SYSTEM AND METHOD FOR DELIVERY OF REGIONAL CITRATE ANTICOAGULATION TO EXTRACORPOREAL BLOOD CIRCUITS
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Abstract
The present invention includes a comprehensive replacement fluid system and method for the delivery of regional citrate anticoagulation (RCA) to extracorporeal blood circuits, wherein the system may include an online clearance monitor (OCM) and a circuit effluent online sensor system (OSS) for the continuous determination of patient plasma content of ultrafilterable soultes.
87 Citations
189 Claims
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1-145. -145. (canceled)
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146. A system for regional citrate anticoagulation in an extracorporeal blood circuit including an arterial blood line arranged to be connected to a vascular access for withdrawing blood from a patient and a venous blood line arranged to be connected to the vascular access for returning blood to the patient, the system comprising:
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a hemofilter in fluid communication with the arterial and venous blood lines and having a dialysis-fluid in connector and a dialysis-fluid out connector; a first pre-filter infusion line and pump having a connection to the arterial blood line upstream from the hemofilter for infusing a first pre-filter infusion solution comprising a citrate anticoagulant-containing solution; a second pre-filter infusion line and pump capable of a connection to the arterial blood line upstream from the hemofilter for infusing a second pre-filter infusion solution comprising a first bicarbonate-containing solution; a fresh dialysis fluid line and pump capable of a connection to the hemofilter dialysis-fluid in connection for providing dialysis with a second bicarbonate-containing solution countercurrent to a direction of blood flow in the hemofilter; a post-filter infusion line and pump capable of a connection to the venous blood line downstream from the hemofilter for infusing a post-filter infusion solution comprising a third bicarbonate-containing solution; an effluent fluid line and pump connected to the hemofilter dialysis-fluid out connection for receiving filter effluent fluid; an additional infusion line and pump having a connection to the venous blood line downstream from the connection of the post-filter infusion line for infusing an additional infusion solution comprising a calcium- and magnesium-containing solution; and a monitor for determining a performance of the hemofilter in removing citrate from the blood. - View Dependent Claims (147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169)
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170. A system for regional citrate anticoagulation in an extracorporeal blood circuit including an arterial blood line arranged to be connected to a vascular access for withdrawing blood from a patient and a venous blood line arranged to be connected to the vascular access for returning blood to the patient, the system comprising:
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a hemofilter in fluid communication with the arterial and venous blood lines and having a dialysis-fluid in connector and a dialysis-fluid out connector; a pre-filter infusion line and pump having a connection to the arterial blood line upstream from the hemofilter for infusing a pre-filter infusion solution comprising a citrate anticoagulant-containing solution; a post-filter infusion line and pump having a connection to one of
1) the hemofilter dialysis-fluid in connector to provide dialysis with a bicarbonate-containing solution countercurrent to blood flow or
2) the venous blood line downstream from the hemofilter for infusing a post-filter infusion solution comprising a bicarbonate-containing solution;an effluent fluid line and pump connected to the hemofilter dialysis-fluid out connector for receiving filter effluent fluid; an additional infusion line and pump having a connection to the venous blood line downstream from the connection of the post-filter infusion line for infusing an additional infusion solution comprising a calcium- and magnesium-containing solution; and a monitor for determining a performance of the hemofilter in removing citrate from the blood. - View Dependent Claims (171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189)
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Specification