer 174- with adjustable Switching contact 174a for the time expected by the doctor to run a single amount of dialysis fluid into the patient's body.

The buttons 176 and 177 are used to switch the Mains voltage for the peritoneal dialysis machine and for the energy supply the heater (heating resistor 31) is provided, the Button 178 for the start of a dialysis cycle (at the beginning of the program), which begins with the dosing and tempering of the first individual amount of dialysis fluid. The button 179 is once by the operator to initiate the construction run-in to press during the first dialysis. The central control arrangement 16 also has a presettable one Counter 181 for counting the individual dialysis, a warning lamp 182 and counters 183 and 184 for counting the abdominal enemas or the quantities recorded in measuring container 101. The punctures of the central control arrangement 16, the adjustment buttons 171 and 172, timers 173 and 174, buttons 176 to 179, counters 181, 183, 184 and the warning lamp 182 are explained in detail with reference to FIG. The electrode arrangement of 'Figure 2 for high-precision measurement of liquid levels has a tube 122 provided with a slot 121, the inside with a Sohioht 123 made of insulating Plastic is lined and is immersed in the liquid to be monitored with regard to its level. The tube 122 is attached to a partially broken-open housing 124, which is electrically connected to it by an insulating layer 125 is separated, attached.

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Bergedorf, December 11, 1969

A flexible electrically conductive metal strip 127 is attached to the peg 126 around which it is loosely wound is lying around. On the metal strip 127 is one in the Tube 122 up and down movable measuring tip 128 made of electrically conductive material attached, the vnn the tube walls through a plastic sleeve 129 is kept away. To drive the metal strip 127 is provided with a friction lining Roller 131 is provided, which is connected to a non-visible rotary knob on the outer wall of the housing. Another Roller 132 serves as a counter bearing for the metal strip 127. The tube 122 is connected to one pole of a voltage source, the Housing 124 and with it the metal strip 127 with the other | Pole connected. Immersing or submerging the measuring liquid from the liquid standing in the pipe 122 is, depending on the circuit, evaluated as a measuring signal, since here a Current flow between the poles is established or interrupted. The housing 124 is together with connecting pieces 133 and 134 can be attached to an insulating plate 136, for example by means of screw connections (not shown), so that it can be easily - e.g. for cleaning - can be detached from the insulating plate 136 and reattached to it. Through the slot 121 is achieves that the current paths when immersing the measuring tip 128 in the liquid to be monitored standing in the tube 122 are small even with a raised probe tip. It is also ensured that the level of the liquid in the pipe corresponds to the ' Corresponds to the liquid level in the vessel containing the liquid, since only a lower liquid level in the tube Adhesion phenomena that are practically non-falsifying can occur. The electrode arrangement is also great because of it Space-saving design advantageous in which no parts protrude from the housing 124 even when the probe tip is raised. Corresponding to the electrode arrangement shown in FIG. 2, the electrodes 21, 22, 94 and 103 and 104 in FIG be trained.

The hose pump of Figure 3 consists of two rollers 141 and

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142, of which there is always a roll with a hose line 143, is to be conveyed in the liquid, is engaged by pressing on the hose line and its cross-section practically reduced to Hull. Ibels 141 and 142 are seated rotatable on levers 144 and 146, which are rotatably mounted about axes 148 and 149 fixedly arranged on a disk 147 and are connected to one another by means of a tension spring 150. The shaft 151 of the disk 147 is not visible from one another electric drive motor can be driven, which is advantageously designed as a direct current motor, especially when the direction of rotation is reversed and adjustable speed are required. The driven rollers 141 and 142 press upon rotation of the Disc 147 against a hose line 143, the cross-section of which is reduced at the point of contact so that! Liquid is conveyed in the hose line. The tension spring 150 has the purpose that the rollers 141 and 142 lift off the hose line 143 when a certain delivery pressure in the hose line 143 is exceeded, so that the peristaltic pump is secured against overpressure which could damage the patient. Corresponding The hose pumps 12 and 73 of FIG. 1 can be designed in the hose pump shown in FIG. 3.

The solenoid valve of Figure 4 consists of a cutting edge 152 on one side of a hose 153, which is on the on the other hand, a pressure plate designed as a pressure plate, which can be displaced by an electromagnet 156 against the action of a compression spring 154 Anchor 157 faces. In the illustrated solenoid valve, the stroke of the armature is smaller than that Diameter of the hose line, reduced by its double wall thickness. The effective cross-section when the valve is open is practically not reduced in the arrangement shown, but the armature travel is smaller. Small anchor routes are however related the response times and the reliability of the response are advantageous. When the electromagnet is excited, the armature moves 157 in the position shown in which the hose line

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is open. When the excitement disappears, e.g. by switching off the excitation voltage, the compression spring 154 presses the armature 157 again from the position shown cutting edge 152 so that tubing 153 is compressed and the valve closes. The compression spring. 154 also ensures that the valve closes if the voltage is used, e.g. in the event of a power failure, to excite the electromagnet 156 fails. According to the solenoid valve shown in Figure 4, the solenoid valves 11, 55, 76, 99 and 111 in FIG.

