Method for temporarily interrupting an extracorporeal blood treatment, control device and blood treatment apparatus

Abstract

This disclosure relates to a method for temporarily interrupting an extracorporeal treatment of blood of a patient by use of a blood treatment apparatus. The method comprises activating or controlling a control device provided and configured to bring the blood treatment apparatus into a state in which the blood treatment of the patient can be interrupted with the intention to continue the blood treatment. This disclosure further relates to a control device, a blood treatment apparatus, a digital storage means, a computer program product as well as a computer program.

Claims

1. A control device configured: (i) to be activated or controlled in order to temporarily interrupt a blood treatment being effected by a blood treatment apparatus or (ii) to effect a temporary interruption of the blood treatment apparatus; wherein the blood treatment apparatus is configured to be connected to a patient via an extracorporeal blood circuit during the blood treatment; wherein the control device is configured to effectuate the blood treatment by activating a blood pump of the blood treatment apparatus to: (i) withdraw blood from the patient, (ii) convey the blood through the extracorporeal blood circuit, and (iii) return the blood to the patient; wherein the control device is configured to transition the blood treatment apparatus into a state in which the blood treatment is temporarily interrupted while the blood treatment apparatus is disconnected from the patient and while blood of the patient remains in the extracorporeal blood circuit; wherein the control device is configured to transition the blood treatment apparatus to subsequently continue the blood treatment after the state in which the blood treatment is temporarily interrupted, the blood treatment apparatus being reconnected to the patient prior to continuing the blood treatment; wherein the control device is configured to, during the state in which the blood treatment is temporarily interrupted and while the blood treatment apparatus is disconnected from the patient and while the blood of the patient is remaining in the extracorporeal blood circuit, induce a first connection of an arterial line section of the extracorporeal blood circuit to a source of substituate and a second connection of a venous line section of the extracorporeal blood circuit to the source of substituate, or configured to advise a user to make the first connection of the arterial line section and the second connection of the venous line section of the extracorporeal blood circuit to the source of substituate; wherein the control device is further configured to, during the state in which the blood treatment is temporarily interrupted and while the blood treatment apparatus is disconnected from the patient and while the blood of the patient is remaining in the extracorporeal blood circuit, activate the blood pump to induce or effect a circulation of at least one substituate liquid supplied from the source of substituate in the extracorporeal blood circuit; wherein, in response to temporarily interrupting the treatment, the control device is configured to automatically change or deactivate, during the temporary interruption of the blood treatment, (i) threshold windows of parameters or (ii) monitoring processes, wherein the threshold windows of parameters or the monitoring processes are set or used during the blood treatment; and wherein the control device is configured to automatically deactivate monitoring processes during the temporary interruption of the blood treatment.

2. The control device according to claim 1, wherein the control device is configured to induce or effect that the interrupted blood treatment is continued by at least one medical device that had been used before interruption of the blood treatment.

3. The control device according to claim 2, wherein the at least one used medical device is disposable.

4. The control device according to claim 1, wherein the control device is configured to transition the blood treatment apparatus into a state in which the blood treatment is configured to be temporarily interrupted without returning blood to the patient.

5. The control device according to claim 1, wherein the control device is activated or controlled by actuating a single one actuation device in order to transition the blood treatment apparatus into the state in which the blood treatment is temporarily interrupted.

6. The control device according to claim 1, wherein the control device is configured to initiate the temporary interruption of the blood treatment by inducing or effecting at least one of the following processes: stopping the blood pump of the blood treatment apparatus; closing a patient tube clamp of a blood withdrawal line and closing a patient tube clamp of a blood return line of the extracorporeal blood circuit; stopping an administration of an anti-coagulating agent; terminating a balancing; and stopping an addition or administration of substituate.

7. The control device according to claim 1, wherein the control device is further configured to induce a disconnection of a blood return line of the extracorporeal blood circuit from the patient or to advise the user to disconnect the blood return line of the extracorporeal blood circuit from the patient.

8. The control device according to claim 1, wherein the blood treatment is continued with parameters or conditions as set at the beginning of the blood treatment or during a course of the blood treatment before the temporary interruption.

9. The control device according to claim 1, wherein the control device induces or effects the continuation of the blood treatment when a detection device for detecting a composition of a line content of the extracorporeal blood circuit detects a predetermined or preset optical density.

10. The control device according to claim 1, wherein the control device reactivates threshold windows of parameters or monitoring processes which were changed or deactivated during the temporary interruption of the blood treatment.

