RU2290209C2 - Method and device for cleaning dialyzing solution in "artificial kidney' apparatus - Google Patents

Abstract

FIELD: medicine; nephrology; surgery; reanimation.

SUBSTANCE: method and device for cleaning dialyzing solution can be used for replacement of lost function of removal of metabolites and toxic matter out of organism. Dialyzing solution flow with discharge, being commonly accepted for normal procedure of dialysis, which flow goes out dialyzer, is subject to division to two flows with smaller controlled discharge. One flow is passed through electrolyzer and additional cleaning unit together with sorbents, and the other one is sent to reservoir of ultra-filtrate. Then both flows are brought together and are applied to dialyzer again but with discharge being equal to flow coming out of dialyzer. For the purpose additional pump is built in dialyzing circuit to find its place behind the pump, which pump is disposed output of dialyzer. The pump has smaller controlled discharge. There is tap between two pumps, which pump is connected with reservoir of ultra-filtrate.

EFFECT: higher physiological efficiency of out-kidney cleaning of blood; improved quality of cleaning; reduced sizes and weight of device.

2 cl, 1 dwg

Description

The invention relates to medicine and can be used in nephrology, surgery, resuscitation and disaster medicine to replace the lost function of eliminating metabolites and toxic substances from the body.

Known apparatus "Artificial kidney" with electrochemical regeneration of a dialysis solution (Nefedkin SI Development of electrochemical methods and devices for cleaning and monitoring aqueous technological media containing dissolved organic substances. Abstract for the degree of Doctor of Technical Sciences. M., 2004) [ 1], in which the BRD-02 and “Diareg” electrochemical regeneration units implement a method and device in the form of a combined regeneration scheme based on the oxidation of nitrogen-containing toxins into the stream ohm electrochemical device control the electrochemical process and using disposable sorption cartridge for purification of dialysate.

Also known apparatus "Artificial kidney" (patent RU 2110283, IPC ⁶ A 61 M 1/14, publ. 10.05.1998) [2], in which the solution coming from the dialyzer is sequentially passed through an electrolytic cell with electrocatalytic platinum electrodes, through gas-liquid a separator and a filter with platinum charcoal followed by the return of the solution to the dialyzer. A device for implementing this method includes a dialyzer, an electrolyzer, a gas-liquid separator, a platinum-carbon filter and a pump closed in series in a liquid circuit.

All of these devices for extrarenal blood purification with the regeneration of the dialysis solution are not effective enough, and the regeneration units used in them are bulky and are comparable in size to the artificial kidney apparatus itself, which prevents their widespread adoption in medical practice.

The closest in technical solution is the method of purification of the dialysis solution in the "Artificial kidney" apparatus and the device for its implementation, implemented in the ADR-01 dialysis apparatus (V.M. Grinwald et al. Design and first test results of the ADR-01 dialysis apparatus with regeneration dialysis solution.Medical equipment No. 3, Moscow, Medicine, 1993, p. 28-31) [3].

A prototype dialysate solution cleaning device comprises a dialyzer forming a dialysis circuit, an electrolyzer, a post-treatment unit with sorbents, an ultrafiltrate tank, and pumps for moving the dialysate (dialysis solution) located at the inlet and outlet of the dialyzer. The dialysis solution is purified by electrolysis (electrochemical regeneration) and subsequent sorption. Blood purification occurs in the dialyzer, through which, on the one hand, the blood to be purified is pumped, and on the other hand, the dialysate, which moves in a closed circuit with a constant flow rate of 500 ml / min.

The disadvantage of this device is the unsatisfactory performance of the regeneration unit, due to the fact that when the dialysate flow rate is necessary, which is generally accepted for the normal dialysis flow and is 500 ml / min [1, 3], the contact time of the dialysate with the electrodes of the electrolyzer and sorbents is short. For more efficient use of the electrolyzer and sorbents, the dialysate must pass through them at a lower rate (flow rate). To reduce the dialysate flow rate through the electrolyzer and sorbents, it is necessary to divide the initial dialysate flow, for example, into two flows with a flow rate, for example, 250 ml / min each, but the number of electrolysis cells and sorbents will double.

When creating this invention, the problem was solved of developing a method for purifying a dialysate solution that increases the efficiency of using the electrolyzer and sorbents while ensuring the required quality of dialysate purification.

When developing the device, the problem of simplifying the device and reducing its dimensions and weight was solved.

When solving this problem, the technical result of the method and device was to increase the physiological process of extrarenal blood purification and the quality of dialysate purification, reducing the mass and dimensions of the device.

This result is achieved by the fact that, compared with the known method of purification of a dialysis solution, in which the flow of a dialysis solution with a flow rate of 500 ml / min passes through a dialyzer, an electrochemical regeneration unit and sorbents, the inventive method includes a new one - that the flow of the dialysis solution with a certain the flow rate leaving the dialyzer is divided into two streams with a lower and adjustable flow rate, one of which is passed through the electrolyzer and a post-treatment unit with sorbents, the other is sent to the ultrafine tank ltrata, then both streams are combined with the flow rate of exiting from the dialyzer is fed back to the dialyzer.

