EP3573550A1 - Système et procédé pour l'introduction automatisée d'une canule - Google Patents

Système et procédé pour l'introduction automatisée d'une canule

Info

Publication number
EP3573550A1
EP3573550A1 EP18702267.8A EP18702267A EP3573550A1 EP 3573550 A1 EP3573550 A1 EP 3573550A1 EP 18702267 A EP18702267 A EP 18702267A EP 3573550 A1 EP3573550 A1 EP 3573550A1
Authority
EP
European Patent Office
Prior art keywords
patient
data
cannulation
treatment
automated
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP18702267.8A
Other languages
German (de)
English (en)
Inventor
Pascal Kopperschmidt
Pia Daniel
Reiner Spickermann
Otto Arkossy
Cäcilia SCHOLZ
Kai-Uwe Ritter
Elke Schulte
Christopher Hauke
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Fresenius Medical Care Deutschland GmbH
Original Assignee
Fresenius Medical Care Deutschland GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Fresenius Medical Care Deutschland GmbH filed Critical Fresenius Medical Care Deutschland GmbH
Publication of EP3573550A1 publication Critical patent/EP3573550A1/fr
Pending legal-status Critical Current

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Classifications

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    • A61B34/30—Surgical robots
    • A61B34/32—Surgical robots operating autonomously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0116—Steering means as part of the catheter or advancing means; Markers for positioning self-propelled, e.g. autonomous robots
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
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    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
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    • A61B6/504—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of blood vessels, e.g. by angiography
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    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3659—Cannulae pertaining to extracorporeal circulation
    • A61M1/3661—Cannulae pertaining to extracorporeal circulation for haemodialysis
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    • A61B2017/3409—Needle locating or guiding means using mechanical guide means including needle or instrument drives
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    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
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    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
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    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/158—Needles for infusions; Accessories therefor, e.g. for inserting infusion needles, or for holding them on the body
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    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/158—Needles for infusions; Accessories therefor, e.g. for inserting infusion needles, or for holding them on the body
    • A61M2005/1588—Needles for infusions; Accessories therefor, e.g. for inserting infusion needles, or for holding them on the body having means for monitoring, controlling or visual inspection, e.g. for patency check, avoiding extravasation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards
    • A—HUMAN NECESSITIES
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    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178—Syringes
    • A61M5/31—Details
    • A61M5/32—Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/3287—Accessories for bringing the needle into the body; Automatic needle insertion
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    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/42—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests having means for desensitising skin, for protruding skin to facilitate piercing, or for locating point where body is to be pierced
    • A61M5/427—Locating point where body is to be pierced, e.g. vein location means using ultrasonic waves, injection site templates
    • A—HUMAN NECESSITIES
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    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/52—Arm-rests

Definitions

  • the invention relates to a system for automated cannulation of the blood vessels of patients and a corresponding method, in particular for hemodialysis.
  • Blood vessel puncture also referred to as cannulation
  • cannulation is a routinely required step in the medical treatment of many patients in which a fluid connection is created between the patient's bloodstream and an external fluid system, particularly a cannula.
  • Cannulation is performed in the medical practice by physicians or trained personnel.
  • the quality of the vascular access created by the cannulation depends on a large number of parameters, which are characterized in particular by the individually and temporally variable abilities of the medical personnel and physical properties of the patients to be treated as well as by the diversity of the technical aids used in the puncture.
  • cannulation machines In order to standardize the cannulation, cannulation machines have been developed which autonomously prepare a cannulation procedure on the patient and autonomously perform the cannulation by means of suitable sensors and motor systems.
  • Kanülierautomaten and technical means used therein are known for example from US 2015/0065916 A1, WO 2015/052719 A1 and WO 2010/029521 A2.
  • Hemodialysis machines are extracorporeal filter systems used as artificial kidneys into which the patient's blood is passed to be cleaned and treated before being returned to the patient's bloodstream.
  • the removal of the blood and the return of the blood is usually carried out via a surgically in an arm or leg of the patient subcutaneously created, artificial connection between a vein and an artery.
  • This compound may consist of a prepared to the patient's own vessel portion or of an artificial material and is referred to as a fistula or arteriovenous fistula (AV fistula, AVF).
  • AV fistula arteriovenous fistula
  • AVF arteriovenous fistula
  • the most widely used permanent vascular access in chronic hemodialysis patients is a native arteriovenous fistula. After placement of the native arteriovenous fistula, it becomes more intense due to increased blood flow, making repeated puncture easier for dialysis treatment.
  • Hemodialysis must be performed regularly, typically at intervals of a few days. This leads to a high mechanical load on the vessel, or the arteriovenous fistula.
  • various techniques are known which aim to preserve the vessel as much as possible in the course of the recurring punctures.
  • a new cannulation point is searched for each treatment, which is a distance from the previous, for example, about 2 cm.
  • the puncture series is started at the lower end of the vessel and then continued upward until the upper end is reached and the process is started again from below. In this case, the practitioner must observe the positioning scheme exactly in order to enable the healing of the punctured vessel positions.
  • buttonhole technique In contrast, in the buttonhole technique, a needle is always inserted at exactly the same location with the same angle. Over time, a scar cylinder is formed, in which the formed thrombus is repeatedly displaced during puncture and thus becomes more resilient. It has been observed that buttonhole technique results can be improved if the puncture is always performed by the same treatment personnel. Due to the frequency of punctures in hemodialysis patients, the arteriovenous fistula is generally exposed to a particularly high load independent of the puncture technique, which can lead to changes in the skin surface and the nature of the arteriovenous fistula and its course.
  • the present invention has for its object to provide a more efficient technical solution for cannulation under variable operating conditions, as found in particular in hemodialysis.
  • the inventive system for data-dependent automated cannulation of the blood vessels of patients comprises: at least one Kanülierautomaten that is set up for automated cannulation of the blood vessels of patients, at least one control system having at least one data processing device and the execution of a At least one user interface device, by means of which a user input to the control system is enabled, is registered by a patient on the control system, as a result of this registration process from the control system individually assigned to the registered patient Patient identifier is used, which is referred to as a registered patient identifier, and wherein the at least one control system, in particular the at least a control method is set up to determine the program parameters as a function of the registered patient identifier and to control the at least one automatic cannulation device in dependence on the registered patient identifier.
  • the system according to the invention is adapted to adapt the automated cannulation individually to the specific starting conditions present in a specific patient. Much of this adaptation can be done as a preparation before the automated process of cannulation, and therefore need not take place during cannulation. This is possible because the patient was previously logged on to the system via a user interface.
  • One Such a system is particularly efficient and offers the advantage of extended deployment and design options. In particular, such a system offers the advantage of being able to identify and provide extensive patient data for data storage that can be used in subsequent automated cannulation procedures by this system to further enhance reliability.
  • the system offers the advantage that the precision of Kanülierautomaten in combination with their patient-specific and data-based control lead to particularly reliable puncture results while preserving the vessel in the course of repetitive hemodialysis .
  • Automated cannulation operations begin with the understanding of the present invention and, as described below, after the body part of the patient to be punctured has been inserted into a treatment room of the cannulation machine, e.g. by the patient himself or by medical treatment personnel.
  • a cannulation machine is a device which automatically, that is, at least temporarily or continuously, at least one process step of cannulation of a blood vessel of a patient, or some or all provided process steps without human intervention, e.g. medical personnel. This is done in particular by the fact that the program parameters of the automatic cannulation are selected by the system and / or the user accordingly.
