WO2013135902A1

WO2013135902A1 - Flushing bag

Info

Publication number: WO2013135902A1
Application number: PCT/EP2013/055517
Authority: WO
Inventors: Stefan Moll
Original assignee: B. Braun Avitum Ag
Priority date: 2012-03-16
Filing date: 2013-03-18
Publication date: 2013-09-19
Also published as: DE102012102268A1

Abstract

The present invention relates to a method and a device for removing flushing fluid from a flushing bag, which enable only one flushing bag to be used per patient and per dialysis session.

Description

irrigation bags

description

The present invention describes a method and a device for removing rinsing liquid from a rinsing bag, which (s) allows that only one rinsing bag must be used per patient and per dialysis session.

In patients with partial or complete renal insufficiency, natural metabolites, including uremic toxins, are removed by blood treatment procedures such as hemodialysis, with removal of the substances from the blood extracorporeally by contact of the blood with a dialysis solution. The substance transport from the blood into the dialysis solution takes place via diffusive and convective effects. The aim is to remove primarily uremic toxins. This is done by adding vital substances in physiological concentration to the dialysis solution for the patient. With the demographic changes and the associated changes in the age pyramid of a society, these methods win v.a. In the industrialized countries a steadily increasing importance, since the number of chronic kidney-insuffient patients increases continuously. For example, there are currently around 60,000 patients requiring dialysis each year in Germany. The mortality rate is still around 20% per year. The incidence of new cases is 184 per 1 million inhabitants. Even in the emerging economies, the number of patients to be treated will increase sharply in the coming years.

An average hemodialysis treatment takes 4 to 5 hours. Night dialysis lasts up to 8 hours. Such treatment is required at least three times a week for most patients. The frequency of treatment depends i.a. the body weight, kidney function and cardiac output of the patient. The tendency, however, is to rather perform several short treatments.

For example, up to 3 rinsing bags with a total of about 3 l rinsing solution, usually isotonic saline solution, are used in an optimal hygienic preparation and post-processing of the dialysis treatment. To cover this immense need, it requires a complex infrastructure and thus a large staff needs. Also, the material consumption is huge. Projected this means that one dialysis patient per year min. 450L in different rinsing bags this specially sterile filled rinse solution needed. Due to the high quality standards and the fact that a part of said rinse solution can also enter directly into the bloodstream of the patient, these rinse solutions are increasingly sold only as a drug and not as a medical device, which also significantly increases the cost.

Modern dialysis machines are technically so far developed that they are operated in a normal operation on a dialysis station exclusively by a nurse. While the operation of the user interface has been continuously improved in recent years, the handling steps that concern the consumables have remained largely unchanged.

Thus, in three phases of a hemodialysis treatment, rinsing bags are connected, as a rule, to a connection to the tube system of the dialysis machine.

In the first phase, irrigation bags containing 1, 5L or 2L of isotonic saline are used to rinse the tubing and dialyzer while preparing for therapy. For this purpose, the amount of approximately 1 - 1, 5L of the used washing bags is removed via the hose system and the roller pump of the device. After this amount is passed through the tube and dialyzer, it is discarded. The remaining fluid in the irrigation bag is circulated through the irrigation bag through a return loop until the patient arrives and connects to the tube system via the cannula for dialysis treatment. During the circulation of the rinse fluid before the patient is applied, the dialyzer is further rinsed to remove air from the individual capillaries and to ensure optimum wetting and performance.

In the second phase, during the actual dialysis session, hypotensive events occur in up to 25% of cases. To stabilize the patient in these cases, a second rinsing bag (usually 500mL) is used for infusion of isotonic saline and connected to the blood tube system.

In the third phase, during and after the removal of the patient from the dialysis machine after the dialysis session, this is done in the extracorporeal circulation located blood is displaced by isotonic saline. For this purpose again around 500mL and a new, mostly third, purge bags are used.

The cost of the purging bag is made up of the cost of the rinse solution contained and the cost of making the rinse bag. The costs for the preparation of the rinse solution form the much smaller proportion and can be optimized by the amount of rinsing liquid is adapted to the equipment components used in particular the dialyzer and the tube system used. If, for example, the type of dialyzer used and the tube system used are known, then the required amount of rinsing fluid can also be predicted by the dialysis machine. The thus determined amount of rinsing liquid is lower and sometimes significantly lower than the amount to be used if the tube system and dialyzer type are not known, because then for safety reasons larger amounts of rinsing liquid must be used to meet the hygiene requirements. Thus, another aspect of the present invention is directed to the automatic calculation of the required amount of rinsing liquid, as long as the dialysis machine, the tubing system and the dialyzer used are known. The extracorporeal blood treatment device according to the invention therefore preferably has means such as e.g. a data processing unit such as a CPU, which calculates the required amount of rinsing liquid for a given dialyzer and a given tube system and displays the rinsing bag to be used. Furthermore, the extracorporeal invention has

Blood treatment device preferably via mitel such as e.g. Sensors for automatic recognition of the dialyzer and / or for automatic detection of the tube system and more preferably sensors for both to automatically display the rinsing bag to be used.

