WO2018041622A1 - Installation de traitement du sang et procédé pour faire fonctionner un dispositif de traitement du sang - Google Patents

Installation de traitement du sang et procédé pour faire fonctionner un dispositif de traitement du sang Download PDF

Info

Publication number
WO2018041622A1
WO2018041622A1 PCT/EP2017/070634 EP2017070634W WO2018041622A1 WO 2018041622 A1 WO2018041622 A1 WO 2018041622A1 EP 2017070634 W EP2017070634 W EP 2017070634W WO 2018041622 A1 WO2018041622 A1 WO 2018041622A1
Authority
WO
WIPO (PCT)
Prior art keywords
chamber
balancing
chamber half
balancing chamber
liquid
Prior art date
Application number
PCT/EP2017/070634
Other languages
German (de)
English (en)
Inventor
Manfred Weis
Arne Peters
Christoph Wiktor
Stefan Kreber
Gerhard Mager
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
Priority to CN201780052031.3A priority Critical patent/CN109641096B/zh
Publication of WO2018041622A1 publication Critical patent/WO2018041622A1/fr

Links

Classifications

    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A61M1/1694—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3424—Substitution fluid path
    • A61M1/3431—Substitution fluid path upstream of the filter
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3424—Substitution fluid path
    • A61M1/3431—Substitution fluid path upstream of the filter
    • A61M1/3434—Substitution fluid path upstream of the filter with pre-dilution and post-dilution
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3424—Substitution fluid path
    • A61M1/3437—Substitution fluid path downstream of the filter, e.g. post-dilution with filtrate
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/3472—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration with treatment of the filtrate
    • A61M1/3482—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration with treatment of the filtrate by filtrating the filtrate using another cross-flow filter, e.g. a membrane filter

