Computer System for Setting Adjustable Values of a Blood Treatment Apparatus

Abstract

The present invention relates to a computer system (1) for setting adjustment values of a blood treatment apparatus (100), comprising a first input interface (I1), a second input interface (I2), as well as an output interface. Furthermore, having a calculation device (5) and a display device (I3), whereby the calculation device (5) is programmed, after reading a target value for the renal dose via a blood treatment apparatus (100), to display to the user in a graphic via the display device (I3), a selection range (A) from a number of combinations (K1, K2, K3), each of exactly one adjustable value, (Q;.sup.⋅.sub.1, Q;⋅.sub.2, Q;⋅.sub.3) for the flow of the blood pump (101), on the one hand, and precisely one adjustable value ({dot over (D)}1, {dot over (D)}2, {dot over (D)}3) for the flow of the dialysis liquid pump (121), on the other. Based on the displayed selection range A, the user can select one of the displayed combinations via a second input interface (I2). The calculation device (5) is further programmed so that the adjustable value (Q;.sup.⋅.sub.B) for the blood pump (101) and the adjustable value ({dot over (D)}.sub.B) for the dialysis liquid pump (121) of the selected combination (K.sub.B) can be given via the output interface.

Claims

1. A computer system to set adjustable values of a blood treatment apparatus (100), having a first input interface (I1); a second input interface (I2); an output interface; a calculation device (5) (I3) a display device (I3) wherein the calculation device (5) is programmed, to use the first input interface (I1) to read a target value of the renal dose as a parameter value for a treatment of a patient using a blood treatment apparatus (100); in order to display to a user in a graphic, via the display device (I3), a selection range (A), wherein the selection range (A) is determined by the calculation device (5) taking into account on the one hand the read target value of the renal dose and a plurality of combinations (K.sub.1, K.sub.2, K.sub.3) of exactly one adjustable value (Q;.sup.⋅.sub.1, Q;.sup.⋅.sub.2, Q;.sup.⋅.sub.3) for the flow of the blood pump (101) and exactly one adjustable value ({dot over (D)}.sub.1, {dot over (D)}.sub.2, {dot over (D)}.sub.3) for the flow of the dialysis liquid pump (121) on the other hand; and a second input interface (I2) for selecting a combination (K.sub.B) from the displayed combinations (K1, K2, K3) by the user; and wherein the calculation device (5) is further programmed to give the adjustable value (Q;.sup.⋅.sub.B) for the blood pump (101) and the adjustable value (D.sub.B) for the dialysis liquid pump (121) of the selected combination (K.sub.B), via the output interface.

2. The computer system (1) according to claim 1, wherein the calculation device (5) is further programmed to to read further parameter values (B1, B2, B3, B4, B5, B6, B7); wherein the selection range (A) is further restricted by the calculation device (5) taking into account the further parameter values (B1 to B7).

3. The computer system (1) according to claim 1 or 2, wherein the further parameter values (B1 to B7) take into account or relate to a desired anticoagulation, in particular a citrate-calcium-anticoagulation, or a desired bicarbonate concentration in the serum.

4. The computer system (1) according to any one of the preceding claims, wherein the computer system (1) is a mobile device, a hand-held device, a cell phone, a smartphone, a tablet, etc., or an application suitable for this purpose.

5. The computer system (1) according to any one of the preceding claims, wherein the calculation device (5) is programmed to display or give, via the display device (I3) for the attention of the user, the adjustable value (Q;.sup.⋅.sub.B) for the blood pump (101) and the adjustable value ({dot over (D)}.sub.B) for the dialysis liquid pump (121) of the selected combination (K.sub.B).

6. The computer system (1) according to any one of the preceding claims, wherein the computer system (1) is a control device or closed-loop control device (150) of a blood treatment apparatus (100) or is in signal communication with the latter.

7. The computer system (1) according to claim 6, wherein the control device or closed-loop control device (150) is programmed to control or regulate the blood treatment apparatus (100) based on the adjustable value (Q;.sup.⋅.sub.B) for the blood pump (101) and the adjustable value ({dot over (D)}.sub.B) for the for dialysis liquid pump (121) of the selected combination (K.sub.B).

8. A blood treatment apparatus (100), embodied as a dialysis apparatus, comprising a computer system (1) according to any one of the preceding claims.

9. The blood treatment apparatus (100) according to claim 8, embodied as a hemodialysis apparatus, hemofiltration apparatus or hemodiafiltration apparatus, in particular as an apparatus for chronic renal replacement therapy or for continuous renal replacement therapy (CRRT).