It would also be advantageous to reduce the number of rinsing bags used per dialysis session and per patient, ie to use only one instead of two or three rinsing bags. This has not been possible until now, because after the first phase, the remaining liquid in the rinsing bag is circulated through the rinsing bag by a conclusion until the patient has been prepared for the treatment. This flushing bag is therefore considered hygienic no longer perfect and must be discarded. Thus, this purge bag is no longer available if it should come in the second phase to a hypotensive incident. In this case, a new bag must be used, which is also discarded after use. Finally, in the third phase to Dropping the patient requires a third rinse bag. For these reasons, it is not possible to use the rinsing bag from the first or the second phase for this purpose. Moreover, the rinsing bag from the second phase is only conditionally available because, for reasons of hygiene, a renewed connection of the rinsing bag to the same outlet, which is now no longer sterile, may only be carried out within a narrow time window.

The invention is therefore based on the object to provide a method which makes it possible to make do with only one rinsing bag per patient and per dialysis session and thereby meet the high necessary hygienic and legal requirements. There is a lot of potential for savings in this area, which has not been exhausted so far.

This object is achieved by a method in which the rinsing fluid is removed from the same rinsing bag for withdrawing rinsing fluid from a rinsing bag having at least two sterile connections and introducing the rinsing fluid into the blood-side circuit of an extracorporeal blood treatment device, per patient and per dialysis session, the rinsing bag only is used for removal and no liquid is returned to the purge bag or circulated through the purge bag and a backflow of the removed rinse solution is prevented in the purge bag.

It is preferred if the extracorporeal blood treatment device is a dialysis system suitable for conventional dialysis, hemodialysis, hemodiafiltration, hemofiltration, cordial dialysis or apheresis. A preferred embodiment also relates to purging bags which are not subdivided into different segments or chambers, i. the rinsing bag has only one chamber or an undivided cavity.

Further advantageous embodiments of the invention are specified in the dependent claims, the description, the figures and the examples.

Characterized in that the rinsing liquid is not circulated through the rinsing bag and a backflow of the removed rinsing solution is prevented in the rinsing bag, the contents of the rinsing bag remains hygienic and can be used for further withdrawals.

During rinsing of the extracorporeal blood treatment device, a portion of its contents is removed from the rinsing bag to prevent the circulation of the Rinse dialysis machine. The amount withdrawn depends on the extracorporeal blood treatment device used, the filter, the tubing system, and other factors. For economic reasons, it is preferable to remove only the same amount of rinsing solution from the rinsing bag in order to rinse the circuit once. In some cases, however, it may be necessary to use a multiple of the volume of the circuit to rinse it several times. In both cases, the rinsing solution once removed is no longer returned to the rinsing bag, recirculated or otherwise returned to the rinsing bag. The excess rinse solution, ie the rinse solution that has passed through the circuit once, is discarded and not reused as usual.

According to the invention, the rinsing solution is considered removed as soon as it has been removed from the rinsing bag, that is no longer present within the rinsing bag. The introduction of the rinsing solution is usually achieved by pumping the rinsing solution out of the rinsing bag through the hose pump installed in the extracorporeal tube from the rinsing bag into the extracorporeal blood treatment device. By initiation is meant in particular that the rinsing solution is pumped into the tube system of the extracorporeal blood treatment device.

According to the invention, one rinsing bag per patient and dialysis session suffices, without the need for further rinsing bags. An average hemodialysis treatment takes 4 to 5 hours. Night dialysis lasts up to 8 hours. Thus, with only one rinsing bag, the patient can be cared for throughout the duration of the treatment. According to the invention, only one rinsing bag is used for each patient.

By the method according to the invention the high hygienic and legal requirements are satisfied, which allow to use only one rinsing bag.

