PERITONEAL DIALYSIS PATIENT LINE WITH STERILIZING FILTER AND DRAIN BYPASS
20230073788 · 2023-03-09
Inventors
Cpc classification
A61M1/28
HUMAN NECESSITIES
A61M1/1672
HUMAN NECESSITIES
A61M1/1645
HUMAN NECESSITIES
A61M1/1524
HUMAN NECESSITIES
A61M1/155
HUMAN NECESSITIES
A61M1/1561
HUMAN NECESSITIES
International classification
Abstract
A medical fluid treatment system includes a source of purified water; at least one concentrate for mixing with the water from the source to form a treatment fluid; a disposable set including a pumping portion, a concentrate line in fluid communication with the concentrate source and the pumping portion, and a patient line in fluid communication with the pumping portion, the patient line including a filter having a membrane configured to filter the treatment fluid, the filter configured such that (i) fresh treatment fluid flowing from the pumping portion towards a patient flows through the membrane and (ii) used treatment fluid flowing through the filter from the patient to the pumping portion bypasses the membrane; and a medical fluid delivery machine including a pump actuator operable with the pumping portion of the disposable set.
Claims
1. A peritoneal dialysis system comprising: a cycler configured to pump peritoneal dialysis fluid; and a disposable set configured to receive peritoneal dialysis fluid pumped by the cycler, the disposable set including a filter having a membrane configured to filter the peritoneal dialysis fluid, the filter configured such that (i) fresh peritoneal dialysis fluid flowing from the cycler towards a patient flows through the membrane via a pathway having an exit end located downstream from fresh peritoneal dialysis fluid flow through the membrane, and (ii) used peritoneal dialysis fluid flowing through the filter from the patient to the cycler bypasses the membrane.
2. The peritoneal dialysis system of claim 1, wherein the disposable set includes a line extending from the filter to a connector configured to connect to a patient transfer set.
3. The peritoneal dialysis system of claim 1, wherein the disposable set further includes a disposable drain line.
4. The peritoneal dialysis system of claim 1, wherein the filter is connected to a patient line extending from the cycler.
5. The peritoneal dialysis system of claim 1, wherein the pathway is a fresh peritoneal dialysis fluid pathway, and wherein the filter further includes a used peritoneal dialysis fluid pathway placed in parallel with the fresh peritoneal dialysis fluid pathway, the membrane located along the fresh peritoneal dialysis fluid pathway, the used peritoneal dialysis fluid pathway configured to enable used peritoneal dialysis fluid flowing through the filter to bypass the membrane.
6. The peritoneal dialysis system of claim 5, wherein a one-way valve is located at or near the exit end of the fresh peritoneal dialysis fluid pathway, the one-way valve positioned and arranged to prevent used peritoneal dialysis fluid returning from the patient from reaching the membrane.
7. The peritoneal dialysis system of claim 5, wherein a one-way valve is located at an exit end of the used peritoneal dialysis fluid pathway, the one-way valve positioned and arranged to prevent fresh peritoneal dialysis fluid from flowing through the filter via the used peritoneal dialysis fluid pathway.
8. The peritoneal dialysis system of claim 5, wherein the membrane is housed in a membrane housing located along the fresh fluid pathway, and wherein the filter is configured such that fresh peritoneal dialysis fluid flows from outside the membrane housing, through the membrane, and into an interior region of the membrane housing.
9. The peritoneal dialysis system of claim 5, wherein the filter includes a housing having a first port and a second port, the first port opening to a first end of the filter housing and the second port opening to a second end of the filter housing, the first end of the filter housing forming a first end of the fresh and used peritoneal dialysis fluid pathways, and the second end of the filter housing forming a second end of the fresh and used peritoneal dialysis fluid pathways.
10. The peritoneal dialysis system of claim 9, wherein the first end of the fresh fluid treatment pathway at the first end of the filter housing includes a first one-way valve, and wherein the second end of the used fluid treatment pathway at the second end of the filter housing includes a second one-way valve.