The safety electrode of FIG. 5 has one in a hose line 163 made of electrically insulating material, e.g. made of transparent plastic, T-piece 162 made of electrically conductive material, which is connected at its ends 164 and 165 to the hose line 163 and its center piece 166 has a bore 167 for receiving an electrode 168 designed as a banana plug. The electrode 168 is attached to an insulating plate 169: g> ar, e.g. screwable. According to the security electrode of Figure 5, the security electrodes 61 and 62 in Figure 1 are formed are connected in series and electrically via the dialysis fluid the hose line 51 are in communication with one another. There is one between the safety electrodes Air bubble dangerous for the patient, the current flow through the dialysis fluid in the hose line interrupted, virao in the central control arrangement 16 as "Disturbance" is assessed and the dialysis is interrupted. Corresponding to the safety electrode in FIG. 5 the safety electrode 71 is also formed in FIG. 1, those at one. Leak in the bag 9 creates a circuit via the dialysis fluid in the hose line 8, the measuring fluid 17 in the measuring vessel 18 and via the electrode 21 in the central control arrangement 16 closes.

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The sterile hose system 186, which is shown once again especially in FIG. 6, including the bag 9, the Elbow piece «s 57, the throttle 58, which is used as T-pieces 55, 60 and

70 for connecting the safety electrodes 61, 62 or 71 formed connecting pieces and the puncture cannulas 187, 188, 189, 191, 192 and 193 (storage containers 6, 7 containing dialysis fluid for piercing) supplied sterile by the manufacturer.

It can be exchanged particularly easily for each dialysis cycle. The connection of a new hose system 186 the peritoneal dialysis machine according to the invention requires the following Handles:

Insertion of the bag 9 between the hose coil 34 in the Measuring vessel 18, inserting the safety electrodes 61, 62 and

71 in the T-pieces 55 or 60 or 70, insert the hose line 8 in the peristaltic pumps 12 and 73, inserting the hose line 8 between the cutting edge and armature of the solenoid valve 11, inserting the hose line 51 between the cutting edge and armature of the solenoid valve 55, inserting the hose line 72 between the cutting edge and armature of the solenoid valve 76, insertion of the hose line 51a into the safety valve 67, inserting the hose line 77 into the collecting vessel 91, Connect the safety hose line 83 to the hose line 83a by means of the connecting piece 88, piercing one or more of the piercing cannulas 187 to 193 into the associated Reservoirs 6 and 7 containing dialysis fluid 5 or other reservoirs, adjoining inlet cuLauchleitung 52 to the stylet catheter 49, which is inserted into the body of the patient 53 as soon as at the end of the inlet hose line Dialysis fluid appears. An additional fabric, e.g. Medication solution, are introduced by means of an injection needle 194, which is also the Body of the patient is supplied.

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In Figure 7, further details of the dash-dotted lines are framed central control arrangement 16 for the practically automatic program sequence of a dialysis cycle is shown. So far the figure has elements which are described in earlier figures, these have the same reference numerals. the Electrodes 21, 22, 94, 103 and 104 are in the central control arrangement 16 again symbolized as contacts, the drawn switching states of which correspond to the drawn liquid levels correspond in the assigned vessels. The immersion or immersion of the electrodes in liquid calls for a Change the switching status of the contacts. In reality the electrodes are of course the individual Vessels 18, '91 and 101 spatially assigned.

The central control arrangement 16 has the following groups of switching elements:

AND gates 207, 224, 226, 231 and · 243 each with two inputs a and b, which only emit a signal at their outputs c when both inputs a and b simultaneously with one Signal are applied.

OR gates 208 and 236 with inputs a and b or a ... e, each of which emits a signal at their outputs c when a signal is applied to at least one input, Negation elements 216, 223, 233, 242 and 244, which invert a signal present at their input a, i.e. at their output c emit the inverse signal,

bistable memories 202, 209, 217, 218, 232, 234 and 237 with one memory input a and one delete input b. The loading of a memory input a is called "Sbfczen" in its mode of operation, since then at output c of the memory a signal appears which remains stored until the clear input b receives a signal, i.e. the memory is cleared again whereupon the signal at output c disappears, amplifiers 203, 206, 211, 214, 219, 222, 227, 228, 238 and for signal amplification,

Motor contactors 204, 212, 221 and 229, which when energized over

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their contacts a and b are associated drive motors with control voltage supply,

a timing element 213 consisting of an RC element, an emergency switch 241,
a cancel button 246 and

a main line 247 for supplying DC voltage to the central control arrangement 16.