10. A system comprising or consisting of one or more blood treatment apparatuses (100), embodied as dialysis apparatus; a computer system (1) according to any one of the preceding claims 1 to 7, wherein the one or more blood treatment apparatuses (100) and the computer system (1) are provided separate from each other.

11. A method to set adjustable values of a blood treatment apparatus (100), the method encompassing the steps: provision of a computer system (1) according to any one of the claims 1 to 7, a blood treatment apparatus (100) according to any one of the claims 8 to 9, or a system according to claim 10; reading of a target value for the renal dose as a parameter value for the treatment of a patient via a blood treatment apparatus (100), or entering this parameter value via the first input interface (I1); displaying a selection range (A) in a graphic for the attention of the user, via the display device (I3), wherein the selection range (A) is determined by the calculation device (5) taking into account the target value of the renal dose, and displaying on the one hand a plurality of combinations of exactly one adjustable value (Q;.sup.⋅.sub.1, Q;.sup.⋅.sub.2, Q;.sup.⋅.sub.3) for the flow of the blood pump (101), and exactly one adjustable value ({dot over (D)}.sub.1, {dot over (D)}.sub.2, {dot over (D)}.sub.3) for the flow of the dialysis liquid pump (121) on the other; selecting of a combination (K.sub.B) of the displayed combinations (K1, K2, K3) by the user via the second input interface (I2); and giving the adjustable value (Q;.sup.⋅.sub.B) for the blood pump (101) and the adjustable value ({dot over (D)}.sub.B) for the dialysis liquid pump (121) of the selected combination (K.sub.B) via the output interface.

12. The method according to claim 11, encompassing the further step: displaying or giving, for the attention of the user, the adjustable value (Q;.sup.⋅.sub.B) for the blood pump (101) and of the adjustable value (1%) for the dialysis liquid pump (121) of the selected combination (K.sub.B), via the display device (I3).

13. The method according to claim 11 or 12 encompassing the further steps: controlling or regulating the blood treatment apparatus (100) based on the adjustable value (Q;.sup.⋅.sub.B) fort eh blood pump (101) and on the adjustable value ({dot over (D)}.sub.B) for the dialysis liquid pump (121) of the selected combination (K.sub.B).

14. A digital storage medium particularly in the form of a diskette, CD or DVD, EPROM, FRAM or SSD, with electronically readable control signals, configured in such a way to interact with a programmable computer system, so that the computer system can be programmed to be a computer system according to the claims 1 to 7.

15. A computer program product, as a signal wave or having a program code saved on a machine readable carrier, in order to interact with a programmable computer system, so that the computer system can be programmed to be a computer system according to claims 1 to 7.

16. Computer program having a program code so that a computer system can be programmed to be a computer system according to claims 1 to 7, when the computer program is running on a computer.

Description

[0089] The present invention is exemplarily explained with regard to the accompanying drawings in which same reference numerals refer to the same or similar elements. In the figures of the drawing the following applies:

[0090] FIG. 1 shows in a highly simplified representation, a system according to the present invention having a blood treatment apparatus next to a computer system according to the present invention;

[0091] FIG. 2 shows a flow chart of an exemplary embodiment of the method according to the present invention;

[0092] FIG. 3a shows parts of a graphic (or graphic display) as it could be displayed to the user via the display device in an exemplary embodiment of the computer system according to the present invention or the method according to the present invention;

[0093] FIG. 3b shows the graphic of FIG. 3a with a marked selection range for new adjustable values; and

[0094] FIG. 3c shows the graphic of FIG. 3b during a setting procedure.

[0095] FIG. 1 shows in highly simplified representation a blood treatment apparatus 100, optionally connected to an extracorporeal blood circuit 300, as part of a system according to the present invention.

[0096] The extracorporeal blood circuit 300 comprises a first line 301, here in the form of an arterial line section.

[0097] The first line 301 is in fluid connection with a blood treatment device, here exemplarily, a blood filter or dialyzer 303. The blood filter 303 comprises a dialysis liquid chamber 303a and a blood chamber 303b, which are separated from each other by a mostly semi-permeable membrane 303c.

[0098] The extracorporeal blood circuit 300 further comprises at least one second line 305, here in the form of a venous line section. Both the first line 301 as well as the second line 305, can serve to be connected to the vascular system of the patient, not shown.

[0099] The first line 301 is optionally connected to a (first) tube clamp 302 for blocking or closing the line 301. The second line 305 is optionally connected to a (second) tube clamp 306 for blocking or closing the line 305.