  • a process step of the cannulation is technically implemented in particular by a device component of the cannulating machine, for example a tool device, which is specifically set up for this process step and is selected from the group of the possible process steps P1, P2, P3... Without specifying an order by this numbering :
  • P1 use of a cannulation accessory set selected prior to automated cannulation, depending on the registered patient identifier; This selection may have been made previously by means of a optional equipment system of the system for selecting an accessory set and / or equipment of an accessory carrier, in particular accessory container; the accessory set may have previously been provided by an optional disposal device of the system, depending on the registered patient identifier, by segregating the accessory contained in the accessory set from an optional storage device of the storage system of accessories; the accessory set may contain one or more medical accessories, in particular gauze bandages, swabs, adhesive tape; the accessories of this accessory set may have been obtained depending on the registered patient identifier and / or patient-specific treatment data that may be derived from the registered patient identifier; the use of this accessory set by the cannulation machine is an automated cannulation operation and may provide that the accessory kit accessory be automatically retrieved from predetermined accessory carrier / container positions, particularly by selecting the appropriate program parameters depending on the registered patient identifier and suitable for removal become; For this purpose, in particular, an optional loading device
  • P2 spatial fixation of a body part of the patient, which has the blood vessel, in particular an arteriovenous fistula; the program parameters of the automated cannulation can depend on the logged
  • Patient identifier ie patient-individual, be selected by these program parameters set the position or distances of one or more optional fixation devices of Kanülierautomaten depending on a previously determined location or previously determined on the body part of this patient intervals so that a suitable fixation is achieved; the fixation takes place in the treatment room of the cannulating machine, in which the body part of the patient is stored for the subsequent at least one puncture;
  • P3 Use of patient data stored in patient database in particular to provide information about past cannulation process steps to determine the patient's blood vessel (historical data), and preferably to determine the cannulation to be made, in particular the program parameters used, as a function of this historical data;
  • historical data contain, in particular, the position of one or more blood vessels of the patient, which were previously measured with an optional measuring device of the cannulation machine for measuring the position and / or dimensions of at least one blood vessel under the skin of the patient (vascular structure measuring device), and in particular as patient data for To be available;
  • such historical data contain, in particular, information about the position and nature of earlier puncture sites on the body part of the patient, which are available in particular as patient data;
  • the vessel structure measuring device can be designed for detecting the position and / or dimensions of at least one blood vessel under the skin of the patient by means of ultrasound or by means of optical radiation;
  • the program parameters of the automated cannulation can here be selected as a function of the registered patient identifier, ie patient-specific, by selecting the cannulation intended for the registered patient on the basis of at least one treatment parameter which is patient-specific; for example, a patient may be provided for hemodialysis; a treatment parameter may encode the need for hemodialysis in this patient; by evaluating the treatment parameter, the cannulation of an arteriovenous blood vessel can be planned; this is to be identified; the identification may be made, for example, in the control system by program-controlled analysis of an image obtained by a vascular structure measuring device;
  • the program parameters of the automated cannulation can here be selected as a function of the registered patient identifier, ie patient-specific, by selecting a disinfection method specifically selected for the skin type or the skin morphology of the patient, for example characterized by the duration of the treatment, or the amount and composition of the disinfecting process used; also treatment data may be considered which are specific to the patient; it can be used for the said disinfection an optional at Kanülierautomaten or separately provided for disinfecting device, which is set up to perform the said function;
  • the skin type or the skin morphology of the patient are preferably known to the system as patient data of the patient database in particular;
  • P6 physical treatment for preparing the puncture of the body part of the patient, which comprises the blood vessel, in particular jamming of the blood flow of the body part, pressure on the body part, temperature control of the body part, positioning of the fixed body part;
  • the program parameters of the automated cannulation can here be selected as a function of the registered patient identifier, ie patient-specific, by using preparation data which are suitable for the planned treatment of the patient, e.g. a hemodialysis, are specific, or that can be taken as previously known preparation data of the patient database;
  • this preparation of the puncture of the body part is carried out in particular by an optionally provided preparation device of the cannulating machine, which is set up accordingly for this purpose;
  • P7 particularly preferred: puncture of the blood vessel, in particular of an arteriovenous fistula;
  • a first puncture and cannulation are preferably carried out automatically for blood withdrawal from the blood vessel, and a second puncture and cannulation for the blood return to the blood vessel, in particular during hemodialysis;
  • the program parameters of the automated cannulation can hereby be selected as a function of the registered patient identifier, ie patient-specific, by the program parameters defining a patient-dependent motion control for an optionally provided cannulometer robot-controlled tool arm, by means of which, for example, a medical accessory such as a hypodermic needle Tool arm is gripped and positioned on the body part, wherein the injection needle was previously selected and prepared patient-specific;
  • two automatic cannulas can be used to puncture blood vessels be set up different body parts, for example, by a first Kanülierautomat for cannulation on one arm can be set up and a second Kanülierautomat for the cannulation on a leg can be set up;
  • the program parameters of the automated cannulation can hereby be selected as a function of the registered patient identifier, ie patient-specific, by preselecting a suitable blood transport device or a suitable sample container depending on patient-specific treatment data and now being used in a suitable manner by the cannulation machine;
  • the Kanülierautomat and the control system can be set up by appropriate choice of program parameters to provide at least one sample container in response to treatment data for the subsequent, preferably automatic and system-controlled processing, in particular diagnostics;
  • the selection of the program parameters used for automated cannulation depending on the registered patient ID is made by means of a selection procedure.
  • the selection process is carried out by the control system, in particular by a control device of a Kanülierautomaten, and may be part of the control method.
  • the selection method may be implemented as a program code executable by a data processor of the control system.
  • the selection method can be set up to access a data matrix in which the necessary program parameters are linked as a function of treatment data and / or treatment data and can be determined in this way.
  • This data matrix can be stored in a database of the system.
  • the selection method can be set up to determine at least one program parameter by means of a calculation algorithm.
  • a computational algorithm may be configured to acquire a required amount of blood to be extracted by cannulation based on the amount and type of the planned procedures or blood diagnostic steps which are then automatically performed by the system following delivery of the blood sample by cannulation.
  • the system preferably the control system, in particular a control device of the control system and / or a control device of a device of the system and / or the control method are preferably adapted to carry out at least one preparatory step after detecting the patient identification and before the start of the automated cannulation automatic removal of the blood sample from a blood vessel of the patient prepared by cannulation.
  • This at least one step can include:
  • Data storage device of the system or is stored on a non-system data storage device to query based on the registered patient identifier so that requested by the control system patient data obtained from the database, which are correlated with the registered patient identifier;
  • S3 selection of an available or treatment-appropriate or patient-suitable automated cannulometer system
  • S4 operation of a transport device of the system, by means of which a patient-dependent and / or treatment-dependent selected accessory set is transported, in particular is transported by a screening device to at least one Kanülierautomaten
  • S5 Selection of program parameters needed to perform automated cannulation.
  • the system preferably the control system, in particular a control device of the control system and / or a control device of a device of the system and / or the control method are preferably adapted, in particular after the start or before the completion of the cannulation and / or during the removal of the automated Cannulation obtained blood sample perform at least one accompanying step, which is carried out in particular at least partially or completely in time parallel to the cannulation.
  • This at least one accompanying step may include:
  • S6 observing the at least one automatically performed cannulation by means of an observation device of the system, wherein this observation device may comprise: a camera, and / or a microphone, and / or at least one sensor for observing at least one physical parameter in the treatment room of the
  • the observation device can also include a device for measuring the disinfection success of a disinfection measure carried out by means of a disinfection device on the skin of the patient; the observation data obtained by observation can be stored or forwarded by the system; in this way, e.g. a physician who is physically absent from the treatment attend the automated cannulation and, if necessary, intervene to interrupt the automatic cannulation by means of an optionally provided electrical interruption circuit;
  • S7 electronically logging at least one of the steps provided for the preparation, execution or follow-up of the automated cannulation, in particular the disinfection, the puncture and / or the blood sampling;
  • the electronic logging can take place by means of an optionally provided logging device of the system, which in particular, may comprise a data processor and / or a data storage device;
  • the logging device can be provided separately from the control system as an autonomous device of the system, on whose log data the system has no access after logging - thereby security and authenticity of the log can be provided; but the logging device can also be fully integrated into the system, in particular the log data can be stored in the database and correlated with the registered patient ID and / or date and time of cannulation;
  • Electronic logging here refers to the recording and storage of log data, which may include, for example, observation data; preferably, automated cannulation and / or electronic logging are designed to meet one or more regulatory standards or medical guidelines for the automated cannulation of patients; in particular, for each cannulation an
  • the system preferably the control system, in particular a control device of the control system and / or a control device of a device of the system and / or the control method are preferably arranged after the start of the automated cannulation and / or after completion of the puncture of the at least one blood vessel and / or after removal of the blood sample obtained by automated cannulation, at least one subordinate step.
  • This at least one subordinate step can include:
  • the Kanülierautomat preferably has a Fixierband listening which is set up in particular for guiding and positioning of the adhesive tape;
  • the program parameters of the automated cannulation can here be selected as a function of the registered patient identifier, ie patient-specific, by patient data be used on the location and / or dimensions and / or condition of the previously known body part of the patient, by means of which the nature and / or dimensions of a suitable fixing band are selected;
  • the dab device may comprise a tool arm whose tool is adapted to hold and / or guide swab material;
  • S10 discharging the blood from the cannulated blood vessel through the cannula into a blood guide device, in particular to a hemodialysis device or a sample container, which was previously selected for the patient and / or treatment and provided as a medical accessory; preferably data-based assignment of the registered patient identifier and a container container identifier, in particular application of a label to the sample container, e.g. a label printed with information by means of a labeling device of the automatic cannulating machine;
  • S1 1 transporting a blood sample obtained by the automated cannulation to one or more other devices, in particular laboratory devices, of the system, in particular for carrying out a previously defined patient and / or treatment data-dependent treatment plan for the analysis, diagnosis, or storage of the blood sample ; Storing the data of the analysis and / or diagnosis determined by the other device as patient data;
  • the system in particular a cannulation machine, preferably has one or more of the following devices, previously and / or subsequently described: accessory carrier, in particular accessory container, disposal device, storage device, equipping device, fixing device, measuring device, treatment chamber, vascular structure measuring device, disinfection device, preparation device, tool arm, Blood transport device, sample container, data storage device, assembly system, transport device, Fixierband worn, dab device, labeling, other devices such as laboratory equipment for analysis and / or diagnosis.
  • accessory carrier in particular accessory container, disposal device, storage device, equipping device, fixing device, measuring device, treatment chamber, vascular structure measuring device, disinfection device, preparation device, tool arm, Blood transport device, sample container, data storage device, assembly system, transport device, Fixierband worn, dab device, labeling, other devices such as laboratory equipment for analysis and / or diagnosis.