Mode of action of the peritoneal dialysis machine according to Figures 1 to 7:

First, as described in Figure 6, a fresh, sterile hose system is inserted into the peritoneal dialysis machine, the inlet hose line 52 already attached to the stylet catheter 49 is connected, but this has not yet been introduced into the body of the patient 53. Doctor in charge then uses the electrodes 21 and 22 in front of the scale 23 to set the individual quantities of dialysis fluid for the dialyses. He can also on the central control arrangement 16 by means of the setting buttons 171 and 172 the speed of the Set the dosage and the abdominal enema or the abdominal outlet. He also sets the dwell time by means of the timer 173 during which a single amount of dialysis fluid is in the patient's body, and by means of the timer 174 the expected maximum duration of the abdominal enema. According to the amount intended for the entire dialysis cycle Dialysis fluid is also preset to the counter 181 for specifying the number of individual dialyses can also use the setpoint generator 38 (potentiometer) to set the temperature of the liquid to be measured and the setpoint generator 44 the Temperature of the heating fluid can be selected. Around that The collecting vessel 91 and the measuring container 101 any remaining liquid from the previous dialysis cycle is drained off. On that the button 176 is pressed, which connects the main line 247 to the network PO. The main line with voltage 247 supplies the voltage for the control and actuating signals of the central control arrangement 16 and the current for

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Heating resistor 31.

After these preparatory actions, press at the beginning of a dialysis cycle to initiate the first dialysis Operator presses button 178. The first dialysis now takes place in the following manner. The button 178 enters the memory 202 setting signal at its input a, so that the memory 202 at its output c via amplifier 203 the motor contactor 204 excited. This closes its contacts a and b, so that the drive motor 13 of the hose pump 12 via a double line 15 receives control voltage and can start in the metering direction of rotation (arrow 251). At the same time that excites from the exit c of the memory 202 incoming signal via amplifier 206 and line 14, the solenoid valve 11, which opens. The peristaltic pump can now pump dialysis fluid 5 from the containers 6 and 7 via hose line 8 to the bag 9. With measuring liquid 17 is displaced with increasing bag contents, so that its level in the measuring vessel 18 rises. During this dosing process, the dialysis fluid is already heated, since the pump 41 heats fluid through the heating coil promotes and thus increases the temperature of the measuring liquid 17. When the set temperature value of the measuring liquid is reached, the temperature sensor 36 of the first thermal Control loop 35 is determined, the control deviation at comparison element 47 disappears and the pump 41 is at a standstill quiet. The temperature of the heating fluid 29 is kept constant by the second thermal control circuit 40. Is the one you want The amount of dialysis fluid in the bag 9 is then reached the level of the measuring liquid 17 the upper electrode 22 (in Figure 7 means closing the correspondingly labeled contact). The measurement signal of the electrode 22 passes over line 26 to the central control arrangement 16, in which it applied to the delete input b of the memory 202, so that the memory is erased and the signal at its output c and thus the control voltages on lines 14 and 15 disappear. As a result, the drive motor 13

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stands still and that the solenoid valve 11 closes, i.e. that the dosing, that is, the supply of dialysis fluid to the bag 9 is finished. A signal from the electrode 22 also reaches the input a of the U] H) -gl ie of the 207 »its input b only receives a signal when the operator presses the button 179 for the following completely automatic sequence of the dialysis cycle has pressed. This button is only pressed when the dialysis fluid in the bag 9 has reached its prescribed temperature has certainly achieved what-through a not shown, on the heating time and / or temperature of the dialysis fluid responsive display device can be reported. The actuation of the button 179 by the doctor is necessary, since this is followed by the insertion of the stylet catheter 49 into the body of the patient 53. That at its entrance a OR element 208 to which a signal is applied outputs a signal to input b of AND element 207 at its output c. The AND gate 207 to which signals are applied to both inputs a and b now emits a signal at its output c, which arrives at the input a of the memory 209 and sets it. The signal output from its output c is over-excited Amplifier 211 the motor contactor 212, which closes its contacts a and b and thus line 15 with a control voltage reversed Polarity applied so that the drive motor 13, the hose pump 12 in the opposite direction of rotation accordingly Arrow 252 drives. Solenoid valve 11 remains closed. The peristaltic pump 12 circulates the dialysis fluid through hose line 8, elbow 57 and hose line 51a_. around. During this agitation, the doctor may use one at the bottom The injection needle 194 inserted into the curved section 57 Add medication to the dialysis fluid. During the agitation is also used in the hose lines outside the Bag 9 located Dialyaierlösung heated. The signal emitted by output c of the memory 209 also reaches the timing element 113 after a certain delay time Via amplifier 214 air-e control voltage on line