11. The peritoneal dialysis system of claim 1, wherein the membrane is housed in a membrane housing, and wherein fresh peritoneal dialysis fluid entering the filter flows to an outside of the membrane housing, and fresh, filtered peritoneal dialysis fluid exiting the filter flows from an inside of the membrane housing.
12. The peritoneal dialysis system of claim 1, wherein the membrane is a first membrane, wherein the filter includes a second membrane, wherein the first and second membranes are housed in a membrane housing, and wherein fresh peritoneal dialysis fluid entering the filter is split into a first branch flowing to an outside of the first membrane and a second branch flowing to an outside of the second membrane.
13. The peritoneal dialysis system of claim 12, wherein the membrane housing includes a grid of passageways located between the first and second membranes.
14. The peritoneal dialysis system of claim 12, wherein the first and second membranes are located on opposing sides of the membrane housing, respectively, the first branch extending to a first side of the housing and the second branch extending to a second side of the housing.
15. The peritoneal dialysis system of claim 1, which includes at least one hydrophobic vent for removing air from the filter.
16. A peritoneal dialysis system comprising: a cycler configured to pump peritoneal dialysis fluid; and a disposable set configured to receive peritoneal dialysis fluid pumped by the cycler, the disposable set including a filter in which peritoneal dialysis fluid is intended to flow in first and second directions, wherein the filter is configured to filter peritoneal dialysis fluid flowing in the first direction and to not filter peritoneal dialysis fluid flowing in the second direction, the filter including a filter housing, a first fluid pathway provided by the filter housing for flowing peritoneal dialysis fluid in the first direction, a second fluid pathway provided by the filter housing for flowing peritoneal dialysis fluid in the second direction, and a membrane positioned to filter peritoneal dialysis fluid flowing in the first direction, and wherein an exit end of the first fluid pathway is located downstream from peritoneal dialysis fluid flow through the membrane.
17. The peritoneal dialysis system of claim 16, wherein the membrane is housed in a membrane housing located within the filter housing and along the fresh fluid pathway, and wherein the filter is configured such that fresh peritoneal dialysis fluid flows from outside the membrane housing, through the membrane, and into an interior region of the membrane housing.
18. The peritoneal dialysis system of claim 16, wherein the filter housing includes a first port and a second port, the first port opening to a first end of the filter housing and the second port opening to a second end of the filter housing, the first end of the filter housing forming a first end of the fresh and used peritoneal dialysis fluid pathways, and the second end of the filter housing forming a second end of the fresh and used peritoneal dialysis fluid pathways.
19. The peritoneal dialysis system of claim 16, wherein the membrane is housed in a membrane housing located within the filter housing, and wherein fresh peritoneal dialysis fluid entering the filter flows to an outside of the membrane housing, and fresh, filtered peritoneal dialysis fluid exiting the filter flows from an inside of the membrane housing.
20. The peritoneal dialysis system of claim 16, wherein the membrane is a first membrane, and wherein the filter includes a second membrane, wherein the first and second membranes are housed in a membrane housing located within the filter housing, and wherein fresh peritoneal dialysis fluid entering the filter is split into a first branch flowing to an outside of the first membrane and a second branch flowing to an outside of the second membrane.
Description
BRIEF DESCRIPTION OF THE FIGURES
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DETAILED DESCRIPTION
System Overview
[0078] The examples described herein are applicable to any medical fluid therapy system that delivers a medical fluid that may be mixed at the point of use, prior to and/or during treatment, such as dialysis fluid, substitution fluid, or an intravenous drug. The examples are particularly well suited for kidney failure therapies, such as all forms of peritoneal dialysis (“PD”), hemodialysis (“HD”), hemofiltration (“HF”), hemodiafiltration (“HDF”) and continuous renal replacement therapies (“CRRT”), referred to herein collectively or generally individually as renal failure therapy. Moreover, the machines described herein may be used in clinical or home settings. For example, the machines and associated methods may be employed in an in-center PD or HD machine, which runs virtually continuously throughout the day. Alternatively, the machine and methods may be used in a home PD or HD machine, which can for example be run at night while the patient is sleeping. The machines and methods discussed herein are also applicable to medical delivery applications. The following examples will be described in the setting of a peritoneal dialysis system having point of use dialysis fluid production but may instead be used to make point of use treatment fluid for any of the above modalities.
