DEVICE FOR EXTRACORPOREAL BLOOD TREATMENT WITH GRAVIMETRIC BALANCING AND POSSIBILITY OF ULTRAFILTRATION
20190134292 ยท 2019-05-09
Inventors
Cpc classification
A61M1/1605
HUMAN NECESSITIES
A61M1/1637
HUMAN NECESSITIES
A61M2205/3396
HUMAN NECESSITIES
A61M2205/3337
HUMAN NECESSITIES
A61M1/1635
HUMAN NECESSITIES
International classification
Abstract
A device for extracorporeal blood treatment, in particular a dialysis machine, including an internal fluidic system to which a blood treatment unit, in particular a dialyzer, can be connected, the internal fluidic system comprising at least one balancing chamber on the fresh flow side for balancing fresh treatment fluid flowing to the blood treatment unit and at least one balancing chamber on the used flow side for balancing used treatment fluid flowing off the blood treatment unit, wherein the device has a measuring device for gravimetric detection of treatment fluid in the balancing chamber on the fresh flow side and/or a measuring device for gravimetric detection of treatment fluid in the balancing chamber on the used flow side. A method of balancing treatment fluid in such a device.
Claims
1.-13. (canceled)
14. A device for extracorporeal blood treatment comprising: an internal fluidic system to which a blood treatment unit can be connected, wherein the internal fluidic system comprises a balancing chamber on a fresh flow side for balancing fresh treatment fluid flowing to the blood treatment unit and a balancing chamber on a used flow side for balancing used treatment fluid flowing off the blood treatment unit, at least one of a measuring device for gravimetric detection of treatment fluid in the balancing chamber on the fresh flow side or a measuring device for gravimetric detection of treatment fluid in the balancing chamber on the used flow side, wherein two balancing chambers are fluidically arranged in series on each of at least one of the fresh flow side or the used flow side of the treatment unit.
15. The device according to claim 14, wherein the measuring device comprises at least one of a balance or a force sensor to determine the mass of treatment fluid present in the balancing chamber.
16. The device according to claim 14, wherein the two balancing chambers are arranged on each of at least one of the fresh flow side or the used flow side of the treatment unit, wherein the two balancing chambers are fluidically arranged parallel.
17. The device according to claim 14, wherein a switchable shut-off valve is arranged in the internal fluidic system on each of at least one of the inflow side or the outflow side of the respective balancing chamber for at least one of controlling or regulating the inflow and the outflow of the treatment fluid to or from the respective balancing chamber.
18. The device according to claim 14, wherein at least one of the balancing chambers has a ventilation opening having a filter unit.
19. The device according to claim 14, wherein the internal fluidic system comprises a pump for pumping treatment fluid on the inflow side of the balancing chamber and on the outflow side of the balancing chamber.
20. The device according to claim 14, wherein the balancing chamber is configured as a piston-cylinder unit with the balancing chamber as a cylinder and a piston cooperating with the cylinder and accommodated therein.
21. The device according to claim 14, wherein a constriction in the flow cross-section is formed in the internal fluidic system upstream of the balancing chamber on the fresh flow side for generating a local negative pressure and degassing the treatment fluid.
22. The device for extracorporeal blood treatment, wherein the device is a dialysis machine and the blood treatment unit is a dialyzer.
23. A method of balancing treatment fluid in a device for extracorporeal blood treatment, comprising: balancing fresh treatment fluid flowing to a blood treatment unit through an internal fluidic system of the device with a balancing chamber on a fresh flow side of the internal fluidic system; balancing used treatment fluid flowing off the blood treatment unit with a balancing chamber on a used flow side of the internal fluidic system, and determining a deviation from a target balance or a misbalance by comparing the balance on the fresh flow side and the balance on the used flow side, wherein at least one of treatment fluid present in the balancing chamber on the fresh flow side or treatment fluid present in the balancing chamber on the used flow side is gravimetrically detected by a measuring device; wherein in a first phase fresh treatment fluid on the fresh flow side is conveyed into a first balancing chamber on the fresh flow side, whereas fresh treatment fluid from a second balancing chamber on the fresh flow side is conveyed to the treatment unit, and used treatment fluid on the used flow side is conveyed from the treatment unit into the first balancing chamber on the used flow side, whereas used treatment fluid is conveyed from a second balancing chamber on the used flow side to a drain of the device, and wherein in a second phase fresh treatment fluid on the fresh flow side is conveyed from the first balancing chamber on the fresh flow side into the second balancing chamber on the fresh flow side, whereas fresh treatment fluid from the second balancing chamber on the fresh flow side is conveyed to the treatment unit, and used treatment fluid on the used flow side is conveyed from the first balancing chamber on the used flow side into the second balancing chamber on the used flow side, whereas used treatment fluid is conveyed from the treatment unit into the first balancing chamber on the used flow side.