  • accessory carrier in particular accessory container, disposal device, storage device, equipping device, fixing device, measuring device, treatment chamber, vascular structure measuring device, disinfection device, preparation device, tool arm, Blood transport device
  • the system in particular the at least one automatic cannulizer, can have a recognition system which, by means of a sensor based on the measurement of radiation or light and / or ultrasound, determines the position and / or dimensions and / or condition (eg skin color, skin morphology) of the Treatment room positioned, recorded to be punctured body part, in particular continuously and / or in real time, and stored in the form of recognition data.
  • the detection system may include the vascular structure measuring device.
  • the detection data are also patient-dependent, but were only recorded by the system after the start of automated cannulation.
  • the identification data preferably contain the patient-dependent data on the position and / or dimensions and / or condition of the punctured body part and / or on the position and / or dimensions and / or condition of the subsystemically arranged in the body part vascular system containing the blood vessel to be punctured, in particular one arteriovenous fistula.
  • Recognition data were only obtained after automated cannulation and could not be used to prepare for automated cannulation.
  • the recognition data are preferably stored in a data storage device, in particular as patient data. It is preferred that the system, in particular the at least one canister, be set up to prepare the automated treatment by using historical data, wherein the historical data may be part of the patient data and stored in the database.
  • the system may comprise a robot-controlled tool arm, which may in particular have at least one connection point for connecting a tool head.
  • a tool head is therefore preferably designed as a module.
  • a tool head is preferably set up to perform a specific function of the cannulating machine.
  • a first tool head may be adapted to disinfect the skin by, for example, applying disinfectant to the skin
  • a second tool head may be configured to hold and guide a cannula
  • a third tool head may be used to dab a dotted skin site Swab material may be formed
  • a fourth tool head may be formed for fixing a cannula inserted into the blood vessel by means of fixing strap.
  • Such a tool arm is referred to herein as a universal tool arm.
  • Patient data may be collected by the logon process or other data collection procedure performed by the system and stored in a database, particularly the patient database, or already stored.
  • Treatment data may be collected by the logon process or other data collection process performed by the system and stored in a database, particularly the treatment database, or already stored.
  • Patient data and treatment data can be correlated with one another so that, in particular, the system can unambiguously determine the patient data and treatment data correlated therewith, based on a patient identifier;
  • This correlation information or correlation data can be stored in the database.
  • a database can be provided in which patient data, treatment data and correlation data can be stored.
  • a "patient identifier” is a data-based identifier that preferably identifies a particular patient or group of patients, and more particularly, the patient identifier identifies that particular patient or group of patients to whom a particular patient is associated
  • a patient identifier is in particular a patient number, a name of the patient, if this is unique or unambiguous by means of an additional identifier, a (health) insurance number, a card number or a unique number or a unique name of the particular group of patients
  • Patients according to the invention may in particular be respectively male or female patients, patients with a certain chronic disease, patients with a certain blood group, patients with a certain skin type, dialysis patients with arteriovenous fistula (AV fistula) - ie with Cimino shunt - .
  • AV fistula arteriovenous fistula
  • the information characterizing such a group may also be in the form of patient data and / or treatment data in an optional stored database of the system, and can be uniquely correlated with a patient identifier.
  • a “treatment identifier” is a data-aware identifier that identifies a particular treatment or group of treatments, and in particular, the treatment identifier identifies that particular treatment or group of treatments to which a particular treatment is associated In particular, a treatment number or a unique name for a treatment or a group of treatments.
  • a group of treatments within the meaning of the invention may each include certain operations, the therapy of a particular disease, the initial examination of a patient or dialysis treatments, which in turn may be subgroups, in particular Hemodialysis, hemofiltration, hemodiafiltration, hemoperfusion or peritoneal dialysis, etc.
  • the information characterizing such a group can also be provided in the form of patient data and / or treatment data in an optio stored system database, and can be uniquely correlated with a treatment identifier.
  • cannulation is understood to mean a process in which a cannula is inserted into the blood vessel by puncturing the skin and puncturing the wall of a blood vessel in the body part of the patient, so that the distal end of the cannula is arranged in the blood vessel, and the proximal one The end of the cannula is arranged outside the body part, so that a fluid connection between the cannula and the blood vessel is provided, via which fluid, in particular blood and / or fluid media, can be exchanged via the fluid connection.
  • the fluid is transferred from the bloodstream of the patient into an extracorporeal fluid system, that is to say located outside the patient's body, in particular for fluid storage or fluid guidance, and / or that the fluid is transferred from the extracorporeal system into the bloodstream.
  • a cannula is a tubular body, particularly a rigid or flexible hypodermic needle, having a lumen, with a geometry and outer dimensions suitable for use in cannulation of the blood vessel.
  • the system according to the invention for data-dependent automated cannulation of the blood vessels of patients hereinafter also abbreviated as "system" contains in particular at least one device and at least one method which in particular jointly solve the underlying technical problem several Kanülierautomaten, preferably at least one control system and preferably one or more user interface devices.
  • the methods used in the system preferably include the control method, preferably the selection method for selecting the program parameters depending on the registered patient identifier, and preferably a registration method by which a patient is logged on the control system, wherein the result of the registration process includes that the control system registered patient ID is present.
  • a control system, or a control device of the control system, or a control device of a device of the system, in the context of the present invention in particular, in particular a data processing device, in particular a data processor, that is, a processing unit (CPU) for processing data, and / or a volatile or permanent Data memory, and / or a microprocessor or is a data processing device.
  • a computing unit of the control system is preferably set up to control the system and in particular to control the cannulation process.
  • the control system may be formed by a single control device of the system.
  • the control system comprises a plurality of control devices, which may be stand-alone devices or may be components of other devices of the system, in particular the at least one user interface device and / or the at least one cannulation device.
  • these control devices may be partially or all organized in a network for data exchange.
  • the at least one user interface device includes its own control device and / or the at least one automatic cannula device includes its own control device
  • these control devices can be regarded as components of the control system.
  • the control system does not include these optional control devices.
  • the control system is preferably adapted to carry out the application method and the control method, in particular by a suitable for this purpose formed by a data processor executable program code.
  • the control system of the system and / or the at least one automatic cannula and / or the user interface device can - in particular all - be integrated in a physical device unit, but may each also be a separate physical device unit.
  • a physical device unit may, in particular, be a module which is at least data-connected to the system or can be connected.
  • the control system and / or the at least one automatic cannula and / or the user interface device or components of these components can also be implemented at least partially by software functions or, in particular, can partially implement program code.
  • a cannulation machine may have a controller, e.g. a computer which, in combination with software functions, at least partially implements one or more functions of the control system of the system and / or of the at least one cannulation machine and / or the user interface device.
  • a module may in particular comprise the control system or its components and / or a user interface device.
  • a module is a device which is separate from other devices, in particular the devices of the system, and / or a device which can be separated from the other device, in particular automatic cannulas.
  • a Kanülierautomat may have a connecting device by which the module with the Kanülierautomaten is mechanically connected, in particular by means of a user-detachable connection.
  • a module can be portable, ie transportable by a user. The module can also be firmly connected to the Kanülierautomaten.
  • the modular design offers advantages in the provision of the system.
  • a portable module also provides greater flexibility in using the system.
  • the control system and / or preferably the at least one user interface device are part of the at least one cannulation machine.
  • the at least one automatic cannula preferably has the control system and / or the at least one User interface device.
  • the system has exactly one cannulating machine, which has the control system and the at least one user interface device.
  • the control system is preferably a component of a first of these at least two cannulas.
  • the at least one user interface device is in this case preferably part of the first of the at least two Kanülierautomaten, or is part of at least one other, second Kanülierautomaten, or forms a separate device or its component.
  • the use of at least two Kanülierautomaten in the system offers the advantage of increased throughput through the simultaneous operation of at least two Kanülierautomaten, which are particularly advantageous in systems that are set up for use in hospital operation.
  • the provision of multiple automatic cannisters offers the possibility that at least two of the automatic cannulas are set up in different ways to be used in different situations.
  • different types of patients may be considered by the apparatus, e.g. the body size of the patients, which distinguishes in particular children and adults.
  • the puncture of vessels on different parts of the body may be provided by equipment specification, e.g. a first Kanülierautomat for cannulation can be arranged on one arm and a second Kanülierautomat for the cannulation can be arranged on a leg.
  • An adaptation of the apparatuses may be particularly in the dimensioning of components, e.g. the different dimensions of a fixing device for fixing the body part, which has the blood vessel to be punctured.
  • Another preferred feature of the system which includes a plurality of automatic cannulas, includes having at least two of these automated cannulas positioned at geographically different positions.
  • a supply of automatic cannulation can be provided in each case for different geographical positions, which in particular are controlled by a common control system.
  • These geographically different positions can in particular within a clinic, eg in different rooms of one or several buildings and / or in different floors of the building, or are distributed within a medical care area, especially within a city, or may in principle be distributed regionally, in particular country or worldwide.
  • the control system is preferably a central device with which the geographically differently distributed Kanülierautomaten be controlled.
  • a Kanülierautomat can each have a control system.
  • the Kanülierautomaten are in this case preferably designed for data exchange with at least one other device, in particular an external device.
  • the Kanülierautomaten are preferably configured to form a data connection and / or have a data connection to an external device.
  • This external device may be a data storage device or a server to which this data storage device is connected.
  • the data storage device preferably contains a database, the data of which may be stored in particular on at least one non-volatile storage medium of the data storage device.
  • This database may be or may be the patient database.