[0079] Referring now to the drawings and in particular to
[0080] Cycler 20 includes a housing 24, which holds equipment programmed via control unit 22 to prepare fresh dialysis solution at the point of use, pump the freshly prepared dialysis fluid to patient P, allow the dialysis fluid to dwell within patient P, then pump used dialysis fluid to a drain. In the illustrated embodiment, water purifier 210 includes a drain line 214 leading to a drain 216, which can be a house drain or a drain container. The equipment programmed via control unit 22 to prepare fresh dialysis solution at the point of use in an embodiment includes equipment for a pneumatic pumping system, including but not limited to (i) one or more positive pressure reservoir, (ii) one or more negative pressure reservoir, (iii) a compressor and a vacuum pump each under control of control unit 22, or a single pump creating both positive and negative pressure under control of control unit 22, to provide positive and negative pressure to be stored at the one or more positive and negative pressure reservoirs, (iv) plural pneumatic valve chambers for delivering positive and negative pressure to plural fluid valve chambers, (v) plural pneumatic pump chambers for delivering positive and negative pressure to plural fluid pump chambers, (vi) plural electrically actuated on/off pneumatic solenoid valves under control of control unit 22 located between the plural pneumatic valve chambers and the plural fluid valve chambers, (vii) plural electrically actuated variable orifice pneumatic valves under control of control unit 22 located between the plural pneumatic pump chambers and the plural fluid pump chambers, (viii) a heater under control of control unit 22 for heating the dialysis fluid as it is being mixed in one embodiment, and (ix) an occluder 26 under control of control unit 22 for closing the patient and drain lines in alarm and other situations.
[0081] In one embodiment, the plural pneumatic valve chambers and the plural pneumatic pump chambers are located on a front face or surface of housing 24 of cycler 20. The heater is located inside housing 24 and in an embodiment includes heating coils that contact a heating pan or tray, which is located at the top of housing 24, beneath a heating lid (not seen in
[0082] Cycler 20 in the illustrated embodiment includes a user interface 30. Control unit 22 in an embodiment includes a video controller, which may have its own processing and memory for interacting with primary control processing and memory of control unit 22. User interface 30 includes a video monitor 32, which may operate with a touch screen overlay placed onto video monitor 32 for inputting commands via user interface 30 into control unit 22. User interface 30 may also include one or more electromechanical input device, such as a membrane switch or other button. Control unit 22 may further include an audio controller for playing sound files, such as voice activation commands, at one or more speaker 34.
[0083] Water purifier 210 in the illustrated embodiment also includes a user interface 220. Control unit 212 of water purifier 210 in an embodiment includes a video controller, which may have its own processing and memory for interacting with primary control processing and memory of control unit 212. User interface 220 includes a video monitor 222, which may likewise operate with a touch screen overlay placed onto video monitor 222 for inputting commands into control unit 212. User interface 220 may also include one or more electromechanical input device, such as a membrane switch or other button. Control unit 212 may further include an audio controller for playing sound files, such as alarm or alert sounds, at one or more speaker 224 of water purifier 210.