A dialysis session begins with the rinsing of the extracorporeal blood treatment device for the preparation of the therapy and ends with the return of the blood by means of the rinsing solution. The next dialysis session, in turn, begins with purging the extracorporeal blood treatment device to prepare for the next patient's therapy, using a new purging bag for the next patient. Advantageously, the components used (filter, tube system, dialyzer) can be recognized by the extracorporeal blood treatment device (eg RFID detection). According to the specification and size of the components, the necessary amount of liquid and speed for initial rinsing is determined from a table stored in the control unit of the extracorporeal blood treatment device and transmitted to the control of the peristaltic pumps. The necessary flushing volume and speed can either be taken in advance either from the product descriptions of the individual articles or better determined in the form of a test for specific component combinations.

Since this flushing amount is low and flows only once through the tube and dialyzer, the dialyzer should be filled on the blood side from below, so that all the fibers of the dialyzer are wetted and the air is completely removed from the system. Preliminary wetting of the dialysate side filter or pressure build-up may be beneficial to avoid excessive loss across the membrane. It should be mentioned here that in each case one new dialyzer is used per patient and per dialysis session. Once used dialyzer is not rinsed and used again for another patient. Dialyzers are disposable items that are disposed of after a single use after a dialysis session.

Upon completion of the flushing operation, withdrawal from the flushing bag is stopped and the extracorporeal blood treatment device is now ready to connect to a patient. Until the patient is connected, the rinse bag may be separated from the extracorporeal blood treatment device and the ports protected by closure means such as caps. In a preferred variant of the method according to the invention, during the dialysis session the rinsing bag remains connected to the extracorporeal blood treatment device via a connection and more preferably via two or both connections.

According to the invention, inter alia between the phases of rinsing and applying a backflow of the once removed rinsing solution from the rinsing bag is prevented by the fact that the rinsing bag itself and / or on the extracorporeal blood treatment device components are present, which prevent the backflow of the rinsing solution. This can either be a free-fall line (drip chamber), a check valve or a monitoring of the pumps and pressures in the hose system. In one embodiment, the backflow of the rinsing liquid into the rinsing bag is prevented by at least one check valve or one-way valve on the rinsing bag and / or by at least one backflow preventer (4) on the extracorporeal blood treatment device.

In a further embodiment, the backflow of the rinsing liquid into the rinsing bag is prevented by at least one pressure control in the extracorporeal blood treatment device.

This ensures that at no time there is the danger that once taken rinsing liquid can get back into the rinsing bag, which in turn is the prerequisite that one and the same rinsing bag for multiple withdrawals is available. During the removal of the rinsing liquid from the rinsing bag, a return of the rinsing liquid is additionally prevented by the hose pump pumping the liquid only in one direction and thus actively counteracts the return.

In one embodiment, after removal, the irrigation bag may be applied over the second sterile port upon reapplication to the blood-side circuit of the extracorporeal blood treatment device. The second sterile connection prevents a contamination of the rinsing bag being caused by a renewed connection of the rinsing bag to the already used first connection. Preferably, the sterile connections are each sealed separately.

It is also preferable to use a rinsing bag having two, three or more sterile ports. These can be used individually and independently of each other by "breaking" the sterility seal.Today connections to rinsing pouches lose their sterility at the same time as opening the outer packaging, and the connection is already exposed to the environment, resulting in use after a time However, the rinsing bags used in accordance with the invention preferably have at least 2 connections which are designed so that they can be connected individually and in particular one after the other without impairing the sterility of the respective other connection.

In a further embodiment, it is possible to leave the rinsing bag on the extracorporeal blood treatment device during the dialysis treatment, thus the rinsing bag remains connected when the patient is put on. Also in this case, the contents of the rinse bag remain sterile because the rinse solution is not recirculated into the bag and backflow of the rinse solution from the extracorporeal blood treatment device into the rinse bag is prevented. This has the advantage that the rinsing bag does not have to be changed, but rinsing solution can be removed directly from the rinsing bag. In this embodiment, for example, the arterial connection has to be widened via a corresponding T-piece so that the patient can be connected to the one connection and the rinsing bag remains at the second connection.

In another embodiment, after removal and re-application of the rinse bag, it is determined via a timer located on the blood treatment device whether the first previously used port can be reused or the second sterile port must be used. This has the background that, for reasons of hygiene and safety, it is assumed as a precaution that a connection already in use, which has not been used for some time, is no longer sterile. In most cases, with due caution, the connection already used will still be sterile - depending on the duration of treatment - this should be considered as an additional precautionary measure.