The physiological nature of the process of extrarenal blood purification according to the proposed method is increased by mitigating the impact on the patient’s body of a foreign artificial medium - a purified analysis solution (after electrochemical regeneration and sorption) by partially diluting it with untreated dialysate before being fed to the dialyzer, while the patient is much better and easier to tolerate the procedure extrarenal cleansing of the blood, which lasts an average of about 4 hours.

The proposed method for cleaning the dialysis solution is illustrated by the scheme shown in the drawing.

This result is achieved by the fact that, compared with a device for cleaning a dialysis solution containing a dialyzer, an electrolyzer, a post-treatment unit with sorbents, an ultrafiltrate tank, dialysate transfer pumps located at the outlet and entrance of the dialyzer, the claimed device contains a new one, that in the dialysis circuit after the pump located at the outlet of the dialyzer, an additional pump with a lower and adjustable flow rate is built in front of the electrolyzer, and between the pumps is made od connected to the tank UF.

The pumps located at the inlet and outlet of the dialyzer provide a constant flow of dialysate when passing through the dialyzer, which is accepted as optimal for the extrarenal blood purification procedure and equal to 500 ml / min. An additional pump with a lower and adjustable flow, located in front of the electrolyzer, allows you to separate the dialysate stream and control its flow to the electrolyzer, and, therefore, to the ultrafiltrate tank through the outlet, thus ensuring the required dialysate quality before entering the dialyzer.

Due to the presence of an additional pump 14 and outlet 15, dividing the dialysate stream with a flow rate of 500 ml / min into two streams with a lower and adjustable flow rate, the possibility of more efficient use of expensive electrolyzer (platinum plate) and sorbents is created, since the contact time of the dialysate is increased solution. The crude part of the dialysate stream entering the reservoir 6 through outlet 15 into the purified dialysate with optimal separation of the stream helps to increase the physiological nature of the process of extrarenal blood purification, mitigating the impact on the patient's body of a foreign artificial medium - dialysis solution.

The use of the drawing scheme in a device for cleaning a dialysate solution while reducing the dialysate consumption in the electrolyzer and the after-treatment unit to 300 ml / min significantly increased the efficiency of using the electrolyzer and sorbents and significantly reduced the number of sorbents used, which made it possible to reduce the overall dimensions and weight of the device.

The drawing shows a diagram of the operation of the claimed device.

A device for cleaning a dialysis solution contains a dialyzer 1, in which blood contacts the dialysis solution through a membrane, pumps 2 and 3, an electrolyzer 4, a post-treatment unit with sorbents 5, an ultrafiltrate tank 6, a metering pump 7, valves 8, 9, 10, 11 , canisters 12 and 13, additional pump 14, outlet 15.

The device operates as follows. The patient’s purified blood is pumped through dialyzer 1, on the other hand, the dialyzer membrane is moved by pump 2 with a flow rate of 500 ml / min dialysis solution. Pump 14 with a flow rate of, for example, 300 ml / min passes only part of the dialysate stream, the rest of the stream through branch 15 enters the ultrafiltrate tank 6. Part of the stream moved by pump 14 passes through the electrolyzer 4 and the after-treatment unit with sorbents 5 is supplemented to the required flow rate of 500 ml / min from the ultrafiltrate tank and is fed by the pump 3 again to the dialyzer 1. Valves 8, 9, 10, 11 are turned on when the device operating mode changes. The dosed volume of the ultrafiltrate is drained from the reservoir 6 by the metering pump into the canister 13. The system is filled with dialysate by the pump 3 from the canister 12.

Information sources

1. Nefedkin S.I. Development of electrochemical methods and devices for purification and monitoring of aqueous technological media containing dissolved organic substances. Abstract of dissertation for the degree of Doctor of Technical Sciences, M., Moscow Power Engineering Institute (Technical University), 2004.

2. Patent RU No. 2110283, IPC ⁶ A 61 M 1/14, publ. 10.05.1998.

3. V.M. Grinwald et al. Design and first test results of the ADR-01 dialysis machine with dialysis solution regeneration. Medical equipment No. 3, Moscow, Medicine, 1993, pp. 28-31.

Claims (2)

1. The method of purification of the dialysis solution in the apparatus "Artificial kidney", including electrochemical regeneration followed by post-treatment with sorbents, characterized in that the flow of the dialysis solution with a flow rate generally accepted for the normal flow of dialysis coming out of the dialyzer is divided into two streams with a lower and more controlled flow rate , one of which is passed through an electrolyzer and a post-treatment unit with sorbents, the other is sent to an ultrafiltrate tank, then both flows are combined with a flow equal to izatora is fed back to the dialyzer. 2. A device for cleaning the dialysis solution in the "Artificial kidney" apparatus, containing a dialyzer, an electrolyzer forming a dialysis circuit, an aftertreatment unit with sorbents, an ultrafiltrate tank, dialysate transfer pumps located at the outlet and entrance of the dialyzer, characterized in that the dialysis circuit after of the pump located at the outlet of the dialyzer, an additional pump with a lower and adjustable flow rate is built in front of the electrolyzer, and an outlet connected between the ultrafiltrate tank is made between the pumps .