APPARATUS FOR DETERMINING THE PERITONEAL PRESSURE

Abstract

The present invention relates to an apparatus for determining the peritoneal pressure in the abdomen of a patient and/or for determining the drainage state of the abdomen of a patient, wherein the apparatus comprises at least one pump for conveying a dialysis solution into the abdomen as well as at least one measurement device for measuring the pressure in the dialysis solution, wherein the apparatus comprises at least one control unit that is configured such that it controls the pump and the measurement device such that a first measurement of the pressure is carried out by the measurement device with a stationary pump to obtain a first measured pressure value, the pump is subsequently put into operation to convey a partial volume of the total inflow volume of the dialysis solution into the abdomen, and the pump then stops, and then a second measurement of the pressure is carried out by the measurement device to obtain a second measured pressure value.

Claims

1. An apparatus for determining the peritoneal pressure in the abdomen of a patient and/or for determining the drainage state of the abdomen of a patient, wherein the apparatus comprises at least one pump for conveying a dialysis solution into the abdomen as well as at least one measurement device for measuring the pressure in the dialysis solution, characterized in that the apparatus comprises at least one control unit that is configured such that it controls the pump and the measurement device such that a first measurement of the pressure is carried out by the measurement device with a stationary pump to obtain a first measured pressure value, the pump is subsequently put into operation to convey a partial volume of the total inflow volume of the dialysis solution into the abdomen, and the pump then stops, and then a second measurement of the pressure is carried out by the measurement device to obtain a second measured pressure value.

2. An apparatus in accordance with claim 1, characterized in that the control unit is configured such that the partial volume conveyed by the pump does not exceed a specific percentage of the overall total inflow volume administered to the patient or exactly corresponds to such a percentage.

3. An apparatus in accordance with claim 1, characterized in that the control unit is configured such that the partial volume conveyed by the pump corresponds to or does not exceed a specific absolute value.

4. An apparatus in accordance with claim 1, characterized in that the apparatus comprises at least one evaluation unit that is configured such that it determines the difference between both measured pressure values and determines the drainage state of the abdomen from the determined difference.

5. An apparatus in accordance with claim 4, characterized in that the evaluation unit is configured such that a conclusion is drawn on a drained abdomen when the difference between the two pressure values exceeds a specific absolute or relative limit value.

6. An apparatus in accordance with claim 1, characterized in that the apparatus comprises at least one evaluation unit that is configured such that it determines the difference between both pressure values and determines the peritoneal pressure from the determined difference.

7. An apparatus in accordance with claim 6, characterized in that the evaluation unit is configured such that the peritoneal pressure is considered equivalent to the first measured pressure value when the difference between the two pressure values exceeds a specific absolute or relative limit value.

8. An apparatus in accordance with claim 1, characterized in that the apparatus has at least one store in which the peritoneal pressure is stored.

9. A peritoneal dialysis machine comprising at least one apparatus in accordance with claim 1.

10. A peritoneal dialysis machine in accordance with claim 9, characterized in that the machine has means for generating an alarm in dependence on the measured pressure; and in that the means are configured such that the determined peritoneal pressure is taken into account on the generation of the alarm.

11. A method of determining the peritoneal pressure in the abdomen of a patient and/or for determining the drainage state of the abdomen of a patient, with the method comprising the introduction of dialysis solution into the abdomen of the patient, and with the method comprising the following steps: a. measuring a first pressure value of the dialysis solution while the pump for conveying the dialysis solution is stationary; b. conveying a partial volume of the total inflow volume of the dialysis solution into the abdomen; and c. stopping the pump and measuring a second pressure value of the dialysis solution with a stationary pump.

12. A method in accordance with claim 11, characterized in that the partial volume conveyed by the pump does not exceed a specific percentage of the overall total inflow volume administered to the patient or exactly corresponds to such a percentage.

13. A method in accordance with claim 11 or claim 12, characterized in that the partial volume conveyed by the pump corresponds to or does not exceed a specific absolute value.