Definitions

  • the invention relates to a blood treatment device with an extracorporeal blood circulation and a fluid system which is separated from the extracorporeal blood circulation by a semipermeable membrane of a filter having a first filter chamber and a second filter chamber, wherein the first filter chamber is part of
  • Extracorporal blood circulation and the second filter chamber is part of the fluid system and the fluid system comprises means for balancing fresh and used treatment liquid. Moreover, the invention relates to a method for operating such a blood treatment device.
  • Dialysis fluid and the used dialysis fluid discharged from the filter taking into account the amount of fluid removed from the patient via the membrane of the filter over the entire treatment time.
  • Ultrafiltration withdrawn amount of liquid can be supplied to the patient with controlled dehydration as a substituent partially or completely.
  • the supply of substituate in the extracorporeal blood circulation upstream of the dialyzer is referred to as pre-dilution and the supply of substituate downstream of the dialyzer is referred to as post-dilution. Both methods can also be combined with each other.
  • the accuracy of the accounting is very high demands. This presupposes that with the balancing systems an exact balancing of fresh and used dialysis fluid is possible.
  • the prior art includes balancing systems that have balancing chambers which are divided by a flexible membrane into two balancing chamber halves.
  • DE-A-28 38 414 describes a dialysis machine with a balancing system, which has two balancing chambers whose balancing chamber halves are alternately filled with fresh dialysis fluid with rejection of used dialysis fluid from the other chamber half.
  • the part of the fluid circuit enclosed between the balancing system and the dialyzer therefore behaves like a closed system whose volume is constant. Via an ultrafiltration pump, liquid can be withdrawn from the closed system.
  • the membrane of the known balancing chambers is not permeable to the substances contained in the dialysate, so that a mass transfer can not take place.
  • Balancing systems which have only one balance chamber which is not subdivided by a membrane into two chamber halves. In these
  • Balancing chambers displaced in the chamber spent dialysate is displaced by inflowing dialysate.
  • the invention has for its object to provide a blood treatment device with improved balancing and a method for operating a
  • the blood treatment device has a volumetric balancing system with a balancing chamber.
  • the balancing chamber according to the invention is characterized in that the first balancing chamber half and the second balancing chamber half of the balancing chamber are separated by a membrane, which is a semi-permeable membrane, so that a mass transfer between the first and second chamber halves is possible via the semipermeable membrane. Consequently, the balance chamber can also act as a filter.
  • the balancing chamber according to the invention can in different ways in the
  • Liquid system of a blood treatment device are involved.
  • Balance chamber can be used in different blood treatment methods, for example, in a hemodialysis or hemofiltration or a
  • the treatment liquid can in a known manner by means of pumps in
  • the liquid lines can be arranged such that the treatment liquid, in particular dialysate, along the
  • the semipermeable membrane through which a chamber half, along the membrane through the other half of the chamber or through the membrane flows from one to the other half of the chamber.
  • the liquid flow can be interrupted in the other chamber halves.
  • the fluid system may be connected to an inlet and / or outlet of the first
  • Balancing half include connected fluid lines and / or connected to an inlet and / or outlet of the second balancing chamber half fluid lines.
  • the control of the pumps and the shut-off can be done with a control unit.
  • the operation of the blood treatment device can take place in successive working cycles, which can each comprise two work cycles.
  • the work cycles may include other work cycles.
  • control unit for controlling the pumps and shut-off valves is configured such that flows in a first cycle of a cycle of successive cycles, treatment liquid, in particular dialysate, via the semipermeable membrane of the balance chamber from the first balance chamber half in the second balancing chamber half, and in a second work cycle
  • treatment liquid in particular dialysate, from the second filter chamber of the filter, which is part of the
  • Fluid system is, in the first balance half of the balance and the second
  • Treatment liquid the semipermeable membrane of the balance chamber.
  • Treatment liquid the semipermeable membrane of the balance chamber.
  • extracorporeal blood circulation fluid can be withdrawn.
  • This liquid can from the second filter chamber in the first balance half of the balance and from the second
  • Balancing chamber half to a connection of a leading to the first filter chamber blood supply line (predilution) and / or outgoing from the first filter chamber discharge line (postdilution) flow (hemofiltration).
  • predilution blood supply line
  • postdilution postdilution
  • an exchange of fresh and used treatment liquid can take place.
  • the fresh dialysate may be provided in a dialysate source and directed to a drain.
  • Balance chamber half incoming fresh dialysate displaces the dialysate located in the first and second balancing chamber half, which can flow into the drain.
  • the volume of dialysate relevant for balancing is determined by the volume of dialysate
  • the timing can also be effected as a function of the substance concentration, flow rate, pressure, etc., wherein these quantities can be measured with suitable sensors in the liquid system.
  • control unit for controlling the pumps and shut-off devices is configured such that in a first cycle of a cycle of successive working cycles treatment liquid flows through the semi-permeable membrane of the balancing chamber from the first balancing chamber half into the second balancing chamber half, and in a second Working cycle of