24. The method according to claim 23, wherein the treatment fluid present in the respective balancing chamber is continuously detected by the measuring device.
25. The method according to claim 24, wherein the treatment fluid present in the respective balancing chamber is continuously balanced.
26. The method according to claim 23, wherein an undesired deviation from the target balance or misbalance is compensated by generating an excess or reduced delivery of treatment fluid by a pump.
27. The method according to claim 23, wherein a pump is used to generate an excess or reduced delivery of treatment fluid such that ultrafiltration is affected.
28. The method according claim 23, wherein in the first phase fresh treatment fluid on the fresh flow side is conveyed into a first balancing chamber on the fresh flow side, whereas fresh treatment fluid is conveyed from a second balancing chamber on the fresh flow side to the treatment unit, and used treatment fluid on the used flow side is conveyed from the treatment unit into a first balancing chamber on the used flow side, whereas used treatment fluid is conveyed from a second balancing chamber on the used flow side to a drain of the device; and wherein in the second phase fresh treatment fluid on the fresh flow side is conveyed into the second balancing chamber on the fresh flow side, whereas fresh treatment fluid is conveyed from the first balancing chamber to the treatment unit, and used treatment fluid on the used flow side is conveyed from the treatment unit into the second balancing chamber on the used flow side, whereas used treatment fluid is conveyed from the first balancing chamber on the used flow side to a drain of the device.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0041] The invention is best understood from the following detailed description when read in connection with the accompanying drawings. Included in the drawings are the following figures:
[0042]
[0043]
[0044]
[0045]
[0046]
[0047]
[0048]
[0049]
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0050]
[0051] On the fresh flow side, the internal fluidic system 2 comprises an inflow line 8 connected to a (not shown) reservoir for fresh treatment fluid. A first fresh flow pump 9 is arranged in said inflow line in the internal fluidic system 2. Downstream of the pump 9, the line 8 is divided into a first fresh flow line branch 10 and a second fresh flow line branch 11, which are realized so as to be fluidically parallel to each other.
[0052] In the first fresh flow line branch 10, a valve 12 is arranged upstream of the first balancing chamber 4 on the fresh flow side and a valve 13 is arranged downstream of the first balancing chamber 4 on the fresh flow side. In the second fresh flow line branch 11, a valve 14 is arranged upstream of the second balancing chamber 5 on the fresh flow side and a valve 15 is arranged downstream of the second balancing chamber 5 on the fresh flow side. Downstream of the two valves 13, 15, the first fresh flow line branch 10 and the second fresh flow line branch 11 merge again to form a fresh flow line 16, in the further course of which a second fresh flow pump 17 is arranged and which is finally connected to the dialyzer 3 as treatment unit 3.
[0053] On the used flow side, the internal fluidic system 2 has a used flow line 18 which is fluidically connected to the dialyzer 3. A first used flow pump 19 is arranged in said used flow line. Downstream of the first used flow pump 19, the used flow line 18 is divided into a first used flow line branch 20 and a second used flow line branch 21, which are realized so as to be fluidically parallel to each other.
[0054] In the first used flow line branch 20, a valve 22 is arranged upstream of the first balancing chamber 6 on the used flow side and a valve 23 is arranged downstream of the first balancing chamber 6 on the used flow side. In the second used flow line branch 21, a valve 24 is arranged upstream of the second balancing chamber 7 on the used flow side and a valve 25 is arranged downstream of the second balancing chamber 7 on the used flow side. Downstream of the two valves 23, 25, the first used flow line branch 20 and the second used flow line branch 21 merge again to form a used flow line 26, in the further course of which a second used flow pump 27 is arranged and which is finally connected via a drain 28 to a (not shown) reservoir for used treatment fluid.