14. A method in accordance with claim 11, characterized in that the difference between two measured pressure values is determined and the drainage state of the abdomen is determined from the determined difference.

15. A method in accordance with claim 14, characterized in that a conclusion is drawn on a drained abdomen when the difference between the two pressure values exceeds a specific absolute or relative limit value.

16. A method in accordance with claim 11, characterized in that the difference between both pressure values is determined and the peritoneal pressure is determined from the determined difference.

17. A method in accordance with claim 16, characterized in that the peritoneal pressure is considered equivalent to the first measured pressure value when the difference between the two pressure values exceeds a specific absolute or relative limit value.

18. A method in accordance with claim 11, characterized in that the peritoneal pressure is saved.

Description

[0040] There are shown:

[0041] FIG. 1: the temporal desired and actual development of the filling volume in the abdomen during a peritoneal dialysis treatment; and

[0042] FIG. 2: the pressure values associated with the measured points in FIG. 1.

[0043] FIG. 1 shows the treatment volume, i.e. the volume of the dialysis solution administered to the patient in the course of a peritoneal dialysis treatment over time.

[0044] In this respect, the line A represents the time development of the prescribed treatment volume and the line B represents the time development of the actually conveyed volume, i.e. the volume of dialysis solution in the abdomen of the patient.

[0045] FIG. 1 shows a so-called tidal treatment that is divided into two base cycles and two tidal cycles. In a base cycle, the abdomen of the patient is completely drained of the dialysis solution; in the tidal cycles, a residual volume of the dialysis solution remains in the abdomen, i.e. no complete drainage of the abdomen of dialysis solution takes place.

[0046] The dots X1 to X13 on the line B mark the times of the pressure measurements. The pressure values obtained in this process can be seen from FIG. 2.

[0047] At the measurement point X2, the abdomen is completely drained, i.e. there is no longer any dialysis solution in the abdomen. The pressure adopts a minimal value, as can be seen from FIG. 2. In the example shown here the vacuum amounts to approximately 92 mbar. During draining, the pressure in the abdomen or in the dialysis solution decreases greatly as can be seen from a comparison of the measurement values X1 and X2.

[0048] If, starting from the drained state of the abdomen, i.e. starting from point X2, a partial volume of dialysis solution is introduced into the abdomen, the point X3 results. In the example shown here, the partial volume amounts to approximately 100 ml.

[0049] The pressure increase between the points X2 and X3 is substantial, as can be seen from FIG. 2. The same situation results for the completely drained state at measurement point X8. The supply of a quantity of dialysis solution (approx. 100 ml) that is small in comparison with the total inflow volume (approx. 2 l) produces a substantial increase in the measured pressure. This large pressure difference allows the conclusion that a complete drainage of the abdomen took place. It can be recognized in this manner that the abdomen has been drained. Apart from this, the peritoneal pressure can be determined, i.e. the pressure in the drained state of the abdomen (in the embodiment approx. 93 mbar vacuum at the measurement points X2 and X8).

[0050] The pressure measurement at X2 and X2 takes place with a stationary pump. A partial volume of the dialysis solution is subsequently introduced, the pump is stopped and the pressure is measured again (pressure measurement at X3 and at X9). As stated, it can be concluded from the pressure difference shown in FIG. 2 that the abdomen was drained.

[0051] A different situation results if, in contrast, there is still a residual volume in the abdomen, as is the case at measurement points X5 and X11, and if the method is then likewise carried out, i.e. pressure measurement in the stationary dialysis solution at X5 and X11, introduction of a partial volume by means of the pump, stopping the pump, and repeat pressure measurement at the measurement points X6 and X12.

[0052] As can be seen from FIG. 2, the pressure increase between X5 and X6 and between X11 and X12 is comparatively small. This allows the conclusion that there was no complete drainage of the abdomen at the points X5 and X11, which is correct, as can be seen from FIG. 1, since only a portion of the total dialysis solution in the abdomen was drained between the points X4 and X5 and between the points X10 and X11. The vacuum measured at X5 and X11 (approx. 20 mbar in the embodiment) is thus not representative for the peritoneal pressure.