  • the system comprises a data storage device in which a patient database is stored containing the patient records, each containing at least one patient identifier, of a plurality of patients.
  • a single control method is preferably arranged to be executed using some of these control systems, or preferably each of these control systems.
  • the system it is also possible and preferred for the system to have a plurality of control methods, in particular a plurality of copies of a control program executing the control method, which is in each case executed by a control system.
  • at least two of the devices constituting components of the system are placed at geographically different positions.
  • at least one or more of the devices forming part of the system are designed as mobile devices.
  • a mobile device is understood to mean a device which, when used as intended, can be positioned at different geographical positions and is also positioned.
  • a mobile use in the context of the system includes in particular that a mobile device of the system is arranged on a means of transport, in particular a transport vehicle, which gives this device the desired mobility.
  • a mobile device is used as intended during its movement as part of the system.
  • the means of transport is a motor vehicle, e.g. an ambulance, or a ship, a train, an airplane, a helicopter or a lift.
  • a user interface may be mobile to allow a patient to log on during transport.
  • a cannulation machine can be mobile in order to enable the supply of medical treatment requiring cannulation also in the vehicle.
  • the at least one user interface device is positioned or positionable at a geographically different location than the at least one cannulation machine.
  • at least one user interface device is a mobile device. It is also possible and preferred that the at least one user interface device is a component of at least one device of the system, e.g. an external device, in particular computer or server can be.
  • the system comprises at least two user interface devices, wherein preferably at least two of these user interface devices are set up at geographically different positions.
  • the data storage device which preferably stores the database, in particular the patient database, is preferably positioned or positionable at a geographically different location than the at least one canister and the at least one user interface device.
  • the data storage device may be data-connected to the other devices of the system via a network, eg, a Wide Area Network (WAN) and / or the Internet.
  • the database may be located in one central location by the geographically divergent positioning, and the other devices of the system may access the same database via data links.
  • the data storage device can also be arranged at the geographically same location as a cannulation machine, eg within the same room or building, or the clinic, or can be part of a cannulation machine.
  • One device of the system preferably each device of the system, preferably has a data interface enabling the formation of a data connection with another device of the system.
  • one device of the system preferably each device of the system, has a communication device by means of which, in particular, a wireless data connection is made possible with another device of the system or with a network, in particular a local or global network, in particular the Internet.
  • the system preferably has a network for exchanging data.
  • all devices of the system are designed to exchange data over the network.
  • the network can have a central server, to which preferably each of the devices of the system is data-connected or is designed to be connectable to form a data connection.
  • the network may also be formed by reticulated devices or annularly connected devices.
  • the network may include one or more routers and / or hubs via which one or more devices of the system for data exchange within the system are connected to the network.
  • the network may implement one or more Ethernet standards.
  • a device of the system in particular any device of the system, can have a data interface device and / or a communication device.
  • At least one automatic cannulation device and one user interface device of the system are set up as components of an outpatient treatment station, which in particular is mobile and which can be set up, in particular, at the place of residence of a patient.
  • an outpatient treatment station which in particular is mobile and which can be set up, in particular, at the place of residence of a patient.
  • treatment means in particular that a laboratory sample, in particular a blood sample or a blood volume, is moved, and / or transported and / or examined and / or altered, in particular in its composition, physically, chemically, biochemically or otherwise altered becomes.
  • a communication device is preferably set up for the transmission and / or reception of data, in particular for the data exchange via a data connection provided by the communication device, in particular for a remote data connection with a remote device.
  • the remote device is also referred to as a "remote device" or external device.
  • a data processing device or device that is not part of a canister is also referred to as an external data processing device / device , can be established via a limited (in particular an intranet) or worldwide network of computers (in particular a WAN and / or the Internet) .
  • the data connection, in particular remote data connection can also be established via a wireless connection, in particular radio connection
  • Remote data connection in particular can be established via a mobile connection.
  • a data link connects two data processing units, in particular two data processing devices or devices, in such a way that data can be exchanged between the units, either unidirectionally or bidirectionally.
  • the data connection can be realized wired or wireless, in particular as a radio link.
  • a remote data connection in particular, connects two data processing units, in particular two data processing devices, which are arranged remote from one another, ie which are not part of the same device, in particular the same automatic cannulaserator, user interface device or control system, if said devices are designed as separate devices.
  • a data connection, in particular a remote data connection, of a device with another device is preferably realized via a direct connection of the two devices, or an indirect connection of the two devices, so that a third device is connected between the two devices in order to forward the data.
  • a remote data connection can be realized via a network of computers in which the devices connected via the remote data connection are connected via the network.
  • the network may be a limited network, eg an intranet, or may be a worldwide network, in particular a WAN and / or the Internet.
  • a data processing device preferably has a computing unit, in particular a CPU, furthermore preferably at least one data storage device, in particular for the volatile and / or permanent storage of data.
  • the data processing device is preferably designed to produce via a first interface device one or more first data connections with one or more user interface devices, which may be components of a cannulation machine in particular, and preferably via the second interface device to establish a second data connection with a Kanülierautomaten.
  • An interface device is used to connect two devices, each of which can process signals, in particular information, in particular data, in particular to send and / or receive.
  • An interface device may include at least one hardware interface and / or at least one software interface.
  • Hardware interfaces are in particular interfaces between electrically operating units, according to the usual understanding in electrical engineering and electronics.
  • the term "hardware interface” designates in particular also the connection components between at least two electrically operating units themselves, ie in particular all components which make this connection possible, eg integrated circuits, electronics and lines through which electrical signals are sent between the at least two electrically operating units.
  • These two electrically operating units may in particular be a cannulation machine and an external data processing device or two automatic cannulas or two electrically operating units within a cannulizer.
  • a hardware interface need not, but may have a releasable connection means for releasing and / or restoring this connection, in particular at least one plug.
  • Software interfaces in particular software-side data interfaces, are in particular logical points of contact in an information management system, in particular a software system: they enable and regulate the exchange of commands and data between different processes and components.
  • Software interfaces can only be data-oriented interfaces used for communication. In this case, the software interface contains only the information exchanged between involved parts of the system.
  • a - especially external - data processing device or data processing device may be a computer, in particular a server, which is set up in particular for establishing a data connection to more than one user interface device, and / or more than one Kanülierautomaten.
  • a data processing device or device, particularly an external one may comprise a computer or microprocessor or may be a computer or microprocessor.
  • a server is in particular a computer whose hardware is preferably tuned to server applications.
  • An external data processing device may be a mobile data processing device that is set up to produce a wireless data connection, in particular a data connection via a limited, in particular an intranet, or a global computer network, in particular the Internet.
  • a computer network is a combination of various technical, primarily self-contained, electronic systems (in particular computers, but also sensors, actuators, agents and / or other radio components, etc.), which enables the communication of the individual systems with each other.
  • the control system is preferably set up to distinguish patients or users clearly from each other.
  • a patient or user is preferably uniquely identified by the control system.
  • the control system preferably processes identification data.
  • the access controller is configured to authenticate the enrolling patient or user, that is, to perform a verification procedure that verifies the authenticity of the requesting patient or user and authenticates the patient or user if the evidence is positive.
  • Authentication data includes, for example, a login text and a password text or record for face recognition or iris scan or fingerprint scan, or other data or biometric data.
  • Biometrics has the advantage that the patient or medical staff can identify the identity without cognitive performance, which is particularly advantageous if, for example, the patient is unresponsive or otherwise unable to actively participate in the authentication.
  • the authentication can also be done using RFI D chips or NFC chip or gesture recognition. Authentication can be done in particular by direct access to the laboratory device or its access control on site or remotely.
  • the control system and / or the control method can be set up to register the enrolling patient with the system as a function of a successful authentication, to determine a patient identifier and / or to record the patient as a registered patient by determining the registered patient identifier. Authentication may require that the patient has previously been registered to the system so that comparative identification data is available to the system.
  • the control system and / or the control method may be configured to register the patient in the system, thereby associating a unique set of patient data containing the patient identifier with the patient. This patient record can be stored in the patient database.
  • a patient may also use an identification medium, such as a patient card, identity cards, or any other uniquely identifiable document identified by the user interface device on the system.
  • a user interface device preferably has an authentication device, which may include an information reader.
  • the control system and / or the control method can each be set up to register a clearly identifiable document of the patient by means of the user interface device on the system, in particular by the user interface device having an information reading device, eg an optical scanner, a magnetic stripe reader, or an RFI D chip reader ,
  • An information reader can be designed, in particular, for reading coded information or as a biometric reader.
  • a biometric reader can be designed, for example, to scan a fingerprint or as an iris scanner.
  • the system preferably has an information management system with which the patient's logon to the system is realized.
  • Each user may enter into a first data connection with the system via the same user interface device or multiple users may enter into a first data connection with the system via different user interface devices.
  • a user interface device may be part of a Kanülierautomaten.
  • a user interface device may be part of an external device.
  • a user interface device preferably each comprises: a user interface device controller; a communication device for establishing a data connection with a Kanülierautomaten and / or the control system via an interface device thereof; an input device for detecting user inputs of a user; an output device, in particular a display and / or a display, for outputting information to the user.