  • treatment liquid again from the second filter chamber of the filter which is part of the fluid system, can flow into the first balance half and out of the second balance chamber half into the second filtration chamber so that dialysate circulates in the fluid system (hemodialysis).
  • treatment liquid flows through the semipermeable membrane of the balance chamber again.
  • liquid can be withdrawn from the extracorporeal blood circulation in the first working cycle via the semipermeable membrane of the filter.
  • the liquid can flow from the second filter chamber into the first balance half of the balance and out of the second balance chamber half to a connection of a blood supply line (predilution) leading to the first filter chamber and / or a discharge line (postdilution) leaving the first filter chamber (hemofiltration).
  • a blood supply line predilution
  • postdilution discharge line
  • Balancing chamber half fresh dialysate displaces the dialysate located in the first and second balancing chamber, which can flow into the drain.
  • the blood treatment device according to the invention can also have a
  • the blood treatment device according to the invention and the method according to the invention allow both the use of a filter as balance chamber both balancing and a material separation.
  • an additional barrier can be created.
  • a concentration or concentration of certain substances in one of the balance chamber halves is possible.
  • the entire blood treatment device can have a compact construction with the balancing chamber according to the invention.
  • 1A the balance chamber of the blood treatment device according to the invention in a simplified schematic representation
  • 1B is a simplified schematic representation of a formed as a hollow fiber filter 1 balance chamber
  • Fig. 2A shows a first switching state of the balance chamber in a power stroke of a
  • Fig. 2B shows a second switching state of the balance chamber in a power stroke of a
  • 2C shows a third switching state of the balancing chamber in a working cycle of a
  • FIG. 2D shows a fourth switching state of the balancing chamber in a working cycle of a
  • 2F shows a sixth switching state of the balancing chamber in a working cycle of a
  • Fig. 3 shows a first embodiment of the invention
  • Fig. 4 shows a second embodiment of the invention
  • Fig. 5 shows a third embodiment of the invention
  • Fig. 6 shows a fourth embodiment of the invention
  • FIG. 1A shows a balance chamber 1 in a simplified schematic representation.
  • the balancing chamber 1 has a rigid housing 2, which is divided into a first balancing chamber half 4 and a second balancing chamber half 5 by a semi-permeable membrane 3, which is a rigid diaphragm.
  • the semipermeable membrane 3 is impermeable to low permeability materials, such as urea or beta 2 microglobulin, and permeable to high permeability materials, such as water.
  • both chamber halves have the same volume.
  • an asymmetric division into chamber halves with different volumes is possible.
  • the first balancing chamber half 4 has an inlet 4A and an outlet 4B and the second balancing chamber half 5 has an inlet 5A and an outlet 5B.
  • liquid lines for example hose lines
  • the supply or discharge of liquid into and out of the chamber halves can be interrupted by means of shut-off devices 6 which are only shown as a hint. Arrows indicate the flow direction in and out of the chamber halves.
  • Fig. 1B shows an embodiment of a balance chamber 1, which is designed as a hollow fiber filter.
  • the low permeability fabrics are bright dots and the high permeability fabrics are dark dots.
  • the outlet 4B of the first chamber half and the inlet 5A of the second chamber half are closed, while the inlet of the first balancing chamber half 4A and the outlet 5B of the second balancing chamber half are open. For example, if the fabric is high
  • Permeability to water and the low permeability material is urea
  • the high permeability water flows through the semipermeable membrane formed by the hollow fiber bundle from the first balancing chamber half to the second
  • the semipermeable membrane retains the low permeability materials, such as urea.
  • FIG. 2A shows a switching state in which the inlet 4A of the first balancing chamber half 4 and the outlet 5B of the second balancing chamber half 5 are open and the outlet 4B of the first balancing chamber half 4 and the inlet 5A of the second balancing chamber half 5 are closed.
  • FIG. 2B shows a switching state in which the inlet 4A and the outlet 4B of the first balancing chamber half 4 are opened and the inlet 5A and the outlet 5B of the second balancing chamber half 5 are closed. The liquid flows through the first
  • Balance chamber half 5 can get (clock B).
  • FIG. 2C shows a switching state in which the inlet 4A of the first balancing chamber half 4 and the outlet 5B of the second balancing chamber half 5 are closed and the outlet 4B of the first balancing chamber half 4 and the inlet 5A of the second balancing chamber half 5 are opened.
  • the high permeability materials flow through the balancing chamber 1, with the low permeability substances being retained by the semipermeable membrane 3 (clock C).
  • FIG. 2D shows a switching state in which the inlet 4A and the outlet 4B of the first balancing chamber half 4 are closed and the inlet 5A and the outlet 5B of the second balancing chamber half 5 are opened.
  • the liquid flows through the second Balance chamber half 5, with substances with a high permeability in the first
  • Balance chamber half 4 can pass (clock B).
  • Figures 2E and 2F show the switching states of Figures 2A and 2B, respectively, wherein a liquid is supplied to the inlet with both a low permeability material and a high permeability material ( Figure 2E) and a liquid having a high permeability fabric at the inlet is supplied (Fig. 2F). It turns out that the low-permeability substance is retained by the semipermeable membrane 3 and does not enter the second balancing chamber half 5.
  • Fig. 3 shows a simplified schematic representation of an inventive
  • Blood treatment device having the balance chamber according to the invention.
  • the blood treatment apparatus in the present embodiment is one