[0084] Referring additionally to
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[0087] Water purifier 210 outputs water and possibly water suitable for peritoneal dialysis (“WFPD”). Sterile sterilizing grade filter 100 in patient line 50 ensures that any contaminants in the water exiting water purifier 210 are removed. In addition to sterile patient line sterilizing grade filter 100, system 10 may, but does not have to, provide one or more sterile sterilizing grade filter in one or more of the water lines. In the illustrated embodiment, a sterile sterilizing grade filter 90a is placed upstream from a downstream sterile sterilizing grade filter 90b, respectively. Filters 90a and 90b may be placed in water line segment 64a upstream of water accumulator 66. Sterile sterilizing grade filters 100, 90a and 90b may be pass-through filters that do not have a reject line. Pore sizes for the filtering membranes of filters 100, 90a and 90b may, for example, be less than a micron, such as 0.1 or 0.2 micron. Suitable sterile sterilizing grade filters 100, 90a and 90b may be provided by the assignee of the present disclosure. In an embodiment, only one of upstream or downstream sterilizing filter 90a and 90b is needed to produce WFPD, nevertheless, two sterile sterilizing grade filters 90a and 90b may be provided in the illustrated embodiment for redundancy in case one fails.
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[0091] In an embodiment, to begin treatment, patient P loads cassette 42 into cycler 20 and in a random or designated order (i) places heater/mixing bag 62 onto cycler 20, (ii) connects upstream water line segment 64a to water outlet connector 228 of water purifier 210, (iii) connects drain line 56 to drain connector 218 of water purifier 210, (iv) connects first cassette concentrate connector 80a to first container concentrate connector 80b, and (v) connects second cassette concentrate connector 82a to second container concentrate connector 82b. At this point, patient connector 52 is still capped. Once fresh dialysis fluid is prepared and verified, patient line 50 including sterile sterilizing grade filter 100 is primed with fresh dialysis fluid, after which patient P may connect patient line connector 52 to transfer set 54 for treatment. Each of the above steps may be illustrated graphically at video monitor 32 and/or be provided via voice guidance from speakers 34.
[0092] For disposable set 40, the rigid portion of cassette 42 may be made for example of a thermal olefin polymer of amorphous structure (“TOPAS”) cyclic olefin copolymer (“coc”). The flexible membranes of cassette 42 may be made for example of a copolyletser ether (“PCCE”) and may be of one or more layer. Any of the tubing or lines may be made for example of polyvinyl chloride (“PVC”). Any of the connectors may be made for example of acrylonitrile-butadiene-styrene (“ABS”, e.g., a connector 70 of heater/mixing bag or container 62 and/or for concentrate connectors 80a, 80b, 82a, 82b discussed below), acrylic (e.g., for drain line connector 58) or PVC (e.g., for water line connector water line connector 68). Any of the bags or containers, such as heater/mixing bag or container 62 discussed below, may be made of PVC. The materials for any of the above components may be changed over time. The housing for sterile sterilizing grade filter 100 may be made of any of the materials listed above.
[0093] Control unit 22 may be programmed to cause cycler 20 to perform one or more mixing action to help mix dialysis fluid properly and homogeneously for treatment. For example, any of fluid pump chambers 44 may be caused to withdraw into the pump chambers some amount of mixed fluid (e.g., made from one or both first and second concentrates 84a, 84b and purified water) from heater/mixing bag 62 and send such mixture back to heater/mixing bag 62 and repeat this procedure multiple times (described herein as a mixing sequence or “waffling”). In particular, to perform a mixing sequence, control unit 22 in an embodiment causes cycler 20 to close all fluid valve chambers 46 at cassette 42 except for the fluid valve chamber 46 to heater/mixing line 60 and heater/mixing bag 62. Fluid pump chambers 44 are stroked sequentially and repeatedly (i) pulling a possibly unmixed fluid combination of purified water and concentrates from heater/mixing bag 62 into the pump chambers, followed by (ii) pushing the mixed purified water and concentrates from the pump chambers back to heater/mixing bag 62 and (iii) repeating (i) and (ii) at least one time. Control unit 22 may be programmed to stroke fluid pump chambers 44 and associated valves 46 together so that they both pull and push at the same time, or alternatingly so that one pump chamber 44 pulls from heater/mixing bag 62, while the other pump chamber 44 pushes to heater/mixing bag 62, creating turbulence in heater/mixing line 60.