  • control device of the user interface device is preferably configured to exchange data with the control system and / or the Kanülierautomaten over the data connection, which were obtained from the user inputs, and cause the cannulation machines used in the invention that the user from the control system, in particular the control method, as registered user is detected, which is used in particular as a result of this application by the control system, the registered patient individually assigned patient identifier, which is referred to as a registered patient ID.
  • device-controlled treatment of a laboratory sample, in particular a blood sample or a blood volume, means that the treatment of the at least one laboratory sample is at least partially controlled by the device, in particular a laboratory device, particularly if the treatment is controlled and / or performed by the device
  • device-controlled treatment is preferably understood to mean that the treatment is dependent on a patient identifier, in particular the registered patient identifier, at least
  • the user input for registration may be made prior to the start of treatment of a patient's laboratory sample and / or during this treatment
  • the user interface device which is preferably a component of a device or a Kanülierautomaten, or which is preferably provided separately from Kanülierautomaten and is signal-connected to the control system.
  • the user input is used, in particular, for the input of at least one parameter whose value influences and / or controls the cannulation by the automatic cannulometer and / or the treatment by a device or laboratory device.
  • this parameter can be a program parameter.
  • a partially automated treatment it is possible, in particular, for the treatment to be carried out in such a way that at least one user input with which a user, eg medical staff, can influence the ongoing treatment, in particular by starting the treatment and before terminating the treatment For example, it answers an automatic query that takes place via a user interface device, in particular confirms or negates an input or makes other entries.
  • the treatment in particular, for the treatment to have a plurality of treatment steps, which are carried out automatically in particular successively in terms of time and have at least one treatment step, which requires a user input, in particular via a user interface device.
  • a Kanülierautomat in an automated cannulation by a Kanülierautomaten be provided - and a Kanülierautomat can be set up accordingly - that the automated cannulation is made dependent on the user input.
  • the automated cannulation is not started until the patient himself has made a user input, by means of which he starts the cannulation. Or it can be provided that the automated cannulation is not started or aborted when the patient himself has made a user input.
  • the system may be arranged to provide the registered patient with safety instruction, legal instruction, and / or other information, e.g. via the user interface device before the automated / semi-automated cannulation is started or continued. This ensures that the patient is prepared and can be reliably cannulated.
  • a device-controlled treatment in particular cannulation, is preferably a program-controlled treatment, ie a treatment controlled by a program.
  • a program-controlled treatment of a sample is to be understood that the process of the treatment is carried out essentially by processing a plurality or plurality of program steps.
  • the program-controlled treatment preferably takes place using at least one program parameter, in particular at least one program parameter selected by the user.
  • a user-selected parameter is also referred to as a user parameter.
  • the program-controlled treatment is preferably carried out by means of a data processing device, which may be part of the control system or the control device of a cannulation machine.
  • the data processing device may have at least one processor, ie a CPU, and / or at least one microprocessor.
  • the program-controlled treatment is preferably controlled and / or carried out in accordance with the specifications of a program, in particular a control program. In particular, in a program-controlled treatment at least after detection the user required program parameters essentially no user activity required.
  • a program parameter is understood to be a variable which can be set in a predetermined manner within a program or subprogram for at least one execution (call) of the program or subroutine.
  • the program parameter is changed, e.g. from the user, sets and controls the program or subroutine, and causes data output in response to that program parameter.
  • the program parameter and / or the data output by the program control and / or control the device in particular the control of the treatment, in particular cannulation, by means of at least one cannulation machine or a device which has in particular an automated or semi-automated treatment device.
  • a program parameter may be a user-required program parameter.
  • a user-required program parameter is characterized in that it is necessary for the execution of a treatment, in particular cannulation, e.g. a user input that starts the cannulation or puncture procedure.
  • Other program parameters that are not required by the user can be derived from the user-required program parameters or otherwise made available, in particular optionally set by the user.
  • the setting of a program parameter by a user is effected in particular by displaying a selection of possible preset values from a list of predefined values stored in the system or in the automatic teller or laboratory device, whereby the user selects and thus sets the desired parameter from this list. It is also possible that this program parameter is set by the user inputting the value by e.g.
  • numeric keypad enters a number corresponding to the desired value or by the user increasing or decreasing a value continuously or in increments until it corresponds to the desired value and sets the value in this way.
  • Other forms of input e.g. by voice control and / or gesture control, are conceivable.
  • a program is understood in particular as a computer program.
  • a program is a sequence of instructions, in particular declarations and instructions, to perform a specific function on a digital data processing system. to handle and / or solve problems, tasks or problems.
  • a program is usually software that is used with a digital data processing system.
  • the program may be in the form of firmware, in the case of the present invention in particular as firmware of the control system or the control device of a cannulation machine or a laboratory device and / or a user interface device.
  • the program is usually on a disk as an executable program file, often in the so-called machine code, which is loaded for execution in the main memory of the computer of the digital data processing device.
  • the program is processed and executed as a sequence of machine, ie processor instructions, by the processor (s) of the computer.
  • Computer program means, in particular, also the source text of the program from which the executable code can be generated during the control of the laboratory device.
  • An instruction is usually referred to as a central element of a programming language.
  • the programs of such languages are primarily composed of one or more instructions.
  • a statement represents a single rule formulated in the syntax of a programming language to be executed during the execution of the program. How a statement must look syntactically is determined by the respective programming language or its specification.
  • Instructions are usually assignments, control statements (such as jumps, loops, and conditional statements) and procedure calls.
  • assertions, declarations, class and function definitions are statements.
  • the instructions of the control program can thus be designed in the usual way.
  • the control method can be designed in particular as a control program in the system, which executes the control method.
  • a control program is understood to mean an executable computer program which preferably controls and / or performs the desired treatment, in particular cannulation, in particular as a function of at least one program parameter and in dependence on the registered patient identifier.
  • This program parameter may be a user-influenced and / or adjusted program parameter.
  • the treatment, in particular cannulation can be controlled by the control system or a Control device of Kanülierautomaten or laboratory device depending on the program parameters generated one or more control parameters, by means of which, for example, the at least one treatment device of the laboratory device or Kanülierautomaten, eg a tool controlled or its kinematics.
  • the system and / or a Kanülierautomat and / or a laboratory device on an operating system which may be or may have a control program.
  • the control program may in particular designate an operating system of the system and / or the automatic cannulae and / or a laboratory device or a component of the operating system.
  • the operating system controls the treatment, in particular cannulation, in particular the registration of the patient, and in particular further operating functions of the system.
  • the control method may be or include an operating system.
  • the control program which preferably executes the control process may be executed under the operating system.
  • a Kanülierautomat in particular a laboratory device, a communication device for establishing a remote data communication for exchanging data with another device of the system or an external device, which also has a suitable communication device for establishing a remote connection for data exchange with the Kanülierautomat, or laboratory device
  • a communication device can be designed to form a radio connection, in particular a mobile radio connection.
  • the communication device is set up to enable the remote access of a user to the automatic cannula, or the laboratory device, in particular the selection or adjustment of at least one parameter, in particular a parameter that controls a function of the automatic cannulation machine or the laboratory device, in particular the function of Execution of a cannulation or other treatment.
  • the term "laboratory device” refers in particular to a device which is designed for the device-controlled treatment of at least one laboratory sample and which is designed for use in a laboratory.
  • this laboratory may be a chemical, biological, biochemical, medical or forensic laboratory.
  • Such laboratories are used for research and / or analysis of laboratory samples, but may also be used to make products by means of laboratory samples or the production of laboratory samples.
  • the cannulation machine not understood as a laboratory device.
  • a Kanülierautomat can be understood as a representative of a new type of device, which can be described as at least partially or completely autonomously acting medical devices.
  • the system according to the invention is to be assigned to the genus of the at least partially or completely autonomously acting medical treatment systems. If at least one or more cannulation machines of the system are used in a clinic and in particular are stationed there, it is a partially or completely autonomously acting clinical treatment system. This is a preferred embodiment of the invention. The same applies to the method according to the invention.
  • a laboratory sample is a sample that can be treated in a laboratory.
  • a laboratory sample is in particular a blood sample obtained by cannulation, in particular a blood volume.
  • the term "sample” is used instead of the term "laboratory sample.”
  • a liquid sample may be one that is usually handled in a biological, chemical, medical laboratory. a medium, a buffer, etc.
  • a solution comprises one or more dissolved solid, liquid or gaseous substances (solutes) and further comprises a preferably liquid solvent (solvent), in particular the greater proportion or largest proportion of the volume, which The solvent may itself be a solution.
  • the -particularly automated or semi-automated-treatment of a laboratory sample (s), in particular a blood sample obtained by cannulation, may involve one or more of the following operations, in particular simultaneously or sequentially:
  • Non-contact, non-invasive, physical treatment of the sample especially thermal treatment; or freezing or thawing the sample; optical treatment of the sample; Moving the sample, thus performing a mechanical treatment of the sample, in particular shaking, centrifuging;
  • chemical, biochemical or biomedical treatment of the sample addition of chemical, biochemical or biomedical (blood, serum, cell medium) substances;
  • Measurement or analysis of the sample in particular analysis by non-invasive and / or invasive treatment of the sample, in particular to measure at least one or more chemical, physical, biochemical and / or medical properties of the sample; in particular counting cells by means of cell counter;
  • Processing of the sample in particular changes of at least one property of the sample, in particular by means of non-invasive and / or invasive treatment of the sample;
  • Hemodialysis of a blood volume preferably with subsequent return of the blood volume into the bloodstream of the patient.