[0100] The blood treatment apparatus 100 represented in FIG. 1 schematically and only by some of its devices, comprises a blood pump 101. During the patient's treatment the blood pump 101 conveys blood through sections of the extracorporeal blood circuit 300 and towards the blood filter or dialyzer 303 as shown by the small arrows, which generally indicate the direction of flow in each of the figures. Using a pump for dialysis liquid 121, that may be embodied as a roller pump or as any otherwise occluding pump, fresh dialysis liquid is pumped from a source 200 along the dialysis liquid inlet line 104 into the dialysis liquid chamber 303a. The dialysis liquid leaves the dialysis liquid chamber 303a as dialysate, possibly enriched with filtrate, towards an optional effluent bag 400 and will be referred to herein as effluent.

[0101] The source 200 may, for example, be a bag or a container. The source 200 may further be a fluid line from which on-line and/or continuously produced or mixed liquid is provided, for example, a hydraulic outlet or hydraulic port of the blood treatment apparatus 100.

[0102] A further source 201 with substituate may optionally be provided. It may correspond to the source 200 or be a separate source.

[0103] A control device or closed-loop control device 150, only shown schematically can be configured to control or regulate the blood treatment session.

[0104] Where the effluent bag 400 is connected to the blood treatment apparatus 100b is indicated in the bottom right of FIG. 1.

[0105] In addition to the aforementioned blood pump 101, the arrangement shown in FIG. 1 further comprises, purely optionally, a number of other optional pumps, namely the pump 111 for substituate, the pump 121 for dialysis liquid and the pump 131 for the effluent.

[0106] The pump 121 is provided to supply dialysis liquid out of a source 200, for example a bag, through an optionally available bag heater H2 having a heat bag, to the blood filter 303 using the dialysis liquid inlet line 104.

[0107] The thus supplied dialysis liquid exits again from the blood filter 303 via a dialysate outlet line 102, aided by the optional pump 131, and may be discarded.

[0108] An optional arterial sensor PS1 is provided upstream of the blood pump 101. It measures the pressure in the arterial line during a patient's treatment.

[0109] A further optional pressure sensor PS2 is provided downstream of the blood pump 101, but upstream of the blood filter 303 and if provided, upstream of an addition point 25 for Heparin. It measures the pressure upstream of the blood filter 303 (“pre-hemofilter”).

[0110] To measure the filtrate pressure of the blood filter 303 again a further pressure sensor may be provided as PS4 downstream of the blood filter 303, however, preferably upstream of the pump 131 in the dialysate outlet line 102.

[0111] Blood, which leaves the blood filter 303, passes through an optional venous blood chamber 29, which may comprise a ventilation device 31 (also: venting; de-aeration or de-airing device) and/or a further pressure sensor PS3.

[0112] The control device or closed-loop control device 150 shown in FIG. 1 may be in wired or wireless signal communication to any of the components referred to herein—in particular or at least to the blood pump 101—in order to control or regulate the blood treatment apparatus 100.

[0113] The optional pump 111 is provided to supply substituate out of the optional source 201, for example a bag, via an optional available bag heater H1 having a heat bag, to the second line 305.

[0114] In several embodiments a citrate solution is dispensed from an optionally provided source for citrate solution, here exemplarily embodied as a citrate bag 9, into the first line 301, possibly by a citrate pump 15. For example, 4%-Na.sub.3 Citrate is added from the citrate solution source.

[0115] An optional addition device, embodied herein as calcium pump 12, is provided to supply a calcium solution from an optional source for calcium solution, exemplarily embodied in FIG. 1 as a calcium bag 13, into the line 305. For example, a CaCl.sub.2-solution is supplied from the source of calcium solution. This may have a calcium concentration of 91 mmol/l, 100 mmol/l, or another suitable calcium concentration.

[0116] In FIG. 1 to the right of the blood treatment apparatus 100, a computer system 1 according to the present invention is illustrated having a calculation device 5 and an optional storage device 7. The computer system has a first input interface I1 and a second input interface I2 and an output interface I3.

[0117] Blood treatment apparatus 100 and computer system 1 together represent an embodiment of a system according to the present invention.

[0118] The computer system 1 can be provided on a mobile hand-held device, for example a cell phone or tablet, physically separated from the blood treatment apparatus 100. In the embodiment shown in FIG. 1, it is not connected to the blood treatment apparatus 100 in signal communication.

[0119] The computer system 1 can be or comprise a server-based solution where the user, for example, can access, via a website, a program running on the server in order to run or initiate the steps of the method according to the present invention. The computer system 1 can therefore comprise a server. It may comprise user interfaces and/or user devices such as computers, cell phones or tablets which are set up to communicate with the server.

[0120] However, in other embodiments of the blood treatment apparatus than those shown here, the computer system is connected in signal communication and/or physically to the blood treatment apparatus 100 or is a part thereof. In the latter, however, the devices connected in this way no longer relate to a system according to the present invention, but rather to a blood treatment apparatus according to the present invention.