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50 outputs, via which the control voltage is supplied to the solenoid valve 55, which opens. Now the peristaltic pump can 12 Dosing liquid from bag 9 via hose line 8, elbow 57 and hose line 51 to the inlet hose line 52 promote. If dialysis fluid comes at the end of the inlet hose line 52 and at the one on this hose line connected stylet catheter 49, the doctor inserts the stylet catheter 49 into the abdomen of the patient 53 and the delivery of metered and tempered dialysis fluid to the patient, hereinafter referred to as "abdominal enema", begins. Because of the throttle 58, a gas bubble under pressure arises in the bend 57, which prevents any pressure surges attenuates in the dialysis fluid. The signal emitted by the timer 213 is also fed to the counter 183, whose Counter reading is increased by one unit. The counter 183 is used to measure and display the number of abdominal inlets. It can on it also the number of individual doses and thus the amount of the total amount of dialysis fluid supplied to the patient 53 can be preset so that the counter ends the dialysis cycle, e.g. via OR gate 236, as soon as the intended amount of dialysis fluid has been supplied. In this way it is ensured that the Reservoirs 6 and 7 existing dialysis fluid is not completely spent and air in the lines to Patient. If the entire dosed and tempered individual amount of dialysis fluid is conveyed from the bag 9, then the level of the measuring liquid 17 has reached the lower electrode 21 (in FIG. 7 this means opening the correspondingly designated contact).

The measuring signal of the electrode 21 fed to the input a of the negation element 216 via line 24 disappears when the The electrode is no longer immersed in the liquid to be measured, so that the negation element 216 emits a signal at its output c. This signal is applied to the clear input b of the memory 209 and clears it, so that firstly the motor contactor 212

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is de-energized and thus the control voltage to the drive motor 13 disappears on line 15, which stands still, secondly, the control voltage on line 50 disappears, so that the Solenoid valve 55 closes. The dialysis fluid in the patient's body must now linger there, with it absorbs toxins.

The signal emitted by negation element 216 is fed to input a of memory 217 and sets it. The memory outputs a signal at its output c, which starts the drive of the preset timer 173 to specify the dwell time leaves. The signal output by negation element 216 is also fed to the set input a of memory 202, which is thereby set and emits a signal at its output c, which via amplifier 203 and motor protection 204 a control voltage on line 15 and via amplifier 206 triggers a control voltage on line 14, so that the drive motor 13 rotates in the metering direction starts up according to arrow 251 and the solenoid valve 11 opens. This allows in the dwell time of the first dialysis process, in which the dosed individual amount remains in the patient's body, already the individual amount of dialysis fluid prepared for the following dialysis process, i.e. dosed and tempered.

The hose pump 12 thus again conveys dialysis fluid from the storage containers 6 and 7 in the manner described above in the bag 9, with heating already occurring until the electrode 22 adjusts the dosage to that already described Way ended by sending a measurement signal to clear input b of memory 202. The drive motor 13 is at a standstill again, the solenoid valve 11 closes. During the remainder of the dwell time, the dosed in the bag 9 can be Heat the dialysis fluid safely to the desired temperature to the end.

After the dwell time has elapsed, the preset switching contact 173a of the timer 173 sends a signal to the clear input b of the memory 217 and to the set input a of the memory 218.

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The hand of the timer 173 goes because of the disappearing signal at the output c of the memory 217 and at the drive of the timer back to its original position. At its output c, the memory 218 outputs a signal via amplifier 219 to the motor protection 221, which its contacts a and b closes, whereby a control voltage is given on line 79 which causes the drive motor 74 of the hose pump 73 to start. The signal at output c of memory 218 is also after amplification in amplifier 222 via line 81 dem Solenoid valve 76 supplied, which opens. The hose pump 73 now promotes through the inlet hose line -.- 52 and the Tubing 77 dialysis fluid from the patient's body, which has been loaded with toxins there, to the collecting vessel 91, which is referred to as "abdominal outlet". That from Output c of the memory 218 output signal is from the negation element 223 inverted. The AND gates 224 and 226 therefore receive no signals at their inputs a, so that via amplifiers 227 (line 98) to the solenoid valve 99 and via amplifier 228 and motor protection 229 (double line 109) to the Solenoid valve 111 and the drive motor 112 no control voltages can be fed.