11. The control device according to claim 1, wherein the control device is activated or controlled by actuating at least two actuation devices in order to transition the blood treatment apparatus into the state in which the blood treatment is temporarily interrupted.

12. A blood treatment apparatus for an extracorporeal blood treatment, comprising: at least one control device configured to effectuate a blood treatment of a patient by activating a blood pump of the blood treatment apparatus to: (i) withdraw blood from a patient, (ii) convey the blood through an extracorporeal blood circuit connected to the patient, and (iii) return the blood to the patient, wherein the control device is configured: (i) to be activated or controlled in order to temporarily interrupt the blood treatment being effected by the blood treatment apparatus or (ii) to effect a temporary interruption of the blood treatment apparatus, wherein the control device is configured to, while the blood treatment is temporarily interrupted and while the blood treatment apparatus is disconnected from the patient and while blood of the patient is in the extracorporeal blood circuit, induce a first connection of an arterial line section of the extracorporeal blood circuit to a source of substituate and a second connection of a venous line section of the extracorporeal blood circuit to the source of substituate, or configured to advise a user to make the first connection of the arterial line section and the second connection of the venous line section of the extracorporeal blood circuit to the source of substituate; wherein the control device is further configured to, while the blood treatment is temporarily interrupted and while the blood treatment apparatus is disconnected from the patient and while the blood of the patient is in the extracorporeal blood circuit, activate the blood pump to induce or effect a circulation of at least one substituate liquid supplied from the source of substituate in the extracorporeal blood circuit; wherein the control device is further configured to transition the blood treatment apparatus to subsequently continue the blood treatment after the blood treatment is temporarily interrupted, the blood treatment apparatus being reconnected to the patient prior to continuing the blood treatment; wherein the control device functionally interacts with the blood treatment apparatus; wherein, in response to temporarily interrupting the treatment, the control device is configured to automatically change or deactivate, during the temporary interruption of the blood treatment, (i) threshold windows of parameters or (ii) monitoring processes, wherein the threshold windows of parameters or the monitoring processes are set or used during the blood treatment; and wherein the control device is configured to automatically deactivate monitoring processes during the temporary interruption of the blood treatment.

13. The blood treatment apparatus according to claim 12, further comprising at least one actuation device which is configured to activate or control the control device.

14. The blood treatment apparatus according to claim 12, wherein the control device is configured to automatically transition the blood treatment apparatus into a state in which the blood treatment is configured to be temporarily interrupted with the ability to subsequently continue the blood treatment.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The present invention is in the following illustrated by way of example with reference to the appended drawings, wherein:

(2) FIG. 1 shows a schematic overview of an exemplary arrangement for performing the method according to the present invention; and

(3) FIG. 2 shows a flow diagram of a method according to the present invention.

DETAILED DESCRIPTION OF THE DRAWINGS

(4) As stated above, there are extracorporeal blood treatment methods in which the blood withdrawal line of an extracorporeal blood circuit is the arterial line section or segment of the extracorporeal blood circuit and in which the blood return line is the venous line section or segment correspondingly. Examples thereof include blood treatment methods such as extracorporeal blood purification methods, e.g., hemodialysis, hemofiltration, hemodiafiltration and the like.

(5) In other extracorporeal blood treatment methods, e.g., methods of enriching blood with oxygen, the direction of withdrawal can be reversed as compared to the direction of withdrawal of, e.g., a hemodialysis, such that blood is withdrawn via the blood withdrawal line from the venous leg of the patient's vascular system and, following its enrichment with oxygen, is returned via the blood return line into the arterial leg of the patient's vascular system.

(6) In the following embodiments, the present invention is exemplarily illustrated by way of an arterial blood withdrawal line and a venous blood return line. However, as a person skilled in the art will easily recognize, the directions or points of withdrawal and return do not have any influence on the practicability of the method according to the present invention. The method shall not be limited to the said embodiment.

(7) FIG. 1 shows a schematic overview of an arrangement for performing a blood treatment session.

(8) FIG. 1 shows an extracorporeal blood circuit 100 which is connected to a blood treatment apparatus 1 according to the present invention. The blood treatment apparatus 1 comprises a control device 3 and an actuation device 4.