In a preferred embodiment, the same irrigation bag is used in hypotensive events. As mentioned earlier, hypotensive events occur in up to 25% of cases. To stabilize the patients, a second irrigation bag (usually 500mL) is usually used for infusion of isotonic saline and connected to the bloodline system. This second purge bag is no longer necessary according to the invention. In this case, the rinsing bag already used for rinsing can be connected via its second sterile connection to the extracorporeal blood treatment device, whereby contamination from the first connection can be prevented. Preferably, the rinsing bag already used for rinsing is not separated from the extracorporeal blood treatment device and therefore can continue to be used directly without reconnecting. Nevertheless, one aspect of the invention is to perform the procedure so that it serves only non-therapeutic purposes such as purging the tubing system. In a further preferred embodiment of the extracorporeal blood treatment device according to the invention, the rinsing bag is connected to the blood treatment device via both connections and a multi-way valve or multi-way valve is adjustable such that rinsing solution can be withdrawn from the first or the second connection or both connections are blocked, so that none Removal of rinsing solution can be done. In addition, a timer which also controls the multi-way valve or the multi-way valve can be used to determine whether flushing solution can still be withdrawn from the first connection or sterility requirements can no longer be met and flushing solution can be withdrawn via the second connection. In this embodiment, it is not even necessary for the operating personnel of the extracorporeal blood treatment device to deposit the rinsing bag and possibly re-apply it via the second connection. The rinsing solution can be withdrawn completely automatically via the first or the second connection on the rinsing bag.

Furthermore, a device is provided with which the method according to the invention can be carried out. The device according to the invention is an extracorporeal blood treatment device, which has at least one backflow preventer (4) which prevents the backflow of the withdrawn rinsing liquid into the rinsing bag. A preferred device according to the invention is an extracorporeal blood treatment device with a rinsing bag having at least two sterile connections for withdrawing rinsing fluid and introducing the rinsing fluid into the blood-side circuit of the extracorporeal blood treatment device and a backflow preventer (4), which prevents the backflow of the removed rinsing fluid into the rinsing bag the tubing system is designed so that the rinsing bag is only for removal and no liquid can be returned to the rinsing bag or circulated over the rinsing bag and, moreover, a backflow of the removed rinsing solution into the rinsing bag is prevented.

A further preferred embodiment according to the invention relates to an extracorporeal blood treatment device having a rinsing bag with two or at least two sterile connections for withdrawing rinsing fluid and introducing the rinsing fluid into the blood-side circulation of the extracorporeal blood treatment device, a backflow preventer (4), which returns the rinsing fluid withdrawn into the rinsing bag prevents and a multi-way valve or multi-way valve to control the removal of Rinsing fluid from the rinsing bag, wherein the tube system is designed so that the rinsing bag is only for removal and no liquid can be returned to the rinsing bag or circulate on the rinsing bag and also a backflow of the removed rinse solution is prevented in the rinsing bag. More preferably, the multi-way valve or the multi-way valve is controlled in such a way, for example via a Zeitgeben or timer that rinsing solution is removed via the second port, if the first connection no longer meets the sterility requirements.

Furthermore, it is preferred if the extracorporeal blood treatment device has sensors for the automatic detection of dialyzer, tube system and filter and predetermines the rinsing bag to be used over this detection.

A particularly preferred embodiment according to the invention relates to an extracorporeal blood treatment device with a rinsing bag with two sterile connections for withdrawing rinsing fluid and introducing the rinsing fluid into the blood-side circuit of the extracorporeal blood treatment device, a backflow preventer (4), which prevents the backflow of the removed rinsing fluid into the rinsing bag and a Multi-way valve or multi-way valve for controlling the removal of rinsing liquid from the rinsing bag, wherein the first connection of the rinsing bag via a first supply line and connected via a second supply line from the second supply line, the second connection of the rinsing bag and the arterial connection are connected to the multi-way valve or multi-way valve, wherein the hose system is designed so that the purge bag is only for removal and no liquid is returned to the purge bag or circulate over the purge bag In addition, a backflow of the removed rinsing solution is prevented in the rinsing bag. More preferably, the multi-way valve or the multi-way valve is so controlled, e.g. via a timer or timer, that rinse solution is withdrawn via the second port if the first port no longer meets the sterility requirements. Reflux of rinse in the rinse bag is also in this embodiment by the possibilities disclosed herein such as:. Pump flow direction, free fall distance (drip chamber) or check valve reached.

