DIALYSIS MACHINE AND METHOD OF OPERATING A BALANCING CHAMBER SYSTEM OF A DIALYSIS MACHINE

Abstract

The present invention relates to a dialysis machine having a dialyzer and having a first balancing chamber and having a second balancing chamber of which each has at least two first and second balancing chamber halves separated from one another by a movable wall, wherein each first balancing chamber half is provided with a respective first inflow and with a respective first outflow, wherein the first inflows of the first balancing chamber halves are in fluid communication with a source of fresh dialyzate and the first outflow of the first balancing chamber half is in fluid communication with a dialyzer inflow, and wherein the second inflows of the second balancing chamber halves are in fluid communication with a dialyzer outflow, wherein the second outflows of the second balancing chamber halves are in fluid communication with one another so that consumed dialyzate can be transferred from a second balancing chamber half of one balancing chamber to a second balancing chamber half of the other balancing chamber.

Claims

1. A dialysis machine having a dialyzer (D) and having a first balancing chamber (A) and having a second balancing chamber (B) of which each has at least two first (100, 102) and second balancing chamber halves (200, 202) separated from one another by a movable wall (W), wherein each first balancing chamber half (100, 102) is provided with a respective first inflow (Z1, Z3) and with a respective first outflow (A1, A3), wherein each second balancing chamber half (200, 202) is provided with a respective second inflow (Z2, Z4) and with a respective second outflow (A2, A4), wherein the inflows and outflows (A1-A4, Z1-Z4) are each provided with valves (1.1-1.4; 2.1-2.4) that are configured to close or to open the respective inflow (Z1-Z4) or outflow (A1-A4), wherein the first inflows (Z1; Z3) of the first balancing chamber halves (100) are in fluid communication with a source of fresh dialyzate and the first outflow (A1) of the first balancing chamber half (100) is in fluid communication with a dialyzer inflow, and wherein the second inflows (Z2; Z4) of the second balancing chamber halves (200; 202) are in fluid communication with a dialyzer outflow, characterized in that the second outflows (A2; A4) of the second balancing chamber halves (200, 202) are in fluid communication with one another so that consumed dialyzate is transferrable from a second balancing chamber half (200) of a balancing chamber (A) to a second balancing chamber half (202) of the other balancing chamber (B).

2. A dialysis machine in accordance with claim 1, characterized in that the second outflows (A2, A4) of the second balancing chamber halves (200; 202) are in fluid communication with an drain line (40) that leads to an outlet, in which a drain valve (3.1) is arranged, and by means of which the drain line (40) can be opened and closed.

3. A dialysis machine in accordance with claim 1, characterized in that a control unit is provided that is configured to control the valves (1.1-1.4; 2.1-2.4) such that with an open first inflow (Z1) and a closed first outflow (A1) of the first balancing chamber half (100) of a balancing chamber (A), this first balancing chamber half (100) is filled with fresh dialyzate, such that in this process with a closed second inflow (Z2) and an open second outflow (A2), the second balancing chamber half (200) of the first balancing chamber (A) is emptied, with the second outflow (A2) of the second balancing chamber half (200) being opened so that the consumed dialyzate is conveyed from the second balancing chamber half (200) of the first balancing chamber (A) into the second balancing chamber half (202) of the second balancing chamber (B), with the first outflow (A3) of the second balancing chamber half (102) of the second balancing chamber (B) being opened and the first inflow (Z3) of the first balancing chamber half (102) of the second balancing chamber (B) being closed so that fresh dialyzate is conveyed from the second balancing chamber half (102) of the second balancing chamber (B) to the dialyzer (D).

4. A dialysis machine in accordance with claim 1, characterized in that the machine does not have any substituate pump for conveying a substitution solution into the blood of the patient.

5. A dialysis machine in accordance with claim 2, characterized in that a control is provided that is configured to close the drain valve (3.1) when consumed dialysate is transferred from a second balancing chamber half (200; 202) of a balancing chamber (A; B) to a second balancing chamber half (200; 202) of the other balancing chamber (A; B).