As soon as the liquid level in the collecting vessel 91 reaches the electrode 94, this triggers a measuring signal via line 96 (in Pig. 7 this means closing the correspondingly designated contact); If the vacuum switch 86 responds and sends a measurement signal to the central control arrangement 16 via line 89, which is to be assessed as the end of the ventral outlet, then the AND element 231 receives signals at both inputs a and b, so that it is at its output c emits a signal to the delete input b of the memory 218, the signal of which at output ο disappears. The control voltages on the lines 79 and 81 therefore also disappear, so that the drive motor 74 stops and the solenoid valve 76 closes. The abdominal discharge of the first individual dialysis is thus ended.

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The signal emitted at the output c of the AND element 231 is applied also the input b of the OR gate 208, the output c of which is a signal to the second input b of the AND gate 207 there, the input of which is already from electrode 22 when dosing the second individual amount for the second Dialysis process had received a signal. That at exit c of the AND element 207 applied to the input a of the memory 209 and sets this so that motor protection 212 the line 15 receives a control voltage of such a polarity that the drive motor 13 of the hose pump 12 starts running in the direction of rotation according to arrow 252 to initiate the second dialysis (abdominal enema) and that into the Tubing circulates dialysis fluid. The timer 174 is from the measurement signal of the electrode 21 in their The initial position drawn is reset when its pointer has not yet reached the switch contact 174a, the actual one The abdominal break-in time was therefore shorter than the preset maximum Time was.

After the time determined by the timer 213 after which the dialysis fluid it is heated in the hose system, valve 55 receives control voltage via line 50 so that it can be initiated of the belly enema opens.

The deletion of the memory 218 by the signal coming from the output c of the AND gate 231 causes the output c of the Negation element 223 a signal which is applied to the inputs a of the AND elements 224 and 226. Since at the input b of the AND gate 224 a signal is already present from the memory 232, which is transmitted via the electrode 104 (in Fig. 7 this means that the corresponding contact is open) and via the negation member 233 on its input a it had received a setting signal, i.e. it emits a signal at its output c, it triggers the output c of the AND element 224 emitted signal via amplifier 227 a control voltage on line 98 to the solenoid valve 99, which opens

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Liquid can now flow from the collecting container 91 via the hose 97 into the measuring container 101 until the liquid level reaches the electrode 103 after a certain set amount has been reached. This gives a measurement signal via line 106 to the central control arrangement 16 (in Fig. 7 this means closing the corresponding contact), which acts on the set input a of the memory 234; whose output c then emits a signal that firstly the erase input b of the memory 232 is applied, so that the signal at its output c disappears and, secondly, the input \ b of the AND element 226 is applied. While input b of AND element 224 no longer receives an input signal due to the deletion of memory 232, so that its signal at output c disappears, a signal appears at output G because both inputs a and b of AND element 226 are applied. As a result, firstly, the control voltage on line 98 disappears, i.e. the solenoid valve 99 closes, and secondly, the double line 109 receives a control voltage from the motor protection 229, which was excited by the signal from the output of the AND gate 226 via amplifier 228 . The control voltage on line 109 causes the solenoid valve 111 to open and the drive motor to start, so that the pump 113 conveys the measured liquid via hose line 108 to the drain 114. The electrode 103 simultaneously sends a signal to the preset counter 181, the counter reading of which is decreased by one unit. The electrode 103 also sends a signal to the counter 184, the reading of which is a measure of the amount of fluid withdrawn from the patient. From the difference between the counters of counters 184 and 183, the amount of fluid that was additionally secreted from the patient can be determined.

If the measuring container 101 is empty, electrode 104 is released via a line 107 a measurement signal is output in the central control arrangement (in FIG. 7 this means opening the corresponding

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Contact, which is inverted by the negation element 233 and thus applied to the set input a of the memory 232 as a set signal, so that this is set. The signal appearing at the output c of the memory 232 is applied to the input b of the AND element 224, at the output c of which a signal appears which, again via amplifier 227, has a control voltage the line 98 to the solenoid valve 99 triggers so that it opens. The one appearing at output c of memory 232 However, the signal also acts on the clear input of the memory 234 'whose signal at the output c disappears, so that the signal at input b of AND gate 226 also disappears. This has the consequence that the control voltage on the line 109 disappears, so that the solenoid valve 111 closes and the drive motor 112 comes to a standstill. It can now again liquid flow from the collecting vessel 91 via hose 97 to the measuring container 101 until the electrode 103 emits a measuring signal when immersed in the liquid, which - as described - the closing of the solenoid valve 99 and the supply of control voltage to the drive motor 11t and the solenoid valve 111 triggers. Simultaneously the count of the counter 181 is again decreased by one unit.