  • the Hämodialy sevoroplasty has a filter 10 (dialyzer), which passes through a semi-permeable membrane 11 into a first filter chamber 12 and a second filter chamber
  • a blood supply line At the inlet 12A of the first filter chamber 12 is a blood supply line
  • a Blutabrios Gustav 15 is connected.
  • the blood of the patient is conveyed in the extracorporeal blood circulation I with a blood pump 16 which is provided in the blood supply line 14.
  • the liquid system II has the balancing chamber 17 described with reference to FIGS. 1A and 1B and FIGS. 2A to 2F, which is subdivided by a semipermeable membrane 18 into a first balancing chamber half 19 and a second balancing chamber half 20.
  • the first balancing chamber half 19 has an inlet 19A and an outlet 19B, while the second balancing chamber half 20 has only one outlet 20B.
  • liquid system II has a dialysate source 21 for fresh dialysate, which via a first liquid line 22 to the inlet 19A of the first
  • Balancing chamber half 19 is connected.
  • the dialysate is conveyed into the first balancing chamber half 19 with a first pump 23, which is provided in the first liquid line 22.
  • a first obturator 24, for example an electromagnetically actuated hose clamp, is provided in the first fluid line 22.
  • the outlet 13B of the second filter chamber 13 is connected to the first liquid line 22 via a second liquid line 25.
  • the connection point 26 of the second liquid line 25 to the first liquid line 22 is between the first obturator 24 and the first pump 23.
  • the second liquid line 25 may also be connected downstream of the pump to the first liquid line or to the inlet of the first balance chamber half.
  • a second obturator 27 is provided in the second liquid line 25, a second obturator 27 is provided.
  • the outlet 19B of the first balancing chamber half 19 is connected via a third fluid line 28 to a drain 29, so that used dialysate can flow off.
  • a third obturator 30 is provided in the third liquid line 28, so that used dialysate can flow off.
  • the outlet 20B of the second balancing chamber half 20 is over a fourth
  • Liquid line 31 in which a fourth obturator 32 is provided, connected to the inlet 13 A of the second filter chamber 13.
  • a second pump 33 is provided which promotes dialysate from the second balancing chamber half 20 into the second filter chamber 13.
  • the blood treatment device may also have an ultrafiltration device which has an ultrafiltration pump 34 which extracts ultrafiltrate from the liquid system II.
  • the ultrafiltration pump 34 is in a fifth fluid line 35
  • the blood treatment device has a central control unit 36, via control lines not shown with the first and second pump 23, 33 and the ultrafiltration pump 34 in the fluid system II and the blood pump 16 in the extracorporeal blood circulation I and the shut-off valves 24, 27, 30, 32nd in the Liquid system I is connected so that the flow rates of the pump can be adjusted and the shut-off valves can be actuated.
  • the control unit 36 may comprise a general processor, a digital signal processor (DSP) for continuous processing of digital signals, a microprocessor, an application specific integrated circuit (ASIC), a logic element integrated circuit (FPGA), or other integrated circuits (IC) or hardware devices. Have components to perform the individual process steps. A data processing program (software) can be run on the hardware components to carry out the method steps. It is also possible a plurality or combination of the various components.
  • the control unit 36 is configured such that the subsequent work cycles are carried out in successive work cycles.
  • the successive working cycles each comprise two work cycles.
  • the control unit 36 controls the shut-off devices in such a way that the first and third obturators 24, 30 are closed and the second and fourth obturators 27, 32 are open. Consequently, the balance chamber is operated in the switching state of the take C (Fig. 2C).
  • the control unit controls the
  • dialysate flows from the second filter chamber 13 into the first balancing chamber half 19, from the first balancing chamber half through the semipermeable membrane 18 into the second balancing chamber half 20, from the second balancing chamber half into the second filtering chamber 13 (dialysate chamber) and out of the second filter chamber 13 Substances with a low permeability in the dialysate, such as urea, are retained by the semipermeable membrane 18, so that these substances are concentrated in the first balance chamber half.
  • the dialysate is conveyed by the first and second pumps 23, 33.
  • dialysate flows from the dialysate source 21 into the first
  • the clock C is used to exchange liquid in the dialyzer, wherein blood and dialysate flow in DC. However, the flow of blood and dialysate can also be carried out in countercurrent with an appropriate configuration.
  • the clock D is used to exchange liquid in the balance chamber with filter function.
  • Fluid system is given an additional barrier to the patient.
  • Fig. 4 shows an embodiment in which the blood treatment device is a hemofiltration device.
  • the hemofiltration device has a filter 10, which is subdivided by a semipermeable membrane 11 into a first filter chamber 12 and a second filter chamber 13.
  • a blood supply line 14 To the inlet 12A of the first filter chamber 12 is a blood supply line 14 and to the outlet 12B of the first filter chamber 12 is a
  • Blood discharge line 15 connected.
  • the blood of the patient is conveyed in the extracorporeal blood circulation I with a blood pump 16 which is provided in the blood supply line 14.
  • the fluid system II has the balancing chamber 17 described with reference to FIGS. 1A and 1B and FIGS. 2A to 2F.
  • the first balancing chamber half 19 has an inlet 19A and an outlet 19B, while the second balancing chamber 19
  • Balance chamber half 20 has only one outlet 20B.
  • the fluid system II has a dialysate source 21 for fresh dialysate, which is connected via a first fluid line 37 to a branch 38, which leads to the inlet 19A of the first balancing chamber half 19.
  • the dialysate can be conveyed from the dialysate source 21 into the first balancing chamber half 19 with a first pump 39, which is provided in the first fluid line 37.