  • This treatment is in particular program-controlled, using at least one program parameter.
  • This treatment is carried out in particular according to at least one control parameter which determines the treatment of the laboratory sample by means of the treatment device.
  • a control parameter may specify a time period, a time, a particular sample volume and / or dosing volume, a particular sample temperature, etc.
  • a control parameter may include the automatic use of a particular transport head, a particular type of transport container, a particular type of sample containers, a or more individual samples or specific positions of these components in the work area.
  • a control parameter may involve the treatment of an individual sample or the treatment of several or many samples.
  • a control parameter in dependence on at least one program parameter automatically selected by the laboratory device, in particular laboratory machine, automatically selected in particular automatically depending on the program parameters selected by the user and in particular as a function of selected from a patient ID or registered patient ID.
  • a control parameter can also correspond to a program parameter.
  • the transport of a sample can be a transport from a cannula or a tube or a sample container into a transport container and / or from the transport container to a sample container or another destination. In particular, this transport is carried out programmatically, using at least one program parameter.
  • the transport container is preferably partially or completely made of plastic. It is preferably a consumable that is typically used only for one treatment or a small number of treatment steps of the sample. However, the transport container can also be partially or completely made of a different material.
  • the sample container preferably has a Proben theretokennung. This may carry the patient identifier or may be uniquely correlated in the system with the patient identifier in order to be able to unambiguously deduce the sample patient identifier of a filled sample registered on the system to the associated patient.
  • the blood sample obtained by means of a cannulation machine is preferably stored by the system in at least one sample container;
  • the blood sample is associated in a database of the system with at least one unique sample container identifier, wherein a sample container identifier uniquely distinguishes a sample container, so that each of the sample containers containing the blood sample is clearly linked to the patient identifier and the information about linking the at least one sample container identifier in the database of the system is stored.
  • the transport of a sample may be a transport of the sample from a starting position to a target position.
  • the home position may be when the sample is placed in a first sample container and the target position of that sample may be its position in a second sample container into which the sample is transferred.
  • This type of transport is also referred to herein as sample transfer or transfer.
  • a sample transfer is usually carried out in order to obtain a sample from a storage container in which, for example, the sample was stored and / or, for example, a larger amount of the sample Sample may be transferred to a second sample container in which the sample is further treated.
  • this transport is carried out programmatically, using at least one program parameter.
  • the transport of the sample is preferably a transport from the cannulometer machine where the blood sample was obtained to a device, in particular a laboratory device, where the sample is further treated.
  • the transport container is preferably connected or connectable to a transport device of the system, by means of which the sample is preferably conveyed from the canula lier where the blood sample was obtained to a device, in particular a laboratory device, in particular automatically, where the sample is further processed.
  • the transport device is preferably Bestanteil a robotic transport system, which is preferably part of the system according to the invention.
  • a sample container may be a single container in which only a single sample is contained or may be a multiple container in which a plurality of individual containers are arranged interconnected.
  • a single container may be an open container or a closable container.
  • a cover element in particular a closure cap, may be provided.
  • the lid member may be fixedly connected to the container, e.g. as a hinged lid or hinged cap, or can be used as a separate component.
  • a sample container can have an information area which can have information about the sample container or about its contents, in particular the sample ratio detection.
  • the information area may comprise encoded information, e.g. a barcode or QR code or an RFI D chip or other coded information.
  • the information may include information for identifying the sample and / or a sample container.
  • the system may include an information reading device for reading this information and preferably making it available to the control system.
  • the at least one Kanülierautomat in particular a laboratory device, in particular La bororbautomat, can be connected to a LIMS or connectable.
  • LIMS stands for laboratory Information and Management System.
  • a LIMS is, in a known manner, a software system that relates to data processing in the chemical, physical, biological, medical automatic or semi-automatic laboratory. Such data may come from measurements of the samples, and / or may relate to the control of processing the data.
  • a LIMS is preferably used for measured value acquisition and measured value evaluation. LIMS is used to increase the throughput of labor in a laboratory and / or to optimize the efficiency of the treatment of laboratory samples.
  • the automatic cannulaer in particular a laboratory device or laboratory machine, can have an information reading device for reading information about a sample and / or a sample container and / or a treatment instruction for this sample and / or this sample container and, preferably, the control device of the cannula - tomatoes, the laboratory device or the laboratory machine to provide.
  • the automatic cannulaer in particular the laboratory device or the laboratory automatic machine, preferably has at least one timer device and / or preferably a timing device in order to enable the time-dependent cannulation and / or treatment of the samples.
  • the time-dependent treatment is preferably carried out programmatically, and in particular controlled by at least one program parameter. In this way, the time sequence in the automated cannulation and preferably in subsequent multi-treatment can be controlled and / or logged and / or coordinated by the system.
  • the automatic cannula or a laboratory device preferably has a user interface device for inputting data by a user, and for displaying information, in particular information contained in these data, the user interface device having a display device, in particular a display, in particular a touch-screen display ,
  • the invention further relates to a method for data-dependent automated cannulation of the blood vessels of patients, in particular for hemodialysis, comprising the following steps: detecting a registered patient identifier by registering a patient with a user interface device in data communication with a data processing control system; Determining program parameters depending on the registered patient ID through the control system; and Controlling a Kanülierautomaten that is set up for the automated cannulation of the blood vessels of patients and is in data communication with the control system, depending on the program parameters, for the automated cannulation of a blood vessel of a patient depending on the registered patient identifier, in particular the at least one Kanülierautomat for automatically performing a first puncture for the introduction of a first cannula is set up
  • the inventive method provides the step of automatically performing a second puncture for the introduction of a second cannula in a blood vessel for the automatic return of the blood from the blood guide system for performing hemodialysis.
  • the method according to the invention provides the step of automatically carrying out a selection process for selecting the program parameters which are used for automated cannulation as a function of the registered patient identifier.
  • the selection method preferably provides the step of accessing a data matrix in which the necessary program parameters are linked and determined in accordance with treatment data and / or treatment data, the system having a data storage device (90) in which the data matrix is stored is.
  • the method according to the invention provides for the step, after detection of the registered patient identifier and before the start of the automated cannulation in dependence on the registered patient identifier, to carry out at least one preparatory step which prepares the automatic removal of the blood sample from the blood vessel of the patient by means of cannulation.
  • the method according to the invention provides the step of performing at least one accompanying working step during removal of the blood sample obtained by means of the automated cannulation in dependence on the registered patient identification, which is carried out in particular at least partially or completely in time parallel to the cannulation.
  • the method according to the invention provides the step of carrying out at least one downstream step after the automated cannulation has been started and / or after the end of the puncture of the at least one blood vessel and / or after the removal of the blood sample obtained by the automated cannulation as a function of the registered patient identifier ,
  • the method according to the invention preferably provides the step of determining the position and / or dimensions and / or condition (eg skin color, skin morphology) of the person positioned in the treatment room by means of a sensor system of a detection system based on the measurement of radiation or light and / or ultrasound Capture puncturing body part, in particular continuously and / or in real time, and save in particular in the form of recognition data.
  • a sensor system of a detection system based on the measurement of radiation or light and / or ultrasound Capture puncturing body part, in particular continuously and / or in real time, and save in particular in the form of recognition data.
  • the method according to the invention provides the step of carrying out an automated treatment by using historical data which contains the stored identification data as a function of this registered patient identifier.
  • the method according to the invention provides the step of positioning the at least one user interface device at a geographically different location than the at least one cannulation machine.
  • the method according to the invention provides the step of positioning a data storage device at a geographically different location than the at least one can-milling machine and as the at least one user-interface device.
  • the method according to the invention provides for the step of logging in the patient, depending on a successful authentication, to determine a patient identifier and / or to record the patient by determining the registered patient identifier as registered patient. Further possible preferred embodiments of the method according to the invention can be deduced from the description of the system according to the invention and from its preferred embodiments.
  • Fig. 1 shows schematically an embodiment of the system according to the invention.
  • Fig. 2 shows schematically an embodiment of the present invention
  • Fig. 3 shows schematically an embodiment of the method according to the invention or the control method acting in the system according to the invention.
  • FIGS. 4 to 11 show exemplary embodiments of the partial steps of the method according to FIG. 3.
  • FIG. 12 shows an exemplary embodiment of the method according to the invention or of the control method acting in the system according to the invention.
  • FIG. 1 shows as an exemplary embodiment of the system according to the invention a clinical system 100 for the data-dependent automated cannulation of the blood vessels of patients, which is used to prepare a hemodialysis.
  • the system 100 has two automatic cannulas 1, each of which is adapted for the automated cannulation of the blood vessels of patients.
  • a control system 50, 51 of the system 100 is arranged to execute a control method that can control each of the two cannulation machines in response to program parameters.
  • the control system 50, 51 comprises a central control device 50.
  • the control devices 51 each control a Kanülierautomaten 1 and are as Components of the control system 50, 51 is considered, whose task in the clinical system 100 includes performing the at least one automatic cannulation of a body part 30 of a patient in dependence on the patient identification.
  • the control device 50 and the control device 51 each have a data processing device with data processor and data memory, as well as a communication device for establishing a data connection with another communication device of the system. Through the data connections of the devices 1, 80, 90 with the control device 50, this system components are networked in a network for data exchange. In the present case, the network has the control device 50 as the central computer.