This is crucial so that the flushing bag is not contaminated by returning rinsing solution from the extracorporeal blood treatment device and thus is no longer available for further withdrawals. A backflow preventer (4) is defined as being a component which prevents backflow of the withdrawn rinse solution from the extracorporeal blood treatment device back into the rinse bag, but further allows flow of the rinse solution into the extracorporeal blood treatment device, particularly the tube system. This excludes hose clamps or magnetic clamps, which either allow the flow of the rinse solution in the open state in both directions or no flow in the closed state is possible, but not a flow only from the rinsing bag in the tube system of the dialysis machine but allow no flow back into the tubular bag ,

Preferably, the backflow preventer (4) is positioned in the arterial tubing near the arterial access. Alternatively, the backflow preventer (4) may also be positioned directly in the arterial access. Furthermore, a position immediately behind the outflow of the rinsing bag or in the immediate vicinity of the rinsing bag is preferred.

By way of example, FIG. 1 shows the construction of a blood-side circuit with a component which prevents the backflow of the removed rinsing liquid into the rinsing bag. The rinsing bag (1) is connected to the arterial connection, through which the circuit is rinsed. The next component is followed by the non-return valve (4), which prevents the backflow of the rinse solution from the extracorporeal blood treatment device into the rinse bag (1), but still allows the rinse solution to flow into the extracorporeal blood treatment device. This is followed by the arterial pressure monitor (5), which measures the suction pressure of the blood pump (6). The blood is conveyed through the blood pump (6), enters the arterial chamber (10), is subsequently cleaned in the dialyzer (12) and returned to the patient via the venous chamber (3).

The structure may vary depending on the method used, but essential to the invention is only that the backflow of the rinsing solution from the extracorporeal blood treatment device into the rinsing bag by at least one backflow preventer (4) is prevented.

In one embodiment, the backflow preventer (4) is arranged between the rinsing bag (1) and the arterial pressure monitor (5). The pressure monitor (5) is the first component which follows the backflow preventer (4) in the blood-side circuit. Furthermore, the backflow preventer (4) can also be installed at another point in the blood-side circuit. However, it should be remembered that a backflow preventer (4), which would be installed only after the dialyzer, for example, would not do justice to its purpose and purpose as backflow preventer (4).

Therefore, the backflow preventer (4) is preferably arranged in the vicinity of the arterial port to which the rinsing bag (4) is connected. This means that the backflow preventer (4) is preferably mounted no further than 5 cm, or 10 cm or 15 cm or 20 cm or 25 cm or 30 cm or 35 cm away from the arterial port to which the rinsing bag (4) is connected is, whereby the lengths refer to the length of the hose system, so how many cm hose system has flowed through the rinsing solution from the purge bag to the backflow preventer.

It is further preferred if the backflow preventer (4) follows as the first component on the arterial connection to which the rinsing bag (1) is connected. That after the outflow of the rinsing bag, the next component in the extracorporeal blood treatment device is the backflow preventer (4). This is preferably not more than 35 cm hose distance from the purge bag.

In a preferred embodiment, the non-return valve (4) is a one-way valve or a check valve.

Furthermore, the backflow preventer (4) can be realized in the form of a drip chamber.

In another embodiment, the backflow of rinse fluid from the extracorporeal blood treatment device into the rinse bag is prevented by at least one pressure control by controlling the blood pump such that the pressure to the atmosphere at the port of the rinse bag is negative.

It is also possible to detect the backflow of the rinsing liquid from the extracorporeal blood treatment device into the rinsing bag by at least one pressure control. This is done by the temporally high-resolution monitoring of the pressure in the arterial leg, in how far pressure conditions exist or change, which lead to liquid can be transported against the hydrostatic pressure in the bag. For example, movements of the Pouch down a sinking arterial pressure, which in turn means the risk of reflux. The device would then alert and prompt for use of a sterile bag immediately or after a timer expires.

In another embodiment, the extracorporeal blood treatment device is further characterized in that a timer located on the blood treatment device measures the time the rinse bag is attached to the extracorporeal blood treatment device.

The term timer is hereby understood to mean a timer which measures the time and, if appropriate, can trigger an alarm. Alternatively, a corresponding message may appear on the service monitor of the extracorporeal blood treatment device. The timer may also be realized in the form of a running clock appearing in the service monitor so that the operator can see at any time how much time has already elapsed since the rinsing bag is connected to the extracorporeal blood treatment device or if the first one has already been used Reconnect can be reused or the second sterile connection must be used.

