APPARATUS FOR CARRYING OUT A TIDAL PERITONEAL DIALYSIS TREATMENT

Abstract

The present invention relates to an apparatus for carrying out a tidal peritoneal dialysis treatment of a patient, wherein the dialysis treatment comprises a sequence of cycles which each have a filling period, a dwell period and a drain period, wherein the apparatus has at least one cycler which is suitable for filling the abdominal cavity of the patient with a specific inflow volume of fresh dialysis solution up to a reaching of a specific patient volume in the filling period and for emptying consumed dialysis solution from the abdominal cavity of the patient up to a reaching of a specific tidal outflow target in the drain period, wherein the apparatus furthermore has at least one processor which controls the cycler in at least one operating mode such that the drain period is ended before reaching the tidal outflow target so that a permitted residual volume remains in the abdominal cavity and then a switch is made to a filling period and in that the filling period is carried out such that the filling volume of the patient lies at a permitted patient volume above the specific patient volume on the completion of the filling period.

Claims

1. An apparatus for carrying out a tidal peritoneal dialysis treatment of a patient, wherein the dialysis treatment comprises a sequence of cycles which each have a filling period, a dwell period and a drain period, wherein the apparatus has at least one cycler which is suitable for filling the abdominal cavity of the patient with a specific inflow volume of fresh dialysis solution up to a reaching of a specific patient volume in the filling period and for emptying consumed dialysis solution from the abdominal cavity of the patient up to a reaching of a specific tidal outflow target in the drain period characterized in that the apparatus furthermore has at least one processor which controls the cycler in at least one operating mode such that the drain period is ended before reaching the tidal outflow target so that a permitted residual volume remains in the abdominal cavity and then a switch is made to a filling period and in that the filling period is carried out such that the filling volume of the patient lies at a permitted patient volume above the specific patient volume on the completion of the filling period.

2. An apparatus in accordance with claim 1, characterized in that the permitted residual volume and/or the permitted patient volume can be adjusted.

3. An apparatus in accordance with claim 1, characterized in that the permitted residual volume and the permitted patient volume can be adjusted independently of one another.

4. An apparatus in accordance with claim 1, characterized in that the processor is configured such that the selection of the operating mode depends on the reaching of the tidal outflow target.

5. An apparatus in accordance with claim 1, characterized in that the processor is configured such that time at which the drain period is ended depends on at least one parameter, with this parameter being one or more of the values achieved volume; flow rate during the drain period; and pressure in the abdominal cavity of the patient.

6. An apparatus in accordance with claim 1, characterized in that the processor is configured such that the switchover value at which the drain period is ended amounts to a specific percentage of the tidal outflow target or of the specific inflow volume, with provision preferably being made that the percentage lies in the range from above 0 to 60%, and preferably in the range from 10 to 50%, of the tidal outflow target or of the specific inflow volume.

7. An apparatus in accordance with claim 1, characterized in that the processor is configured such that the permitted patient volume or the volume added within the course of a filling period lies in the range from above 100 to 150%, preferably in the range from above 100 to 120%, and particularly preferably in the range from above 100 to 130%, of the specific patient volume or of the specific inflow volume.

8. A method for carrying out a tidal peritoneal dialysis treatment which comprises a sequence of cycles which respectively have a filling period, a dwell period and a drain period, with the filling of the abdominal cavity of the patient with a specific inflow volume of fresh dialysis solution up to a reaching of a specific patient volume taking place during the filling period and with the emptying of consumed dialysis solution from the abdominal cavity of the patient up to a reaching of a specific tidal outflow target taking place in the drain period, characterized in that the drain period is ended before reaching the tidal outflow target in at least one operation mode so that a permitted residual volume remains in the abdominal cavity and then a switchover into a filling period takes place and in that the filling period is carried out such that the filling volume of the patient lies above the specific patient volume one an ending of the filling period at a permitted patient volume.

9. A method in accordance with claim 8, characterized in that the permitted residual volume and/or the permitted patient volume can be adjusted.

10. A method in accordance with claim 8, characterized in that the permitted residual volume and the permitted patient volume can be set independently of one another.

11. A method in accordance claim 8, characterized in that the selection of the operating mode depends on the reaching of the tidal outflow target.