  • the system 100 includes two user interface devices 80, which in the example are embodied as fingerprint scanner authentication devices 80, by means of which the patients previously registered with the system are authenticated.
  • the registration of a patient includes that his data relevant for the clinical recording are recorded, in particular an image of his fingerprint is stored for comparison in a patient database and this patient data of the patient is assigned an intrinsic patient identifier, referred to herein as a patient identifier.
  • the control system After registration of the registered patient, the control system has recorded the patient as a registered patient, his patient ID is after registration as the "registered patient ID".
  • the system 100 includes a data storage device 90, which may be a hard disk server in which at least one database is stored.
  • stored in the data storage device 90 is the patient database accessed by the system from the registered patient identifier to read the patient data of the logged-in patient required for automated cannulation.
  • the patient data can be continuously supplemented by data collected by the system, eg identification data of a recognition device, as well as optional observation data on the course of a completed cannulation or hemodialysis, as well as data of the treatment performed. This results in a patient record, by the accuracy of which the subsequent treatments of the patient in this clinical system can be continuously improved.
  • the patient data in this exemplary embodiment in particular comprise data for the patient to be performed hemodialysis. In particular, these patient data contain vascular structure data which will be described below.
  • the controller 50 executes the control method of the system, which is program code executable by the data processors.
  • the control method controls the at least one Kanülierautomaten depending on program parameters, and selects after registration of the patient and before the start of cannulation appropriate program parameters, which are patient-dependent, that have been selected depending on the registered patient identifier.
  • the control process carries out a selection process which is stored in the system.
  • the selection method is adapted to access a data matrix stored in the data storage device 90 and in which the necessary program parameters are linked in dependence on patient data and treatment data and can be determined in this way.
  • the system can be known when registering the patient on the basis of its own stored time schedule or due to user input when logging in that now hemodialysis has to be carried out for this patient. This information can be known as treatment data. Depending on this treatment data, the system can determine in the patient record which patient-specific conditions and data are to be observed during hemodialysis.
  • patient-specific conditions and data for hemodialysis may include vascular structure data, data about patient-specific nature and dimensions of fixation tape and swab material or disinfectant, data on the type of cannula to be used in cannulation, etc.
  • the data matrix may contain information that for the treatment " Hemodialysis "the program parameters" vascular structure data ",” condition and dimensions of fixation tape and swab material or disinfectant ",” type of cannula to be used for cannulation "are to be observed.
  • the system then automatically prepares the automatic cannulation in accordance with these patient-specific parameters by setting the program parameters "Condition and dimensions of fixation band and swab material or disinfectant" to "type of cannula" a cannula "so that the system's loading system 70 can provide the necessary accessories in a standardized accessory container, and by passing the appropriate vascular structure data from the patient record to the cannulation machine selected by the cannulation system or the cannulation machine via the" vascular structure data "program parameter issued the instruction for accessing this vessel structure data.
  • the patient record may also contain information that is needed for other treatments and is also patient-specific, e.g. Information about the patient's medication to be regularly dispensed by the system.
  • the devices 1, 50, 80, 90 are partially arranged at different geographical positions.
  • a first group of devices of the system may be arranged. These include, in Figure 1, the devices 1 and 80 connected with solid lines to the control device 50.
  • the data storage device 90 may be arranged, which is preferably associated with the system according to the invention.
  • the data storage device 90 can also be used by other clinical systems. Indicated by a dashed line as a link, another user interface device 80 and a canister 1 may be located at a further geographically different location, e.g. in an ambulatory hemodialysis treatment station, e.g.
  • this further user interface device 80 and a canister 1 may be mobile, e.g. in an ambulance, a train, or a ship, as long as a data connection to the system is maintained.
  • Figure 2 shows an embodiment of a Kanülierautomaten 1, which is used by the inventive system 100.
  • the Kanülierautomat 1 has a robot-controlled diarrheaarm issued 2. This has a tool arm 2a with joints, which is connected at one end to Kanülierautomat 1 and carries a tool head 2b at the other end.
  • the tool head is present depending on the type of treatment, eg puncture, Fixierbandaufbringung or dabbing, designed as a replaceable module function specific.
  • the tool head for the puncture or cannulation is set up and carries a cannula 3, which is to be inserted into the blood vessel in the arm 30 of the patient.
  • Another tool head (not shown) contains the disinfecting device for program-controlled application of disinfectant to the skin points of this patient to be punctured.
  • the Kanülierautomat 1 has an observation device 5, which in the present case contains a camera, by means of the automatic Kaneller istgang from a distant observer in real time is observable.
  • the video data on the cannulation are also or alternatively stored in the patient data memory.
  • Kanülierautomat 1 has a detection device 6, with which the position and dimensions of the arm 30 of the patient and the position and structure of the subcutaneous blood vessels of the patient and the morphology of the skin and vessels can be detected.
  • the recognition device 6 has a vascular structure measuring device (not specifically shown) which is set up for the production of at least one image of the blood vessels by means of ultrasound. These measurements can be carried out in particular before cannulation and / or during and / or after cannulation.
  • the vascular structure data generated by the vascular structure measuring device can be stored as patient data and are available in subsequent treatments as historical data that can improve the cannulation patient-specific.
  • the vascular structure measuring device can also be set up to detect earlier puncture sites on the skin and / or on the blood vessel.
  • the control method can use this information, in particular in dialysis patients, in order to carry out or continue the cannulation according to the rope conductor technique or the buttonhole technique.
  • the information about the buttonhole technique results for the Kanülierautomaten from the patient data.
  • the automated cannula inserts the cannula at the same angle relative to the blood vessel or arteriovenous fistula into the same position and through the channel of the "buttonhole."
  • An automaton is predestined to apply this buttonhole technique with consistent quality, as in this technique is crucial for success
  • Buttonhole technique is therefore a particularly preferred type of process for performing the cannulation by means of automatic cannulation or by means of control methods.
  • the machine offers advantages over the manual cannulation, as on the one hand in the vessel structure, the blood vessel morphology is determined and known, which can be selected by the control process an optimal next position at a distance to the previous puncture, and on the other hand, the puncture vibration-free with maximum precision is feasible.
  • Possible steps of the Kanülierautomaten, in particular the Kanülierautomaten 1, and steps of the control method or the inventive method can be derived from the above-described process steps Px, in particular P1 to P8, and the steps Sx, in particular S1 to S1 1.
  • FIG. 12 shows a first general exemplary embodiment of the method 200 according to the invention, which is used in the previously described system 100.
  • the method according to the invention preferably provides the method steps which are also carried out in the control method used in the system.
  • the method steps include the step 201: detecting a registered patient identifier by registering a patient with a user interface device in data communication with a data processing control system; the step 202: - determining program parameters in dependence on the registered patient identifier by the control system; and step 203: controlling a cannulation machine adapted for automated cannulation of patient blood vessels and in data communication with the control system, in response to the program parameters, for automated cannulation of a patient's blood vessel in response to its registered patient identifier ,
  • FIG. 3 shows a further exemplary embodiment of the method 300 according to the invention, in this case for carrying out the double cannulation of an arteriovenous fistula for hemodialysis, in particular using an exemplary embodiment of the system according to the invention, for example the system 100, in an overview.
  • the method 300 provides the following sequence of steps, in this order: Step 310: Prepare the automated cannulation Step 320: Login with patient identification, preparation
  • Step 330 Analysis of the historical vessel structure data and / or detection of current vessel structure data of the arm 30 introduced in the treatment room 8, for planning the punctures
  • Step 340 Automatic disinfection of the skin points to be punctured
  • Step 380 automatic post-treatment of the punctured areas by pressing, swabbing, gauze bandages
  • Step 320 is alternatively and preferably prior to step 310.
  • FIG. 4 shows an embodiment of the preparation step 310 (preparation):
  • the system or control process begins with the analysis of task (310a). This results e.g. from the patient data of the registered patient in combination with a treatment schedule stored in the system. Alternatively, the system was informed of the plan during / before / after the patient's log-on, particularly as treatment data for a scheduled hemodialysis at a particular time.
  • the system checks whether database entries already exist with regard to the planned hemodialysis and compares these with the treatment plan (310b).
  • the system determines the vascular structure data from the patient database of the (registered) patient and calculates the possible puncture parts using a suitable algorithm (310c). All data are analyzed and measures derived, in particular whether a doctor must be consulted or whether the automated cannulation with subsequent hemodialysis is released (31 Od).
  • the system determines the exact sequence of automated cannulation procedures followed by hemodialysis (31 Oe).
  • the system sends data about required accessories to the assembly system (31 Of).
  • the system checks whether the availability of the requested accessories, in particular the availability of the desired automatic cannulation machine, is automatically confirmed (310g).
  • the system selects a suitable fixation band to later fix the needles to the arm (310h).
  • the fixation band is portioned and dimensioned in particular by the placement system in patient-dependent and treatment-dependent selected sections and transmitted in a standardized, automatically operable by Kanülierautomaten accessory container (31 Oi).
  • Suitable catheters or cannulas are patient-dependent and treatment-dependent discarded (31 Oj) and provided in the accessory container (310k).
  • the accessory container is automatically transported to the automatic cannula (3101).