  • a first obturator 40 for example an electromagnetically actuated hose clamp, is provided in the first fluid line 37.
  • the outlet 13B of the second filter chamber 13 is connected via a second liquid line 41 to the branch 38 leading to the inlet 19A of the first
  • Balancing chamber half 19 leads.
  • a second pump 42 is provided in the second liquid line 41. Downstream of the second pump 42, a second shut-off device 43 is provided in the second liquid line 41.
  • the outlet 19B of the first balancing chamber half 19 is connected to the outlet 29 via a third fluid line 44.
  • the third liquid line 44 is third
  • the fourth fluid conduit 46 branches into first and second portions 46A, 46B, with the first portion 46A leading to a port of the blood supply conduit 14 upstream of the filter 12 and the second portion 46B leading to a port of the blood discharge conduit 15 downstream of the filter such that substituate the extracorporeal blood circulation upstream of the filter (predilution) or downstream of the filter (postdilution) can be supplied.
  • a further obturator 48A, 48B is provided, so that it is possible to switch between a predilution and / or postdilution.
  • the blood treatment device may also have an ultrafiltration device having an ultrafiltration pump 34, which withdraws ultrafiltrate from the fluid system I.
  • the ultrafiltration pump 34 is provided in a fifth liquid line 35 which is connected to the second liquid line 41.
  • the control unit 36 is configured in the hemofiltration device such that the subsequent work cycles are carried out in successive working cycles.
  • the successive working cycles each comprise two work cycles.
  • the control unit 36 controls the shut-off devices such that the second and fourth obturator 43, 47 open and the first and third obturator 40, 45 are closed. Consequently, the balance chamber is operated in the switching state of the clock E in a horizontally mirrored representation (Fig. 2E).
  • the control unit controls the shut-off devices such that the second and fourth
  • dialysate flows from the dialysate source 21 into the first
  • Hemofiltration takes place in the cycle E and in the cycle F an exchange of liquid takes place in the balancing chamber with filter function.
  • An advantage of using the balance chamber with filter function in this application is that the substituate is given a barrier to the patient.
  • Fig. 5 shows another embodiment in which the blood treatment device is a hemodialysis device.
  • the hemodialysis apparatus has a filter 10 (dialyzer), which is subdivided by a semi-permeable membrane 11 into a first filter chamber 12 and a second filter chamber 13. To the inlet 12A of the first
  • Filter chamber 12 is a blood supply line 14 and to the outlet 12B of the first
  • Filter chamber 12 is connected to a Blutab réelle effet 15.
  • the patient's blood will promoted in extracorporeal blood circulation I with a blood pump 16, which in the
  • Blood supply line 14 is provided.
  • the fluid system II has the balancing chamber 50 described with reference to FIGS. 1A and 1B and FIGS. 2A to 2F, which is divided by a semipermeable membrane 51 into a first balancing chamber half 52 and second balancing chamber half 53.
  • the first balance chamber half 52 has an inlet 52A and an outlet 52B
  • the second balance chamber half 53 has an inlet 53A and an outlet 53B.
  • the outlet 13B of the second filter chamber 13 is connected via a first fluid line 54 to the inlet 52A of the first balancing chamber half 52.
  • Liquid line 54 a first pump 55 is provided downstream of the first pump 55. Downstream of the first pump 55, a first obturator 56 is provided in the first fluid line 54.
  • Liquid line 57 in which a second obturator 58 is provided, to a drain 29th
  • the fluid system I has a dialysate source 21 for fresh dialysate, which via a third fluid line 59 with the inlet 53 A of the second
  • the dialysate can be in the second
  • Liquid line 59 is provided downstream of the second pump 60. Downstream of the second pump 60, a third obturator 61, for example an electromagnetically actuated hose clamp, is provided in the third fluid line 59.
  • a third obturator 61 for example an electromagnetically actuated hose clamp
  • the outlet 53B of the second balance chamber half 53 is over a fourth
  • Liquid line 62 in which a fourth obturator 63 is provided, connected to the inlet 13 A of the second filter chamber 13.
  • the blood treatment device may also have an ultrafiltration device having an ultrafiltration pump 34, which withdraws ultrafiltrate from the fluid system I.
  • the ultrafiltration pump 34 is in a fifth fluid line 35
  • the control unit 36 is configured in this embodiment of the Hamödialysevorraum such that in successive working cycles, the subsequent work cycles are performed.
  • the successive working cycles each comprise two work cycles.
  • the control unit 36 controls the shut-off devices in such a way that the first and fourth obturators 56, 63 are opened and the second and third obturators 58, 61 are closed. Consequently, the balance chamber 50 is operated in the switching state of the take A (Fig. 2A).
  • the control unit controls the
  • Dialysathunt in the first balance chamber half 52, from the first half balance chamber through the semi-permeable membrane 51 in the second balance chamber half 53, from the second balance chamber half in the second filter chamber 13 (dialysate) and from the second filter chamber 13 back into the first balance chamber half.
  • the dialysate is conveyed by the first pump 55.
  • Low permeability substances are retained by the semipermeable membrane, so that these substances in the first
  • dialysate flows from the Dialy satuze 21 in the second balancing chamber half 53 and from the second balancing chamber half in the sequence 29, so that the used dialysate can drain off.
  • the dialysate is conveyed by the second pump 60.
  • the clock A serves for the circulation of dialysate through the second filter chamber
  • Dialysate chamber wherein blood and dialysate flow in countercurrent.
  • the flow of blood and dialysate can also take place in a corresponding configuration in direct current.
  • the clock C is used to exchange liquid in the