(9) A patient 200 is connected to the extracorporeal blood circuit 100 via a patient access. More precisely, the patient 200 is connected to a blood withdrawal line, here an arterial line section 7, of the extracorporeal circuit 100 via a first patient access, here an arterial patient access 5. The patient 200 is connected to a blood return line, here a venous line section 11, of the extracorporeal blood circuit 100 via a second patient access, here a venous patient access 9.

(10) In the arterial line section 7, a first patient tube clamp, here an arterial patient tube clamp 13, is arranged. In the venous line section 11, a second patient tube clamp, here a venous patient tube clamp 15, is arranged.

(11) FIG. 1 shows the arterial patient tube clamp 13 and the venous patient tube clamp 15 in an opened state.

(12) By means of a blood pump 17, blood of the patient 200 is conveyed within the extracorporeal blood circuit 100.

(13) A detection device, e.g., an optical detector 19 is provided in the venous line section 11, which can be designed and provided to detect an optical density (OD) of a line content present in the interior of the extracorporeal blood circuit 100.

(14) FIG. 2 schematically shows a flow diagram of a method according to the present invention for temporarily interrupting an extracorporeal blood treatment of a patient.

(15) For easier understanding the co-operation of the single components, reference is made to the arrangement shown in FIG. 1. The components involved in the method according to the present invention are for this reason denoted with the reference numerals of FIG. 1 though they are not necessarily shown in FIG. 2, too.

(16) At first, a user can select a soft key blood treatment interruption in a menu (not shown in FIG. 2).

(17) In the present case, in step S1, the user selects the blood treatment interruption with blood return. The selection can be performed bypreferably only one time actuatingan actuation device 4 such as a soft key. The soft key can be arranged on a screen (not shown) of the blood treatment apparatus 1. The actuation can, however, also be carried out in any other way known to a person skilled in the art.

(18) In subsequent step S2, the control device 3 induces or effects the stop of the blood pump 17 of the extracorporeal blood circuit 100.

(19) Thereby, an arterial patient tube clamp 13 and/or a venous patient tube clamp 15 can be closed.

(20) The control device 3 can further induce or effect the stop of a heparin bolus, the stop of continuous anti-coagulation additives such as heparin, citrate, Ci-Ca (citrate-calcium) with Ca being the antagonist of the anti-coagulation, the termination of a balancing and/or the stop of a substituate bolus.

(21) On the screen of the blood treatment apparatus 1, instructions for the further proceedings and/or information about the current process step can be displayed.

(22) For example, a user can be notified that the patient 200 has to be disconnected arterially. In step S3, the user can be requested to disconnect the patient 200.

(23) The arterial line section 7 of the tube system of the extracorporeal blood circuit 100 is then preferably connected to a source of substituate such as a saline bag.

(24) Before starting the reinfusion, all connections can be checked for their tightness.

(25) The continuous anti-coagulation additions can further be maintained in a ceased state. The balancing can also further be maintained in a ceased state.

(26) In step S4, the reinfusion can be started by the control device 3 inducing or effecting the reinfusionpreferably by means of actuating again another soft key.

(27) For performing the reinfusion, the arterial patient tube clamp 13 and the venous patient tube clamp 15 can be opened. The blood pump 17 can be started. The blood pump 17 can, for example, be operated with a conveyance velocity of 100 ml/min.

(28) A blood flow of 100 ml/min can, for example, indicate that the blood flow during the reinfusion has to be reducedas compared to the blood flow during the blood treatment session. If the blood flow has already been <100 ml/min during the blood treatment session, then the conveyance velocity of the blood pump 17 can be maintained (on this lower value below 100 ml). However, according to the present invention, also velocities above 100 ml/min are possible for the reinfusion.

(29) Instructions for the further proceedings and/or information about the current process step for the user can be displayed again on the screen of the blood treatment apparatus 1.

(30) Further background processes and/or monitoring processes can take place. These processes can be different from the processes performed during a blood treatment session.

(31) In step S5, there can be requested if a detection device such as an optical detector 19 detects if an optical density with the target value OD bright is present inside a predetermined volume.

(32) The presence of the value for OD bright can indicate that there is substantially no blood in a line content inside the extracorporeal blood circuit 100 anymore. The value OD bright can be a predetermined value. It can, e.g., be deposited internally in a storage means and/or a software.

(33) If the value OD bright has not been reached (N for NO), a message can be output. The blood pump 17 can be stopped in each case.

(34) If the predetermined value for OD bright has been reached (J for YES), in step S6, a stop of the blood pump 17 can be induced or effected by means of the control device 3.