  • the system sends a status update (310m) to the cannulometer.
  • FIG. 5 shows an exemplary embodiment of the preparation step 320 (login, authentication, with subsequent preparation of the clinical treatment):
  • the system authenticates the patient (320a). This can be done by means of password, pin or pattern, via chip card, FRID chip, sim card with mTan method, printed digital certificate or 2D code, TAN / iTAN, preferably by means of biometrics.
  • the system quits with an error message if the authentication fails - what can happen if the patient is not yet registered - the registration has already been described and is a separate process. With the registration the system learns about the upcoming treatment - here a hemodialysis. Immediately after logging in, the system will automatically begin, without delay, automatically with the preparation of hemodialysis, whereby no time is lost, which may be crucial in an emergency. In particular, the medical accessory placement system is activated (320d).
  • the patient-dependent automatically equipped accessory container is transported from the placement system to the automatic cannulation machine (320e).
  • the placement system submits a status report (320f).
  • the accessory container is placed in the cannulation machine (320g).
  • the accessory container, in particular its seal, is automatically checked for integrity in order to guarantee the sterility of the contents (320h).
  • the completeness and sterility of the accessories are registered by the cannula machine, which is now ready for cannulation - this information is displayed on a display of the cannula machine for the user (320i).
  • a security step it is provided that a patient's medical attendant authenticates himself to instruct the patient and to release the canister for the patient (320j).
  • steps 320k through 320m are performed.
  • Patient data in particular vascular structure data and planned puncture sites, are transmitted by the system (320k), in particular from the patient database to the data processing device of the cannulation machine, the consistency of the transmitted data is checked (3201), and the transmission is either repeated until consistency is present or confirmed if it has been transmitted correctly (320m).
  • the system checks the preparation status (320n) and informs the staff in case of problems (320p) or (320o) decides the progress of the treatment (320q).
  • FIG. 6 shows an exemplary embodiment of the step of vascular recognition 330 (fistula identification):
  • the patient positions his arm in the treatment room of the canister (330a).
  • the fixation device positions the fixation elements (330b) and inspects the arm fixation (330c). If the fixation is insufficient, readjust (330d). Detection of the fistula begins (330e).
  • the vascular structure measuring device detects at least one image of the vascular structure containing the fistula, which is known from the patient data, and automatically checks the image for abnormalities, such as stenosis, hematomas, infections, or severe fistula changes (330f).
  • the recognition data is compared with historical recognition data from the patient record (330g).
  • FIG. 7 shows an embodiment of the step of automatic skin disinfection of the arm 340 to be punctured:
  • the disinfection to be performed automatically by means of the disinfecting device of the cannulating machine is started (340a).
  • the appropriate disinfection technique is selected depending on the patient and / or treatment (spraying or wiping with a swab, 340b).
  • the disinfection tool head is activated or gripped by the tool arm (340c), the disinfection process begins (340d).
  • the quality of the disinfection is checked by means of a disinfection control test device, an optional component of the automatic cannulometer and / or the disinfection device (340d). If the test is positive, the disinfection is completed, otherwise the disinfection and testing process is repeated (340f).
  • FIG. 8 shows an exemplary embodiment of the step of the first puncture and cannulation of the skin of the arm 350 to be punctured:
  • the first automated cannulation begins (350a).
  • the first cannula tool head equipped with the patient- and / or treatment-dependent preselected cannula, is gripped by the tool arm (350b).
  • the cannula tool head is positioned relative to the arm 30 and the predetermined puncturing portions, in particular, the angle of the cannula relative to the skin surface at the puncturing portions being predetermined (350c).
  • the cannula is inserted into the skin and fistula (puncture 350d).
  • a priming step is automatically performed (350e) to test the fluid connection between the cannula and the fistula by means of an aspiration test
  • the pressure in the cannula is checked (350f) by means of a pressure measuring device of the cannulation machine
  • a fixation band is provisionally positioned by means of a fixation band device around the cannula 350g), the cannula is released (350h) from the cannula tool head, the fixation of the cannula is subsequently reinforced (350i) by means of the fixation device 10.
  • a medication is planned (350j) on condition of release by authorized personnel.
  • FIG. 9 shows an exemplary embodiment of the step of the second puncture and cannulation of the skin of the arm 360 to be punctured:
  • a second cannula tool head equipped with the second patient and / or treatment-dependent preselected cannula, is gripped by the tool arm (360a).
  • the cannula tool head is positioned relative to the arm 30 and to the predetermined puncture site, in particular the orientation of the cannula relative to the skin surface at the puncture site in a predetermined manner (360b).
  • the cannula is inserted into the skin and fistula (puncture 360c).
  • a priming step is automatically performed (360d) to test the fluid connection between the cannula and the fistula by means of an aspiration test
  • the pressure in the cannula is checked (360e) by means of a pressure measuring device of the cannulation machine
  • a fixation band is provisionally positioned by means of a fixation band device around the cannula
  • the cannula is released from the cannula tool head (360g), the fixation of the cannula is subsequently reinforced (360h) by means of the fixation band device
  • the catheter end of the second catheter is positioned in another receptacle in which it is located
  • Figure 10 shows an embodiment of the step of hemodialysis 370 with sub-steps performed by optional devices of the system suitably designed as apparatus:
  • the arm is released from the fixation of the cannulation machine (330a). Additional accessories are connected, eg Fresenius VenAcc (330b).
  • the patient's readiness to connect to the hemodialysis machine is shown on the display (330c).
  • the operational readiness of the medical staff is awaited (330d). If it is not registered ready (330e), steps 330c and 330d are repeated.
  • the connection to the hemodialysis machine is performed (330f)
  • the hemodialysis begins (330g) and is performed (330h).
  • the medical staff is awaited (330j). If it is not registered ready (330k), steps 330i and 330j are repeated.
  • data on hemodialysis are displayed (330m), which can be supplemented as needed by the staff can be displayed (330n) and again.
  • the data is finally added to the patient data and stored in the database 330o).
  • FIG. 11 shows an exemplary embodiment of the step of the aftertreatment 380 with sub-steps carried out by means of optional apparatuses of the system which are suitably configured in terms of apparatus:
  • the arm of the patient is fixed (380a), the access tubes of the blood supply system are closed under aseptic conditions controlled (380b).
  • the tube set is removed (380c), the fixation band is removed (380d), the cannulas are pulled under controlled aseptic conditions and removed (380e).
  • a swab is grasped (380f) and dabbed at the puncture site with a pressure of suitable gentle force (380g).
  • the arm fixation is released (380h), a final signal is output for the patient (380i).
  • a cleaning and disinfection process is requested for cleaning and disinfecting the automatic cannula (380j).
  • the canister is placed in standby mode and its readiness for next cannulation is registered and / or displayed in the system (380k).

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Abstract

L'invention concerne un système (100) pour l'introduction automatisée d'une canule, en fonction de données, dans des vaisseaux sanguins de patients, en particulier pour l'hémodialyse, présentant : au moins un automate (1) d'introduction de canule, qui est conçu pour l'introduction automatisée d'une canule dans des vaisseaux sanguins de patients, un système de commande (50, 51) qui présente au moins un dispositif de traitement de données et qui est conçu pour réaliser un procédé de commande qui commande ledit au moins un automate d'introduction de canule en fonction de paramètres de programme, au moins un dispositif (80) d'interface utilisateur, qui permet une saisie d'utilisateur qui connecte un patient au système de commande (50, 51), le système de commande utilisant une détection de patient associée individuellement au patient connecté, désignée par identifiant de patient connecté, suite à cette connexion. Le système de commande est conçu pour déterminer les paramètres de programme en fonction de l'identifiant de patient connecté et pour commander ledit au moins un automate (1) d'introduction de canule en fonction de l'identifiant de patient connecté. L'invention concerne en outre un procédé correspondant.
EP18702267.8A 2017-01-30 2018-01-29 Système et procédé pour l'introduction automatisée d'une canule Pending EP3573550A1 (fr)

Applications Claiming Priority (2)

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DE102017201437.7A DE102017201437A1 (de) 2017-01-30 2017-01-30 System und Verfahren zur automatisierten Kanülierung
PCT/EP2018/052148 WO2018138343A1 (fr) 2017-01-30 2018-01-29 Système et procédé pour l'introduction automatisée d'une canule

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EP (1) EP3573550A1 (fr)
JP (1) JP7219221B2 (fr)
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WO (1) WO2018138343A1 (fr)

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CN110721380B (zh) * 2019-11-18 2022-07-05 北京大学人民医院(北京大学第二临床医学院) 一种可自主实施气管插管的装置
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CN111481294B (zh) * 2020-04-26 2021-04-09 四川大学华西医院 一种自动注射机器人系统及自动注射方法
CN111513822B (zh) * 2020-04-29 2022-02-25 周彬 一种动静脉内瘘留置针用辅助置入装置
CN111603245B (zh) * 2020-06-02 2022-08-12 嘉兴市第二医院 一体化动静脉内瘘血管穿刺机器人及其控制方法
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DE102017201437A1 (de) 2018-08-02
CN110267609B (zh) 2023-04-28
JP2020505170A (ja) 2020-02-20
JP7219221B2 (ja) 2023-02-07
WO2018138343A1 (fr) 2018-08-02
US20200338309A1 (en) 2020-10-29

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