The entire contents of the collecting vessel are collected in the manner described 91 of a single dialysis. The remainder in the measuring container 101 becomes the following by liquid Dialysis process added up to the level of the electrode 103. In the manner described, a dialysis process is after others are controlled fully automatically and the fluid withdrawn from the patient's body is measured until the counter 181 has reset the preset number to zero. In this case it gives a signal at input c of the OR gate 236 the output c of which is a signal which is fed to the set input a of the memory 237. Its output signal on Output c actuated after amplification via amplifier 238

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a warning lamp 182 and, after amplification via amplifier 239, excites the emergency switch 241, which controls the entire system with the exception the heating switches off. An operator called by the warning lamp 182 now carries out the last dialysis process to the end, i.e. it ends the abdominal discharge, whereupon the entire dialysis cycle is ended.

In a process such as peritoneal dialysis, various types of disturbances can occur which must be recognized and, even if the procedure is automatic, must not cause any dangerous conditions for the patient. In the following the mode of action is described in more safety circuits, which can be countered overall ä drive states.

An important requirement in peritoneal dialysis is avoidance any penetration of germs into the sterile dialysis fluid.

Such a penetration is practically undetectable, for example, when the bag 9 has a leak and unsterile measuring liquid penetrates into the bag 9. The safety electrode 71 is used to monitor such a hazard Line 72 sends a measurement signal to a signal arrangement in the central control arrangement 16 (in FIG. 7 this means Closing the corresponding contact). This signal is applied to the input d of the OR gate 236, so that its output c a signal via amplifier 238 to the warning lamp 182 'and via amplifier 239 an excitation signal to the emergency switch 241 to switch off the entire device. The OR gate 236 forms together with the warning lamp 182 and the emergency switch 241 an alarm device that indicates a malfunction or an error with the warning lamp and the staff and the system automatically switches off via the emergency switch.

Another possible danger is the formation of air bubbles in the area containing the dialysis fluid Soblauohsystem that do not get into the patient's body

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to be allowed to. The are used to display this dangerous state Safety electrodes 61 and 62, between which a current flow is interrupted when air bubbles occur. In this In this case, corresponding measurement signals are sent to the central control arrangement 16 via lines 63 and 64 (in Pig. 7 this means opening a corresponding contact). That Negation element 242 inverts this signal, so that a signal is present at input e of OR element 236. At the Output c of the OR element then appears a signal which actuates the warning lamp 182 and the emergency switch 241.

Another danger is that the patient is "clogged", i.e. that the dialysis fluid is no longer available enters or leaks properly into his body. The timer is used to determine whether there is a blockage in the case of an abdominal enema 174. If the belly inlet has not ended before the preset switching contact 174a is reached, i.e. has until then the electrode 21 does not emit its measurement signal, then a signal arrives at input a of the OR gate 236, at dessea Output c then again a signal that actuates the warning lamp 182 and emergency switch 241 is present.

The determination of a blockage in the case of abdominal discharge is made by Vacuum switch 86 also taken over. Whose measurement signal arrives in addition to the input a of the AND gate 243, the other one Input b is acted upon by the measurement signal of the electrode 94 via the negation element 244. When the electrode 94 at If the response of the vacuum switch 86 has not yet responded, this means that the expected amount of dialysis fluid has not been pumped out of the body of the patient 53 has been, so the negative pressure does not affect the end of the abdominal outlet, but is due to constipation. The output of the output c of the AND gate 243 signal applied to the input b of the OR gate 236, at which Output c a warning lamp 182 and emergency switch 141 actuating Signal is given.

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The memory 237 can be deleted again by the operator after a malfunction has been eliminated using the delete button 276 will.

Except for the safety circuits in the central control arrangement 16, in which logical links are made must, the peritoneal dialysis machine according to the invention still has built-in fuses that act purely mechanically.

When the pressure increases, which is associated with a blockage in the case of abdominal enema, part of the dialysis fluid is released back to bag 9 via safety valve 67. In addition, |

the pressurized liquid in the hose line 8 presses the rollers of the hose pump 12 from the hose line 8 against the action of the spring 180 back. The damaging effect is thus immediately, purely mechanically the blockage (pressure increase in the patient) avoided before the safety circuit of the central control arrangement 16 responded and alerted the operating personnel. With the negative pressure associated with an obstruction in the case of abdominal discharge is, air is sucked in through the safety hose line 83, causing an inadmissible increase in the negative pressure is avoided in the patient before the vacuum switch 86 turns off the entire device.