  • Balance chamber with filter function An advantage of using the balance chamber with filter function in this application is that a mixing of fresh dialysate is avoided with used dialysate.
  • Fig. 6 shows another embodiment in which the blood treatment device is a hemofiltration device.
  • the hemofiltration device has a filter 10, which is subdivided by a semipermeable membrane 11 into a first filter chamber 12 and a second filter chamber 13.
  • a blood supply line 14 To the inlet 12A of the first filter chamber 12 is a blood supply line 14 and to the outlet 12B of the first filter chamber 12, a Blutabrios effet 15 is connected.
  • the blood of the patient is conveyed in the extracorporeal blood circulation I with a blood pump 16 which is provided in the blood supply line 14.
  • the fluid system I comprises the balancing chamber 50 described with reference to FIGS. 1A and 1B and FIGS. 2A to 2F, which is divided by a semipermeable membrane 51 into a first balancing chamber half 52 and second balancing chamber half 53.
  • the first balance chamber half 52 has an inlet 52A and an outlet 52B
  • the second balance chamber half 53 has an inlet 53A and an outlet 53B.
  • the second filter chamber 13 has no inlet in the hemofiltration device but only one outlet 13B.
  • the outlet 13B of the second filter chamber 13 is connected via a first fluid line 54 to the inlet 52A of the first balancing chamber half 52.
  • a first pump 55 is provided in the first liquid line 54 . Downstream of the first pump 55 is in the first liquid line 54 a first
  • Liquid line 57 in which a second obturator 58 is provided, to a drain 29th
  • the fluid system I has a dialysate source 21 for fresh dialysate, which via a third fluid line 59 with the inlet 53 A of the second
  • the dialysate can be in the second
  • Balancing chamber half 53 are conveyed with a second pump 60 which is provided in the third fluid line 59. Downstream of the second pump 60 is provided in the third liquid line 59 in third obturator 61, for example, an electromagnetically actuated hose clamp.
  • the fourth fluid conduit 70 branches downstream of the fourth obturator 71 into first and second portions 70A, 70B, the first portion 70A leading to a connection of the blood supply line 14 upstream of the filter 10 and the second portion 70B to a connection of the blood discharge line 15 downstream of the filter 10, so that substituate may be delivered to the extracorporeal blood circuit upstream of the filter (predilution) or downstream of the filter (postdilution).
  • a further shut-off device 71A, 71B is provided, so that it is possible to switch between predilution and / or post-dilution.
  • the substituate is conveyed with a third pump 73 (Substituatpumpe), in the fourth
  • Liquid line 70 is provided downstream of the third obturator 71.
  • the blood treatment device may also have an ultrafiltration device having an ultrafiltration pump 34, which withdraws ultrafiltrate from the fluid system I.
  • the ultrafiltration pump 34 is in a fifth fluid line 35 provided, which is connected to the first liquid line 54 upstream of the first pump 55.
  • the control unit 36 is configured in this embodiment of the Hamödialysevorraum such that in successive working cycles, the subsequent work cycles are performed.
  • the successive working cycles each comprise two work cycles.
  • the control unit 36 controls the shut-off devices in such a way that the first and fourth obturators 56, 71 are opened and the second and third obturators 58, 61 are closed. Consequently, the balance chamber is operated in the switching state of the take A (FIG. 2A).
  • the control unit 36 controls the
  • liquid is withdrawn from the second filter chamber 12 with the first pump 55.
  • the liquid flows into the first balancing chamber half 52, from the first balancing chamber half through the semipermeable membrane 51 into the second balancing chamber half 53 and from the second balancing chamber half to the blood feed and discharge duct 14, 15.
  • Low permeability substances are produced by the semipermeable membrane 51, so that these substances can not enter the extracorporeal blood circulation I and are concentrated in the first balance chamber half 52.
  • dialysate flows from the Dialy satuze 21 in the second balancing chamber half 53 and from the first balancing chamber half 52 in the drain 29, so that the used dialysate can flow.
  • the dialysate is conveyed by the second pump 60.
  • a hemofiltration takes place and in the cycle C there is an exchange of liquid in the balancing chamber with filter function.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Urology & Nephrology (AREA)
  • Emergency Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention concerne un dispositif de traitement du sang présentant un circuit sanguin I extracorporel et un système de liquide II, qui est séparé du circuit sanguin extracorporel par une membrane 11 semi-perméable d'un filtre 10, qui présente une première chambre 12 de filtre et une deuxième chambre 13 de filtre, la première chambre de filtre faisant partie du circuit sanguin extracorporel et la deuxième chambre de filtre faisant partie du système de liquide et le système de liquide comprenant un dispositif pour équilibrer le liquide traitement frais et usagé. L'invention concerne en outre un procédé pour faire fonctionner un tel dispositif de traitement du sang. Le dispositif de traitement du sang selon l'invention dispose d'un système d'équilibrage volumétrique présentant une chambre d'équilibrage 1 ; 20 ; 50. La chambre d'équilibrage 1 ; 20 ; 50 selon l'invention est caractérisée en ce que la première moitié 4 et la deuxième moitié 5 de la chambre d'équilibrage 1 sont séparées par une membrane 3 qui est une membrane semi-perméable, de telle sorte qu'un échange de substances entre la première et la deuxième moitié de chambre est possible via la membrane semi-perméable. Par conséquent, la chambre d'équilibrage peut également fonctionner comme filtre.
PCT/EP2017/070634 2016-08-27 2017-08-14 Installation de traitement du sang et procédé pour faire fonctionner un dispositif de traitement du sang WO2018041622A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201780052031.3A CN109641096B (zh) 2016-08-27 2017-08-14 血液治疗设备和用于运行血液治疗设备的方法