[0121] It is also encompassed by the present invention that the computer system 1, differently than as it is shown here, is identical to or is encompassed by the control device or closed-loop control device 150.

[0122] FIG. 2 FIG. 2 shows a flow chart of an exemplary embodiment of the method according to the present invention

[0123] Therein, the method step S1 shows the provision of a computer system 1 according to the present invention, a blood treatment apparatus 100 according to the present invention or a system according to the present invention.

[0124] In method step S2 a target value and/or a target range is read for a parameter value for a patient's treatment, for example for a renal dose, using a blood treatment apparatus 100 or this parameter value is entered via a first input interface I1.

[0125] S3 represents the displaying, of a selection range (see reference numeral A in FIG. 3b), calculated by the calculation device (5), for example as described supra, via the display device (I3), for example in a graphic, e.g. a diagram.

[0126] In method step S4, one of the displayed combinations is selected by the user using a second input interface I2, which can optionally be identical to the first input interface, as shown in FIG. 3b.

[0127] In the method step S5, the adjustable value for the blood pump 101 and the adjustable value for the dialysis liquid pump 121 of the selected combination are given via the output interface.

[0128] Optionally, in method step S6, the adjustable value for the blood pump 101 and the adjustable value for the dialysis liquid pump 121 of the selected combination are displayed or given via the display device I3 so that the user can take note of them.

[0129] S7 represents the optional method step of controlling or regulating the blood treatment apparatus 100 based on the adjustable value for the blood pump 101 and on the adjustable value for the dialysis liquid pump 121 of the selected combination.

[0130] FIG. 3a shows essential parts of a graphic or graphical display as it could be displayed to the user via the display device I3 in an exemplary embodiment of the computer system or in an exemplary embodiment of the method.

[0131] In the diagram of the graphical display, the vertical axis represents the blood flow [in ml/min] over the dialysis liquid flow [in ml/h] on the horizontal axis.

[0132] Each point within the diagram shown thus corresponds on the one hand to a combination of a possible adjustable value Q; for the delivery rate for the blood pump and a possible adjustable value T for the delivery rate of the dialysis liquid pump on the other. So, for example, the combination K1 corresponds to a combination of 100 ml/min as the rate for the blood pump (adjustable value Q;.sup.⋅.sub.1=100 ml/min) of 2000 ml/min as the rate for the dialysis liquid pump (adjustable value {dot over (D)}.sub.1=2000 ml/min). The combination K2 however stands for 120 ml/min as the rate for the blood pump (adjustable value Q;.sup.⋅.sub.2=120 ml/min) of—as already in combination K1—2000 ml/min as the rate for the dialysis liquid pump (adjustable value {dot over (D)}.sub.2=2000 ml/min).

[0133] The possible setting of a number of such combinations K1, K2, K3, . . . of a delivery rate for the blood pump and a delivery rate for the dialysis liquid pump, mathematically results in an expected acid-base status (expected (or anticipated)) bicarbonate concentration in the serum).

[0134] The expected bicarbonate concentrations in the serum are shown for a number of combinations of blood flow rate and dialysis fluid flow rate in each case in the form of a ray in the diagram. The lines shown are designated B1 to B7. For each of them, the value (in mmol/l) of bicarbonate to be expected is given on the edge of the diagram, when setting a combination of flows lying on the rays (the values of the graph in FIG. 3a were determined in a simulation).

[0135] In the present example it could be seen that an increase in blood flow of 20%, from K1 to K2, alters the expected bicarbonate concentration in the serum by about 4 mmol/l (from 24 mmol/l to 28 mmol/l, i.e. towards metabolic alkalosis). An increase in dialysate flow of also 20% (to K3) would compensate this effect.

[0136] The underlying constant treatment parameters in this example are: citrate dose 4 mmol per litre of blood, calcium dose 1.7 mmol per litre of blood, net ultrafiltration 100 ml/h.

[0137] ß The selection range which is available to the user according to the present invention is for the sake of clarity, not shown in FIG. 3a. It is indicated by the reference numeral A in FIG. 3b and FIG. 3c.

[0138] FIG. 3b FIG. 3 shows the exemplary graphic or graphical display of FIG. 3a.

[0139] All statements for FIG. 3a therefore also apply to FIG. 3b.

[0140] Illustrated here in FIG. 3b is a selection range A with an indefinite number n of possible combinations of adjustable values Q;.sup.⋅.sub.n for the delivery rate of the blood pump and adjustable values {dot over (D)}.sub.n for the delivery rate of the dialysis liquid pump.