[0055]
[0056] The device of
[0057] Each of the four chambers 4, 5, 6, 7 has a ventilation opening 31, in the present case located at the top of the respective chamber 4, 5, 6, 7. The ventilation opening 31 serves to equalize the pressure when filling and emptying the respective chamber 4, 5, 6, 7. The ventilation opening 31 may be provided with a hydrophobic filter not shown in the Figure.
[0058] Below each individual chamber 4, 5, 6, 7 there is a measuring device 32 in the form of a scale or weighing device 32. Alternatively, the measuring device 32 can be arranged above the respective chamber 4, 5, 6, 7. The measuring device 32 is suitable and intended to continuously determine the weight of the respective chamber 4, 5, 6, 7 which are filled with more or less treatment fluid. The determined weights can be used to ascertain the mass flow of the pumps 9, 17, 19, 27. This is also used to determine the filling level of the chambers 4, 5, 6, 7.
[0059] To ensure a continuous flow of treatment fluid, its delivery is divided into two phases. At the beginning of a first phase, the chambers 4, 5, 6, 7 each having a respective filling volume of 100 ml are filled with the following masses of treatment fluid:
[0060] Chamber 4: 20 g, chamber 5: 80 g, chamber 6: 20 g, chamber 7: 80 g.
[0061] In the first phase, the device 1 is operated as follows:
[0062] Pump 9 fills chamber 4 through valve 12. Valve 12 is open, valve 13 is closed.
[0063] Pump 17 empties chamber 5 through valve 15. Valve 14 is closed, valve 15 is open.
[0064] Pump 19 fills chamber 6 through valve 22. Valve 23 is closed, valve 22 is open.
[0065] Pump 27 empties chamber 7 through valve 25. Valve 25 is open, valve 24 is closed.
[0066] The operation in the first phase continues until the chambers 4, 5, 6, 7 have reached a full or empty state.
[0067] At the beginning of a second phase, the chambers 4, 5, 6, 7 each having a respective filling volume of 100 ml are filled with the following masses of treatment fluid:
[0068] Chamber 4: 80 g, chamber 5: 20 g, chamber 6: 80 g, chamber 7: 20 g
[0069] In the second phase, the device 1 is operated as follows:
[0070] Pump 9 fills chamber 5 through valve 14. Valve 14 is open, valve 15 is closed.
[0071] Pump 17 empties chamber 4 through valve 13. Valve 12 is closed, valve 13 is open.
[0072] Pump 19 fills chamber 7 through valve 24. Valve 25 is closed, valve 24 is open.
[0073] Pump 27 empties chamber 6 through valve 23. Valve 23 is open, valve 22 is closed.
[0074] The operation in the second phase also continues until the chambers 4, 5, 6, 7 have reached a full or empty state.
[0075] As soon as the respective switching point (empty or full) of a chamber 4, 5, 6, 7 has been reached, the two valves belonging to a chamber 4, 5, 6, 7 close. As soon as all valves of all chambers 4, 5, 6, 7 are closed, the next phase begins, i.e. after the first phase the second phase, then again the first phase and so on.
[0076] The device of
[0077] The fresh flow pump 9 and the used flow pump 27 must each be operated in such a way that the chambers fluidically connected to them are filled or emptied at least as quickly as the fresh flow pump 7 and the used flow pump 19 need in order to empty or fill the respectively other chamber fluidically connected to them.
[0078] In addition, the device of the embodiment of
[0079] A matching of the balancing chambers 4 and 5 or 6 and 7 is particularly easy with the device 1 according to aspects of the invention. Via the pumps 9, 17, 19, 27, different filling levels/filling quantities are set in the balancing chambers 4, 5, 6, 7, for example 20 g, 50 g and 80 g. Then the pumps 9, 17, 19, 27 are stopped and all chamber valves 12, 13, 14, 15 and 22, 23, 24, 25 are opened. Via the opened chamber valves 12, 13, 14, 15 and 22, 23, 24, 25, equal levels and thus equal filling quantities (weight) appear in the balancing chambers 4 and 5 or 6 and 7.