12. A method in accordance with claim 8, characterized in that the time at which the drain period is ended depends on at least one parameter, with the parameter being one or more of the values reached drain volume; flow rate during the drain period; and pressure in the abdominal cavity of the patient.

13. A method in accordance with claim 8, characterized in that the switchover value at which the drain period is ended amounts to a specific percentage of the tidal outflow target or of the specific inflow volume, with provision preferably being made that the percentage lies in the range from above 0 to 602%, and preferably in the range from 10 to 50%, of the tidal outflow target or of the specific inflow volume.

14. A method in accordance with claim 8, characterized in that the permitted patient volume or the inflow volume added within the course of the filling period lies in the range from above 100 to 150%, preferably in the range from above 100 to 120%, and particularly preferably in the range from above 100 to 130%, of the specific patient volume or of the specific inflow volume.

Description

[0033] Further details and advantages of the invention will be explained in more detail with reference to an embodiment shown in the drawing.

[0034] There are shown:

[0035] FIG. 1: time schedule of a tidal peritoneal dialysis treatment with a lower swichover point;

[0036] FIG. 2: time schedule of a tidal peritoneal dialysis treatment with an upper and a lower switchover point;

[0037] FIG. 3: time schedule of a tidal peritoneal dialysis treatment with a lower switchover point with a marking of the superimposed switchover point in the outflow and an increased volume toleration in the inflow; and

[0038] FIG. 4: time schedule of a tidal peritoneal dialysis treatment in accordance with the prior art.

[0039] FIG. 1 shows the time development of a tidal peritoneal dialysis treatment in accordance with FIG. 4 with a superimposed lower volume management limit in the form of the line U. This line represents the switchover point or the volume value on whose falling below a switchover to the next filling period takes place in the drain period in accordance with the operating mode in accordance with the invention. As can be seen from FIG. 1, this line is above the switchover points on a procedure in accordance with the prior art. The latter lie at a volume of 1100 ml in the embodiment shown here. The line U or the switchover points in accordance with the invention lie at a volume of 1400 ml or in a volume range of >1100 ml to 1400 ml. The volume values given are the volume of the dialysis solution in the abdominal cavity of the patient. The volume of the dialysis solution in the patient at the line U is called a permitted residual volume within the framework of the invention.

[0040] FIG. 2 shows the time development of a tidal peritoneal dialysis treatment in accordance with FIG. 1 with a superimposed upper volume management limit in the form of the line O. This line represents the switchover point or the volume value on whose reaching or exceeding an ending of the filling period and a start of the dwell period takes place. As can be seen from FIG. 2, this line O is above the upper switchover points (switchover to the dwell period) on a procedure in accordance with the prior art. The latter lie at a volume of 2700 ml in the embodiment shown here. The line O or the switchover points in accordance with the invention lie at a volume of 2900 ml or in a volume range of >2700 ml to 2900 ml. The volume values given are the volume of the dialysis solution in the abdominal cavity of the patient. The volume of the dialysis solution in the patient at the line O is called a permitted patient volume within the framework of the invention. FIG. 2 thus illustrates the additional volume toleration in the inflow, i.e. during the filling period.

[0041] FIG. 3 illustrates that the tidal outflow target (volume 1100 ml) in the second cycle is not reached or is at least not reached within a specific time period because the outflow speed is comparatively small as can be recognized by the lower inclination of the line.

[0042] This has the result that the draining is aborted at the time marked by a) before the tidal outflow target is reached and a switchover to a new filling period is made.

[0043] An increased residual volume is thus accepted. In order nevertheless to be able to dispense a sufficient volume of dialysis solution, an exceeding of the specific patient volume to the amount of 2700 ml is accepted in the following filling period and the filling period is extended until the patient volume, i.e. the volume of dialysis solution in the patient, amounts to 2900 ml.

[0044] If filling took place in this filling period only up to the specific patient volume to the amount of 2700 ml, only a smaller volume of dialysis solution could be dispensed overall in the predetermined treatment time or one or more further cycles would be necessary on an exceeding of the predetermined treatment time.

[0045] It is possible with the volume management in accordance with the invention already to fix a higher outflow volume in the prescription and thus to achieve a more efficient use of the dialysis solution.

[0046] The necessity of carrying out one or more additional cycles can be omitted with the procedure in accordance with the invention. Furthermore, a shortening of the dwell times can be avoided and the patient can nevertheless end the treatment at the provided time.