Reference character list:

LIST OF FIGURES FIG. 1

1 rinsing bag

2 venous pressure monitor

3 Venous chamber

4 non-return valves

5 Arterial pressure monitor

6 blood pump

7 timers

8 heparin reservoir

9 dialyzer inlet pressure monitor

10 Arterial chamber

1 1 outflow

12 dialyzer

13 pressure measurement and pump (dialysate side)

figure description

FIG. 1

Blood-side circuit of an extracorporeal blood treatment device with a component which prevents the return flow of the removed rinsing liquid into the rinsing bag.

The extracorporeal blood circulation essentially consists of an arterial and a venous hose system, with the dialyser in between. When rinsing, the rinsing bag (1) is connected to the arterial port and the rinsing solution is delivered through the arterial tube system from the arterial, i. Blood collection cannula, led to the dialyzer (12). Immediately after the arterial connection (4) is the backflow preventer (4), which allows the flow of the rinsing solution into the tube system, but prevents a backflow of the rinsing solution into the rinsing bag. The transport of the rinse solution is done by a blood pump (6). The rinse solution is pumped into the arterial chamber (10). From here, the rinsing solution / blood is pumped into the dialyzer (12), passes from there via the venous tube system to the venous chamber (3) and is discarded via the venous connection. Both in the arterial and venous hose system is ever a pressure monitor (2, 5), which monitors the pressure conditions in the bloodstream during dialysis. Furthermore, another pressure monitor (9) monitors the dialyzer inlet. Since blood has the property of coagulating outside the body, an anticoagulant may be delivered through a heparin reservoir (8) in the arterial tubing system during dialysis. Dialysate side pump (13) pumps the dialysis fluid into the dialyzer (12). The used dialysate is discarded via the outflow (1 1). A CPU monitors the various pressure monitors and controls the pumps. The timer (7) is also controlled by the CPU and measures the time the rinse bag is attached to the extracorporeal blood treatment device.

FIG. 2

Flushing bag with two separate individually sterile connections to be opened Figure 3

Sterile outlet for a rinsing bag.

Claims

claims

1 . A method for removing rinsing fluid from a rinsing bag with at least two sterile connections and introduction of the rinsing fluid in the blood-side circuit of an extracorporeal blood treatment device, wherein per rinse and per dialysis session, the rinsing fluid is removed from the same rinsing bag, the rinsing bag only for removal and no liquid in the Rinsing bag is returned or circulated through the purge bag and a backflow of the withdrawn rinse solution is prevented in the purge bag.

2. The method of claim 1, wherein the rinsing bag is applied after removal on reapplication to the blood-side circuit of the extracorporeal blood treatment device via the second sterile port.

3. The method of claim 1 or 2, wherein the rinsing bag is determined after removal and when reapplied via a located on the blood treatment device timer, whether the first previously used port can be reused or the second sterile port must be used.

4. The method of claim 1, wherein the rinsing bag remains connected when the patient is applied.

5. The method according to any one of claims 1-4, wherein the backflow of the rinsing liquid into the rinsing bag is prevented by at least one check valve or a one-way valve on the rinsing bag and / or by at least one backflow preventer (4) on the extracorporeal blood treatment device.

6. The method according to any one of claims 1-5, wherein the backflow of the rinsing liquid is prevented in the rinsing bag by at least one pressure control in the extracorporeal blood treatment device.

A method according to any of claims 1-6, wherein the same irrigation bag is used in hypotensive events.

8. Extrakorporale blood treatment apparatus for performing a method according to any one of claims 1-7, characterized in that a backflow preventer (4) on the extracorporeal blood treatment device prevents the backflow of the withdrawn rinsing liquid into the rinsing bag.

The extracorporeal blood treatment apparatus according to claim 8, wherein said backflow preventer (4) is a one-way valve or a check valve.

10. Extrakorporale blood treatment apparatus according to claim 8, wherein the backflow preventer (4) between the rinsing bag (1) and the arterial pressure monitor (5) is arranged.

1 1. An extracorporeal blood treatment device according to claim 8, wherein the backflow of the rinsing fluid from the extracorporeal blood treatment device into the rinsing bag is prevented by at least one pressure control.

The extracorporeal blood treatment device of any one of claims 8-1, further characterized in that a timer (7) measures the time the rinse bag is attached to the extracorporeal blood treatment device.

13. Extrakorporale blood treatment device according to any one of claims 8 - 12, comprising a permanently connected during a dialysis session rinsing bag with at least two sterile connections.

14. Extrakorporale blood treatment apparatus according to any one of claims 1-13, wherein the volume removal is minimized from the bag by balancing with the requirements of the consumables used