6. A dialysis machine in accordance with claim 1, characterized in that a control is provided that is configured to control the valves (1.1-1.4; 2.1-2.4) such that consumed dialyzate is transferred from a second balancing chamber half (200; 202) of a balancing chamber (A; B) to a second balancing Chamber half (200; 202) of the other balancing chamber (A; B) and such that after this transfer or after a plurality of such transfers, the second outflows (A2; A4) of the second balancing chamber halves (200; 202) are moved into fluid communication with an outlet (1) for consumed dialyzate.

7. A dialysis machine in accordance with claim 6, characterized in that a control is provided that is configured to carry out the transfer of consumed dialyzate from the second balancing chamber half (200; 202) of one balancing chamber (A; B) to the second balancing chamber half (200; 202) of the other balancing chamber (A; B) at each nth cycle of the operation of the balancing chamber system.

8. A dialysis machine in accordance with claim 1, characterized in that a control is provided that is configured to carry out the transfer of consumed dialyzate from the second balancing chamber half (200; 202) of a balancing chamber (A; B) to the second balancing chamber half (200; 202) of the other balancing chamber (A; B) evenly in time or unevenly in time over the treatment duration.

9. A dialysis machine in accordance with claim 1, characterized in that the dialyzer (D) is a high-flux dialyzer or a medium cut-off dialyzer.

10. A method of operating a balancing chamber system of a dialysis machine having a first balancing chamber (A) and having a second balancing chamber (B) of which each has at least two first (100, 102) and second balancing chamber halves (200, 202) separated from one another by a movable wall (W), wherein each first balancing chamber half (100, 102) is provided with a respective first inflow (Z1, Z3) and with a respective first outflow (A1, A3), wherein each second balancing chamber half (200, 202) is provided with a respective second inflow (Z2, Z4) and with a respective second outflow (A2, A4), wherein the inflows and outflows (A1-A4, Z1-Z4) are each provided with valves (1.1-1.4; 2.1-2.4) that are configured to close or to open the respective inflow (Z1-Z4) or outflow (A1-A4), wherein the first inflows (Z1; Z3) of the first balancing chamber halves (100) are in fluid communication with a source of fresh dialyzate and the first outflow (A1) of the first balancing chamber half (100) is in fluid communication with a dialyzer inflow, and wherein the second inflows (Z2; Z4) of the second balancing chamber halves (200; 202) are in fluid communication with a dialyzer outflow, characterized in that dialyzate consumed in a first operating mode is transferred from the second balancing chamber half (200) of the first balancing chamber (A) to the second balancing chamber half (202) of the second balancing chamber (B), while the first balancing chamber half (100) of the first balancing chamber (A) is filled with fresh dialyzate and fresh dialyzate is conveyed from the first balancing chamber half (102) of the second balancing chamber (B) to the dialyzer (D).

11. A method in accordance with claim 10, characterized in that dialyzate consumed in the first operating mode is transferred from the second balancing chamber half (202) of the second balancing chamber (B) to the second balancing chamber half (200) of the first balancing chamber (A), while the first balancing chamber half (102) of the second balancing chamber (B) is filled with fresh dialyzate and fresh dialyzate is conveyed from the first balancing chamber half (100) of the first balancing chamber (A) to the dialyzer (D).

12. A method in accordance with claim 10, characterized in that the transfer takes place once or a plurality of times.

13. A method in accordance with claim 12, characterized in that the transfer takes place a plurality of times directly after one another or with interposed cycles of the balancing chamber without any transfer.

14. A method in accordance with claim 10, characterized in that dialyzate consumed in a second operating mode is conveyed from each of the second balancing chamber halves (200; 202) of the balancing chambers (A; B) into the outlet (1).

15. A method in accordance with claim 10, characterized in that no substituate pump is used to supply substituate to the patient.