[0094] Providing container or bag 62 operable with cassette 42 and heater/mixing line 60 enables the purified water from accumulator 66 and the concentrates from first and second concentrate containers 84a and 84b to at least partially mix before entering the container or bag. Even if cassette 42 is not provided, however, the purified water and at least one concentrate will mix partially in heater/mixing line 60 prior to reaching the container or bag.
Patient Line Filter
[0095] Referring now to
[0096] Patient line sterile sterilizing grade filter 100 includes a filter housing 102, any one or more components of which may be made of any of the materials listed above, and which may be made of one or more molded, e.g., injection molded, piece. In the illustrated embodiment, housing 102 includes an elongated enclosure 104 sealed at two ends by a first port cap 106 and a second port cap 112. First port cap 106 includes a first port 108 and defines a first manifold or open area 110, while second port cap 112 includes a second port 114 and defines a second manifold or open area 116. First and second ports 108 and 112 may configured to connect sealingly to segments of patient line 50 via a compression fitting (ports have a compression connector), a hose barb fitting (ports have hose barbs), a luer connection (ports have a male or female luer connector), a stretching of the patient line fitting (outside diameter of the ports is larger than an inner diameter of segments of patient line 50) or combinations thereof.
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[0098] First port cap 106 houses a first one-way valve 150a, which is sealed to the structure forming fresh dialysis fluid pathway 120. Second port cap 112 houses a second one-way valve 150b, which is sealed to elongated enclosure 104 of filter housing 102 forming used dialysis fluid pathway 118 in the illustrated embodiment. First and second one-way valves 150a and 150b may be made of a medically safe rubber or plastic, such as silicone or any of the flexible materials listed above. First and second one-way valves 150a and 150b may be, for example, duckbill check valves.
[0099] As illustrated in
[0100] As further illustrated in
[0101] Referring now to
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[0103] In the illustrated embodiment of
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[0106] Referring now to
[0107] Filter membranes 140 and 142 are each hydrophilic membranes in one embodiment. Hydrophilic membranes in general allow liquid water to pass from one side of the membrane to the other and when properly wetted block air from such passing. Pore sizes for filter membranes 140 and 142 may, for example, be less than a micron, such as 0.1 or 0.2 micron. This pore size helps to remove any lingering contaminants or impurities in the fresh dialysis fluid from any of: the purified water used to make the fresh dialysis fluid, the concentrates used to make the fresh dialysis fluid, and/or any portion of disposable set carrying the purified water or concentrates to patient P.
[0108] Referring now to
[0109] To maintain baffles 136 in their illustrated separated and generally parallel relationship, plural cross-braces 138 may be provided. Cross-braces 138 are sized (narrowed) to enable filtered dialysis fluid to flow along channels 144 defined by baffles 136, over the cross-braces, to a collection channel 146. Collection channel 146 in turn funnels the filtered dialysis fluid to first one-way valve 150a, after which the filtered dialysis fluid exits filter 100 into a downstream segment of patient line 50 as has been discussed herein.
[0110] It should be understood that various changes and modifications to the presently preferred embodiments described herein will be apparent to those skilled in the art. Such changes and modifications can be made without departing from the spirit and scope of the present subject matter and without diminishing its intended advantages. It is therefore intended that such changes and modifications be covered by the appended claims. For example, fluid pump chambers 44 may be pneumatically actuated pump chambers or be a section of peristaltic pumping tube. Similarly, valve chambers 46 may be pneumatically actuated, e.g., be volcano valves, or be sections of tubing operated upon by pinch valves. Likewise, the pump and valve actuators may be pneumatic actuators or be electromechanical actuators, e.g., a peristaltic pump actuator and pinch valves, respectively.