[0080] In addition, the balancing chambers 4 to 6 (or 4 to 7, 5 to 6, 5 to 7) can be easily matched as follows: Via the pumps 9, 17, 19, 27, the balancing chamber 4 is filled (e.g. with 80 g treatment fluid) and the balancing chamber 6 is emptied (e.g. to a quantity of 20 g treatment fluid). The treatment fluid is then pumped from the balancing chamber 4 into the balancing chamber 6. This can be done in a first variant with only one pump by bridging one of the pumps 17 and 19 with a bypass not shown in
[0081] Finally, the device 1 according to aspects of the invention enables a simultaneous matching of all balancing chambers 4, 5, 6, 7. By integrating a short-circuit valve (not shown in
[0082] In an embodiment according to aspects of the invention, the measurement results can be secured with a two-channel measurement. This can be done, for example, by carrying out an additional differential measurement between the respective balancing chambers before and after the dialyzer 3 by weighing the chambers (e.g. chamber 4 with chamber 6 and chamber 5 with chamber 7), in particular with the aid of a rocker device not shown in the Figures, on which the corresponding chambers are mounted. Alternatively, the total weight of two chambers, e.g. of the chambers 4 and 6 and the chambers 5 and 7, can be determined on a scale likewise not shown in the Figures, and the results of the individual scales can be compared by forming a difference.
[0083]
[0084] In this embodiment of the device 1, the balancing chambers 4 and 5 or 6 and 7 are not parallel to each other but arranged in series. The balancing chambers 5 and 6 have approximately double or more than double the volume of the chambers 4 and 7 arranged in series with them. On the fresh flow side, the fresh flow pump 17 continuously pumps treatment fluid from the second balancing chamber 5 through the dialyzer 3. The measuring device 32 or alternatively a flow sensor can be used to determine the (mass) flow caused by this pump 17. The first balancing chamber 4 on the fresh flow side is used for the actual balancing. The weight of the treatment fluid present in it is continuously measured by the measuring device 32 located below the chamber 4. The first balancing chamber 4 on the fresh flow side has, similar to the first embodiment of
[0085] The device 1 according to the second embodiment is also suitable for degassing and set up for creating a negative pressure in the treatment fluid by a constriction 33 in the internal fluidic system 2, here in front of the fresh flow pump 9. Any air bubbles generated thereby will accumulate in the first balancing chamber 4 on the fresh flow side, resulting in an increase in pressure. This increases the outflow speed of the treatment fluid from the balancing chamber 4 into the balancing chamber 5. To avoid excessive pressures in the chamber 4, it is equipped with a pressure relief valve arranged in the ventilation opening 31 and not shown in
[0086] Compared to the first embodiment (
[0087]
[0088] Compared to the first embodiment, their pumps 9, 17, 19 and 27 are replaced by correspondingly arranged linear motors 35, 36, 37, 38. The linear motors 35, 36, 37, 38 interact with pistons 39, 40, 41, 42 movably arranged in the corresponding balancing chambers 4, 5, 6, 7. The pistons 39, 40, 41, 42 are guided in the respective chamber 4, 5, 6, 7 and sealed against the chamber wall, so that the chambers 4, 5, 6, 7 each form a cylinder belonging to the respective piston 39, 40, 41, 42. The chambers 4, 5, 6, 7 are filled and emptied with a movement of the pistons 39, 40, 41, 42 therein caused by the linear motors 35, 36, 37, 38. The pistons can be arranged either hanging or standing within the scope of the invention. The individual balancing chambers 4, 5, 6, 7 may be thermally insulated. Within the scope of the invention, their size is between approx. 20 ml to approx. 1500 ml. Depending on the size of the chambers 4, 5, 6, 7, the switching cycle of the pistons 39, 40, 41, 42 changes.
[0089] The third embodiment shown in
[0090] A fourth embodiment of device 1 according to aspects of the invention is shown in
[0091]
[0092] All chambers 4, 5, 6, 7 are illustrated with open top, but they are provided with a cover (not shown in
[0093] Finally,