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102016010434.1A DE102016010434A1 (de) 2016-08-27 2016-08-27 Blutbehandlungsvorrichtung und Verfahren zum Betreiben einer Blutbehandlungsvorrichtung
DE102016010434.1 2016-08-27

Publications (1)

Publication Number Publication Date
WO2018041622A1 true WO2018041622A1 (fr) 2018-03-08

Family

ID=59593118

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2017/070634 WO2018041622A1 (fr) 2016-08-27 2017-08-14 Installation de traitement du sang et procédé pour faire fonctionner un dispositif de traitement du sang

Country Status (3)

Country Link
CN (1) CN109641096B (fr)
DE (1) DE102016010434A1 (fr)
WO (1) WO2018041622A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2838414A1 (de) 1978-09-02 1980-03-06 Fresenius Chem Pharm Ind Vorrichtung zur ultrafiltrationssteuerung bei der haemodialyse
EP0930080A1 (fr) * 1998-01-19 1999-07-21 Fresenius AG Méthode et dispositif de préparation de dialysate
EP1491222A1 (fr) * 2003-06-25 2004-12-29 Fresenius Medical Care Deutschland GmbH Dispositif de traitement extracorporel du sang équipé pour tester un filtre stérile et méthode associée
EP1595560A1 (fr) * 2004-05-11 2005-11-16 Fresenius Medical Care Deutschland GmbH Méthode et dispositif pour surveiller l'adduction de liquide de substitution pendant un traitement extracorporel du sang
WO2015124716A1 (fr) * 2014-02-24 2015-08-27 Aquaporin A/S Systèmes permettant d'utiliser la teneur en eau de fluides à partir d'un processus de thérapie de substitution rénale