[0141] The selection range A visually highlights the combinations from the n possible combinations in which the associated adjustable values are suitable for being set on the blood treatment apparatus 100, in order to achieve the target value, i.e. for the renal dose, during or with the treatment carried out with them. The combinations marked by selection range A are thus selected or determined taking into account the target value for the renal dose.

[0142] In the example in FIG. 3b, the selection range A is marked by shading. It does not have to be shaded as shown in FIG. 3b, but can also be highlighted in other ways. Coloured backgrounds are also possible. Its shape can of course also differ from the bar shape shown here.

[0143] Purely as an example, it is assumed in FIG. 3b that the user has decided on a combination of K.sub.B, e.g. by marking it using the computer mouse, which should be illustrated by the circle within the selection range A. The adjustable values Q;.sup.⋅.sub.B for the delivery rate of the blood pump and {dot over (D)}.sub.B for the delivery rate of the dialysis liquid pump attributed to this combination K.sub.B can be displayed to the user, optionally with an indication of the exact adjustable values in for example ml/min. Provision may be made for a confirmation by the user before the blood treatment apparatus takes any action based thereon.

[0144] A treatment using the adjustable values Q;.sup.⋅.sub.B {dot over (D)}.sub.B, however, allows a treatment which obtains the desired renal dose, i.e. the target value.

[0145] The displaying or highlighting of the selected combination K.sub.B may correspond to an output via the output interface and/or a display via the display device.

[0146] FIG. 3c In contrast to the representation in FIG. 3b, however, the user has selected a combination K.sub.B which lies outside the selection range A. The adjustable values of this combination are not suitable in order to reach the target value for the renal dose when carrying out a blood treatment with them.

[0147] The user can be made aware of this optionally via a warning, indication or the like. He may have the opportunity to correct his selection and move the first selected combination K.sub.B into the selection range A. If he follows the arrow shown in FIG. 3c, he would maintain the desired bicarbonate concentration.

LIST OF REFERENCE NUMERALS

[0148] 1 computer system [0149] 5 calculation device (or computing device) [0150] 7 storage device (optional) [0151] 9 source for citrate solution, here, e.g. a [0152] citrate bag [0153] 12 calcium pump [0154] 13 source for calcium solution, calcium bag [0155] 15 citrate pump [0156] 25 addition point for Heparin (optional) [0157] 29 venous blood chamber (optional) [0158] 31 ventilation (or venting, de-aeration or de-airing device) [0159] 100 blood treatment apparatus [0160] 101 blood pump [0161] 102 dialysate outlet line, effluent inlet line [0162] 104 dialysis liquid inlet line [0163] 111 pump for substituate [0164] 121 pump for dialysis liquid [0165] 131 pump for dialysate or effluent [0166] in effluent inlet line [0167] 150 control device or closed-loop control device [0168] 200 dialysis liquid source [0169] 201 substituate source, optional [0170] 300 extracorporeal blood circuit [0171] 301 first line (arterial line section) [0172] 302 (first) tube clamp [0173] 303 blood filter or dialyzer [0174] 303a dialysis liquid chamber [0175] 303b blood chamber [0176] 303c semi-permeable membrane [0177] 305 second line (venous line section) [0178] 306 (second) tube clamp [0179] A selection range [0180] I1 first input interface [0181] I2 second input interface [0182] I3 display device [0183] K1 combination 1 [0184] K2 combination 2 [0185] K3 combination 3 [0186] K.sub.B selected combination [0187] B1 expected (or anticipated) bicarbonate concentration in serum of 30 mmol/l [0188] B2 expected bicarbonate concentration in serum of 28 mmol/l [0189] B3 expected bicarbonate concentration in serum of 26 mmol/l [0190] B4 erwartete Bicarbonatkonzentration im Serum of 24 mmol/l [0191] B5 erwartete Bicarbonatkonzentration im Serum of 22 mmol/l [0192] B6 erwartete Bicarbonatkonzentration im Serum of 20 mmol/l [0193] B7 erwartete Bicarbonatkonzentration im Serum of 18 mmol/l [0194] S1 method step a [0195] S2 method step b [0196] S3 method step c [0197] S4 method step d [0198] S5 method step e [0199] S6 further method step [0200] S7 further method step [0201] Q;.sup.⋅.sub.1, Q;.sup.⋅.sub.2, Q;.sup.⋅.sub.3, Q;.sup.⋅.sub.B adjustable values for the blood pump [0202] {dot over (D)}.sub.1, {dot over (D)}.sub.2, {dot over (D)}.sub.3, {dot over (D)}.sub.B adjustable values for the dialysis liquid pump