(35) The arterial patient tube clamp 13 and the venous patient tube clamp 15 are closed.

(36) The patient 200 can be disconnected venously. The patient 200 is now completely separated from the blood treatment apparatus 1 and can, for example, leave the treatment room.

(37) In step S7, a circulation of substituate liquid by means of the control device 3 can be effected or induced.

(38) At first, the screen of the blood treatment apparatus 1 can display a message including a request about if the patient has been disconnected.

(39) If the patient 200 has been disconnected completely from the blood treatment apparatus 1 or parts thereof, respectively, such as the extracorporeal blood circuit 100, instructions for further proceedings and information about the current process can be displayed on the screen.

(40) Next, it is also intended to connect the venous line section 11 to the source of substituate, e.g., the saline bag. This can be carried out by the user.

(41) All connections can be checked for their tightness.

(42) Then, in step S8, the control device 3 can effect or induce the circulation of the substituate liquid. This can advantageously be achieved again by merely actuating a soft key.

(43) The continuous anti-coagulation can further be maintained ceased or stopped. The balancing can further be maintained stopped.

(44) The blood pump 17 can furthermore be operated with a conveyance velocity of 100 ml/min.

(45) Instructions for further proceedings and/or information about the current process step and/or about the duration of the current blood treatment interruption can be displayed on the screen.

(46) At this point, the user canfor example, by means of a message or an information on the screenget the possibility to terminate the current blood treatment interruption (at any point of time).

(47) Further background processes and/or monitoring processes can take place. These process proceedings can differ from process proceedings during the blood treatment session.

(48) For example, other threshold windows, e.g. of the pressure, can be set which differ from threshold windows during the blood treatment. Threshold windows can be deactivated. A lower venous end of scale can be deactivated. An upper arterial end of scale can be deactivated.

(49) The circulation can, for example, stop if an optical density OD dark is detected, wherein OD dark can also be a value which has been deposited in a storage means. The blood treatment session can be continued.

(50) In a case in which a duration of the circulation which had originally been set to a maximum of 4 h is exceeded, a corresponding message can be output. The blood pump 17 can be stopped. This message can be affirmed and the blood treatment interruption or the circulation, respectively, can be continued.

(51) If the blood treatment session shall be continued, the control device 3 can be effect or induce a termination of the circulation of substituate liquid in step S9.

(52) At first, the blood pump 17 which has conveyed substituate liquid during the circulation can be stopped.

(53) The arterial patient tube clamp 13 and the venous patient tube clamp 15 can be closed.

(54) The screen can again display instructions for further proceedings and/or information about the current process step. These can include a hint with instructions for the connection of the patient.

(55) Furthermore, the control device can induce or effect the start of the blood pump 17 by means of, for example, actuating a soft key.

(56) Preferably, the arterial connection of the patient is affirmed. Subsequently, the control device 3 can be activated or controlled, for example, by merely pushing a key, such that the blood pump 17 is started. The blood pump 17 can further convey with a blood flow of 100 ml/min.

(57) The arterial patient tube clamp 13 and the venous patient tube clamp 15 can be opened again.

(58) The screen can again display instructions for further proceedings and/or information about the current process step.

(59) Moreover, several background processes and/or monitoring processes can take place again.

(60) In step S10, the connection of the patient will be started at first.

(61) In step S11, it is requested if a particular (predetermined) optical density OD dark has been reached inside a predetermined volume. The value of the optical density OD dark can have been deposited in a storage means and/or in a software.

(62) If the value for OD dark has not been reached, a corresponding message can be output and the blood pump 17 can be stopped.

(63) If the value for OD dark has been reached, blood pump 17 is stopped.

(64) Then, the arterial patient tube clamp 13 and the venous patient tube clamp 15 can be closed.

(65) As soon as the patient 200 (for example, following another blood treatment) is available again, the procedure can be performed in reverse order such that the blood treatment session can be continued.

(66) In order to continue the blood treatment, in step S12, the control device 3 can induce or effect a restart of the blood pump 17 with the blood flow that had been present before the blood treatment interruption has been started.

(67) The arterial patient tube clamp 13 and the venous patient tube clamp 15 can be opened again.

(68) The continuous anti-coagulation addition (heparin, citrate, Ci-Ca, calcium as anti-coagulating agent) and the balancing can be restarted.

(69) All monitoring processes of the blood treatment session can be reactivated.