FIG. 8 shows the spatial configuration of the peritoneal dialysis machine according to the invention shown as a unit 262 movable on rollers 261. Those already described in previous figures Elements of the device are provided with the same reference symbols and are no longer specifically explained. On the control panel 263 contains all buttons, counters, setting buttons and lamps in a clear arrangement. In addition to the control elements already explained is a button 260 for switching to manual control and a button 266 intended for switching to automatic program control. In addition, a button 267 for manual control of the abdominal

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inlet and a button 268 is provided for manual control of the ventral outlet, which is only effective after pressing button 264 will. Details of the manual control are not shown because they are trivial in terms of circuitry. 269 is an indicator lamp, which lights up as long as the dialysis fluid in the tube system is circulated after dosing. An indicator lamp 271 is used to display the dwell time, the duration of which is controlled by the timer 173. By means of a Button 270 can also end the dwell time prematurely. 272 is the mains connection, 273 is a row of contacts for a remote display of the most important measured values. The space-saving and compact design is particularly good from FIG of the peritoneal dialysis machine according to the invention, in which all control elements and storage containers are housed.

In FIG. 9, a measuring circuit 303 is shown in which, during the measurement of a certain amount of liquid in a measuring container Liquid is conveyed into the drain from another previously filled measuring container. For this purpose are the Collecting vessel 391 with an electrode 394 via hose lines 397a and 397b, in each of which there is an electromagnetic valve 399a and 399b, two measuring containers 401a and 401b connected in parallel with electrodes 403a and 403b are arranged downstream. "A hose line 408a or 408b leads from each measuring container, in the course of which there is an electromagnetic valve 411a or 411b, to the drain 414. The electrodes 394, 403a and 403b and the solenoid valves 399a, 399b, 408a, 408b are so connected to the central control arrangement, not shown, that the valves 399, 411 have the same switching state which is the inverse of the switching state of the solenoid valves 399, 411.

So if, for example, measuring container 401a is filled, including the solenoid valve 399a is open and the solenoid valve 411a is closed, then the measuring container 401b is emptied, wosu §53 solenoid valve 399b closed and the Slaktro-

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solenoid valve 411b is open. If the liquid level has reached the electrode 403a, its measuring signal triggers Switching the valves off in such a way that measuring container 401b is filled and measuring container 401a is emptied. The advantage of this measuring arrangement is the greater measuring speed, since from the collecting container 391 it is practically continuous Liquid can drain off.

FIG. 10 shows a storage container arrangement in which a large storage container 506 with distilled water and several smaller storage containers 507, 5 ^a ^ and 509 are provided for receiving concentrate. Durü ^ f mixing the distilled water of reservoir 506 ait concentrate from one or more of the containers _507; 508 and 509 the dialysis fluid is formed during the dosing. The hose pump 512 can be driven by a drive motor 513. In front of the peristaltic pump 512 there is an electromagnetic valve 511 »The peristaltic pump 512 is again used for dosing and carrying out the abdominal enema. The peristaltic pumps 601, 602 and 603 can be driven by drive motors 604 or 606 or 607, the speed of which can be set by resistance regulators 608 or 609 or 611. The peristaltic pumps 601 to 60 deliver parallel to the peristaltic pump 512. By adjusting the delivery speed of the peristaltic pumps 601 to 603, the mixing ratio of water to concentrate, ie the concentration of the dialysis fluid, can be adjusted. The smaller storage containers 507 to 509 can be blocked by means of the solenoid valves 612 to 614.

The advantage of the invention is generally that it is possible to start regulating the temperature of the dialysis fluid while it is being metered. At the special dosage that works with the highly precise displacement of the measuring liquid, the temperature control can be carried out simply by means of the measuring liquid, that is, with respect to the dialysis liquid, at the same time represents a heating fluid.