Description

[0048] Further details and advantages of the invention will be explained in more detail with reference to an embodiment shown in the drawing.

[0049] There are shown:

[0050] FIG. 1: a schematic view of the dialyzate circuit of a dialysis machine in accordance with the invention; and

[0051] FIG. 2: a schematic view of the dialysis circuit of a dialysis machine in accordance with the prior art.

[0052] Elements that are the same or have the same function are marked in FIG. 1 by the same reference numerals as in FIG. 2 so that reference is made accordingly.

[0053] The operation of the dialysis machine in accordance with the invention is configured as follows.

[0054] First, the first balancing chamber half 100 of the first balancing chamber A is in turn filled with fresh dialyzate; V1.1 is open and V1.2 is closed; V1.3 is closed and V1.4 is open. The first balancing chamber half 100 is thus filled with fresh dialyzate and consumed dialyzate is removed from the second balancing chamber half 200 of the first balancing chamber A.

[0055] A reverse cycle is in turn set in the second balancing chamber B.

[0056] Fresh dialyzate is removed from the balancing chamber half 102, with the valve V2.1 being closed and V2.2 being open. Valve V2.4 is now opened and V2.3 remains closed. A switchover to the opposite cycle again takes place on the conclusion of the process.

[0057] This switching has the result that consumed dialyzate is moved between the two balancing chambers or is moved to and fro.

[0058] Consumed dialyzate is thus no longer removed from the system in this operating mode, as is the case in the situation of FIG. 2. However, since further fresh dialyzate is conveyed into the system, the fluid amount increases. This fluid amount is conveyed over the membrane of the dialyzer into the patient so that this fluid amount (at least one stroke, for example 30 ml) acts as a substituate for the patient.

[0059] At the same time, the dialyzer membrane acts as a sterile filter for the substituate. An internal HDF mode is thus provided so that a sterile filter separately provided for this purpose is dispensed with.

[0060] There is the advantage that no separate substituate pump, no separate tubing set, and no separate sterile filter have to be provided.

[0061] Provision can be made during this oscillating movement of the consumed dialyzate from one second balancing chamber half to the other and/or vice versa that a valve 3.1 is closed downstream of the balancing chambers in the line 40.

[0062] Provision can (preferably) be made that only one filling amount of a balancing chamber is used to provide a substituate (that is, 30 ml, for example).

[0063] Provision can also be made that a “double stroke” is carried out, i.e. an amount of consumed dialyzate is therefore pushed “to” once and “fro “once”.

[0064] Provision can be made that, for example, every 10th cycle is used to produce substituate.

[0065] The apparatus can comprise an evaluation and control unit that evenly distributes the medically prescribed substituate amount over the treatment duration.

[0066] The apparatus can comprise an evaluation and control unit that unevenly distributes the medically prescribed substituate amount over the treatment duration. This means that, for example, the substituate amount is higher or lower at the start of the treatment than at the end of the treatment.

[0067] The apparatus has a particularly good effect when dialyzers are used that are called high-flux dialyzers. Filters are called high-flux dialyzers that have an ultrafiltration rate of 20-70 mL/m2*mmHg*h in human blood.

[0068] The apparatus in accordance with the invention is in particular effective in conjunction with a so-called medium cut-off dialyzer. Such a dialyzer is described, for example, in WO 2015/118046 A to which reference is made to this extent. Such dialyzers have an uncontrolled back rinsing of dialyzate into the blood circuit, which is produced by the internal pressure relationships in the dialyzer. These dialyzers may not be operated in HDF mode since the loss of albumin would otherwise become significantly too high.

[0069] With the aid of the apparatus in accordance with the invention, operation can now be made in a “controlled substituate mode” with a “normal” machine. The substituate amount can in particular be limited by a skillful program selection to volumes between 2 and 15 l/treatment, preferably to volumes between 5 and 12 l/treatment, further preferably to volumes between 5 and 10 l/treatment.