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4308586C1 (de) 1993-03-18 1994-05-11 Fresenius Ag Hämodialysegerät mit einer Bilanzkammer
WO2007003980A1 (fr) 2005-07-01 2007-01-11 Gambro Lundia Ab Appareil et procede d'analyse de filtres
US8858787B2 (en) * 2007-10-22 2014-10-14 Baxter International Inc. Dialysis system having non-invasive fluid velocity sensing
CN202538035U (zh) * 2012-01-19 2012-11-21 广州奥柏仕医疗器械有限公司 一种血液透析系统

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2838414A1 (de) 1978-09-02 1980-03-06 Fresenius Chem Pharm Ind Vorrichtung zur ultrafiltrationssteuerung bei der haemodialyse
EP0930080A1 (fr) * 1998-01-19 1999-07-21 Fresenius AG Méthode et dispositif de préparation de dialysate
EP1491222A1 (fr) * 2003-06-25 2004-12-29 Fresenius Medical Care Deutschland GmbH Dispositif de traitement extracorporel du sang équipé pour tester un filtre stérile et méthode associée
EP1595560A1 (fr) * 2004-05-11 2005-11-16 Fresenius Medical Care Deutschland GmbH Méthode et dispositif pour surveiller l'adduction de liquide de substitution pendant un traitement extracorporel du sang
WO2015124716A1 (fr) * 2014-02-24 2015-08-27 Aquaporin A/S Systèmes permettant d'utiliser la teneur en eau de fluides à partir d'un processus de thérapie de substitution rénale

Also Published As

Publication number Publication date
DE102016010434A1 (de) 2018-03-01
CN109641096A (zh) 2019-04-16
CN109641096B (zh) 2022-08-02

Similar Documents

Publication Publication Date Title
DE19708391C1 (de) Verfahren und Vorrichtung zur Ultrafiltration bei der Hämodialyse
EP2579912B1 (fr) Dispositif et procédé de circulation de liquides dans l'unité de traitement d'un dispositif de traitement médical, en particulier dans le dialyseur d'un dispositif de dialyse
EP1348457B1 (fr) Méthode pour déterminer des paramètres de traitement utilisant un appareil d'hémofiltration et dispositif pour cela
EP2253342B1 (fr) Appareil pour traitement extracorporel du sang
EP2663345B1 (fr) Système d'alimentation pour dialyse
EP2337592B1 (fr) Dispositif pour le traitement extracorporel du sang, en fonctionnement à une seule aiguille
DE69934248T2 (de) Anlage zur nicht-isosmotischen diafiltration
DE60133148T2 (de) Hämodialfiltrationsgerät zur Blutanalyse
DE19704564A1 (de) Vorrichtung zur periodischen Spülung des extrakorporalen Kreislaufs einer Blutbehandlungseinrichtung
EP2482868B1 (fr) Dispositif de traitement par dialyse et procédé d'équilibrage du liquide de dialyse frais et usagé
EP3331587B1 (fr) Unité d'ultrafiltration portative et dispositif d'alimentation de l'unité d'ultrafiltration en liquide de dialyse
EP3238757B1 (fr) Appareil pour le traitement extracorporel du sang au moyen de changement de concentré
DE19854338A1 (de) Verfahren und Einrichtung zur Nierenersatztherapie
EP3500319A1 (fr) Dispositif et procédé pour préparer un liquide de dialyse et dispositif de dialyse
EP3079736B1 (fr) Dispositif de traitement extracorporel du sang
WO2018041622A1 (fr) Installation de traitement du sang et procédé pour faire fonctionner un dispositif de traitement du sang
DE102009048561B4 (de) Vorrichtung zur Dialysebehandlung
DE60314073T2 (de) Verfahren und Vorrichtung zur in-line Vorbereitung von Flüssigkeit für eine Vorrichtung zur Behandlung von Blut durch einen extrakorporalen Kreislauf
WO2019197314A1 (fr) Ensemble de tuyau de sang, dispositif de commande ou de réglage, dispositif de traitement de sang et procédé pour un traitement à aiguille unique
DE2755922B1 (de) Vorrichtung zur Behandlung der Niereninsuffizienz
DE102018118564A1 (de) Vorrichtung und Verfahren zur Herstellung einer Dialyselösung
EP3996768A1 (fr) Appareil de dialyse à trois chambres d'équilibrage
DE102019118548A1 (de) Dialysegerät und Verfahren zum Betreiben eines Bilanzkammersystems eines Dialysegerätes
DE2832870A1 (de) Geraetekonzept zur behandlung eines patienten bei akuter oder chronischer niereninsuffizienz

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 17751773

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 17751773

Country of ref document: EP

Kind code of ref document: A1