- patent claims -

109828/1048

Claims (16)

Bergedorf, February 4, 1970 Patent Hi / Sch Stw .: Peritoneal dialysis dosage - Hauni file 1084 Aktz .: α 69 49 786.5 - - patent Sfci claims / Ί.) Peritoneal dialysis machine with a dosing device for the dialysis fluid, with a temperature control device for the dialysis fluid and with a delivery device for delivering dialysis fluid from the dosing device to the patient, characterized by a measuring vessel (18) Mt a tempered hot liquid (17), the egg of a measuring arrangement (19) is provided for the measuring liquid level and characterized by at least one between the to be metered Dialysis fluid (5) and the ießiquid (17) arranged Partition (9) j from the supply of dialysis fluid Measuring liquid in the measuring vessel (18) can be displaced. 2. Peritoneal dialysis machine according to / nspruoh 1, characterized in that that the partition (9) is iiexible and that of the to be dosed? Dialysis fluid (5) occupied space completely against that taken by the measuring liquid (17) Tree completes. 3. Peritonealdialy3engerät according to claim 1 and / or 2, characterized gekennaeichnet that the partition consists of a bag (9) Made of flexible material for holding dialysis fluid (5) is arranged in such a way in the measuring vessel (18) that it is at least over the largest part of its area of MeßflüBsigkeit (17) is surrounded. 4. Pearl tone dialysis machine according to claim 3, characterized in that that the mer ^ e container (18) and / or the bag (9) consist of transparent material. 109828/1048 Stw .: Peritoneal Dialysis Dosage - Hauni File 1084 File number: G 69 49 786.5 - Bergedorf, February 4, 1970 5. Peritoneal dialysis device according to one or more of the preceding claims 1 to 4, characterized in that a line (M) for heating fluid (29) for supplying heat to the cooling fluid (17) is provided in the i'leßgefäß (18). 6. Peritoneal dialysis machine according to claim 5, characterized in that that the line (34) denotes the dialysis fluid (5) containing the bag (9) and holds it in its position. 7. Peritoneal dialysis machine according to claim 5 and / or 6, ge | characterized by a temperature sensor (36, 42) in at least one of the liquids (measuring liquid 17 $ heating liquid 29), which is connected to a control arrangement (37, 38, 47, 39, 41; 43, 44, 48, 46) for controlling the supply of heat to a liquid in the sense of keeping the measuring liquid temperature constant connected is. 8. Peritoneal dialysis machine according to one or more of the preceding Claims 1 to 7, characterized in that the measuring arrangement (19) for the measuring liquid stand at least a preferably adjustable electrode of an electrical control circuit with a flexible one on a roller (126) windable connected to one pole of a voltage source Metal strip (127) connected and in a slit connected to the other pole of the voltage source Tube (122) is guided, which is lined with an insulating layer (123) and in which the measuring liquid is. 9 · Peritoneal dialysis machine according to claim 1 and 8, characterized by that the measuring arrangement (19) with a control arrangement (16) for a metering conveyor (12) sum supply of dialyeing liquid to be dosed is connected in such a way that that the! dosing conveyor is deactivated., when the measuring liquid (17) reaches the electrode (22) '. ¹ H flififl "~! SMfSi fi Stw .: Peritoneal Dialysis Dosage - Hauni File 1084 Files: G 69 49 786.5 - Bergedorf, February 4, 1970 10. Peritoneal dialysis machine according to one or more of the preceding Claims 1 to 9, characterized by a signal when the measuring fluid (17) and dialysis fluid are mixed (5) emitting signal arrangement (71, 182, 241). 11. Peritoneal dialysis machine according to one or more of the preceding Claims 1 to 10, characterized in that the dosing and temperature control device are structurally combined with one another are. 12. Peritoneal dialysis machine according to one or more of the preceding Claims 1 to 11, characterized in that a circulating conveyor (12) for circulating the in lines (8, 57 » 51) to the measuring vessel (18) and / or on the patient (53) located dialysis fluid (5) after the temperature control of the the dialysis fluid adjacent to the Heßflüasigkeit (17) is provided is. 13. Perltonoaldialysengerät naoh Anspruoh 12, characterized in that that the dosing and circulating conveyor are formed by a Piunpe (12). 14. Peritoneal dialysis machine according to one or more of the foregoing Claims 1 to 13, characterized in that a control arrangement (16) for automatically controlling the Dosing and temperature control of one or more individual lines of dialysis fluid are provided which within a dialysis cycle successively the body of the patient (53) fed in and removed from it again. 15. Peritoneal dialysis machine naoh claim 14 _t daduroh characterized in that the control arrangement (16) during the Vtrweilzeit in which there is a Linzel amount of Dialysierflüsafekeit in the patient's body, automatically the dosage and temperature control of the individual amount of dialysis fluid is designed to control the following dialysis process. 1 0 Λ 8 Stw .: Peritoneal dialysis Oosierung - Hauni file 1084 Alrta .: a 69 49 786.5 - Bergedorf, February 4th 1970 16. Peritoneal dialysis machine after one or more of the preceding ones Claims 1 "to 15» characterized in that the metering device has a device for bringing together individual components forming the dialysis fluid (Pig. 9). 109828/1048 Blank page