HEMODIALYSIS OR HEMO(DIA)FILTRATION APPARATUS AND A METHOD FOR CONTROLLING A HEMODIALYSIS OR HEMO(DIA)FILTRATION APPARATUS

• US 20110098625A1
• Filed: 05/26/2008
• Published: 04/28/2011
• Est. Priority Date: 05/26/2008
• Status: Active Grant

• Current Assignee: Gambro Lundia AB (Baxter International Inc.)
• Original Assignee: Gambro Lundia AB (Baxter International Inc.)
• Inventors: Masala, Pietro, Suffritti, Mauro, Wallenborg, Anders, Gebhart, Thomas
• Granted Patent: US 8,647,290 B2
• Time in Patent Office: Days
• US Class Current: 604/6.09
• CPC Class Codes: A61M 1/342 Adding solutions to the blood, e.g. substitution solutions for preventing coagulation A61M1/3672
• CPC Class Codes: A61M 1/3434 with pre-dilution and post-dilution
• CPC Class Codes: A61M 1/3437 downstream of the filter, e.g. post-dilution with filtrate
• CPC Class Codes: A61M 1/3441 Substitution rate control as a function of the ultrafiltration rate
• CPC Class Codes: A61M 1/3639 Blood pressure control, pressure transducers specially adapted therefor
• CPC Class Codes: A61M 2205/3331 Pressure; Flow

Abstract

In a hemodiafiltration apparatus, a control and command unit (11) halts a replacement fluid supply pump (8) and contemporaneously modifies the control mode of a blood pump (1) passing from a control based on the pump velocity to a control based on the blood pressure measured by a sensor (12) arranged downstream of a hemodiafilter (3). The aim is to prevent risks due to excessive hemo-concentration in the blood circuit between the ultrafiltration zone and the infusion zone.

Claims

1-37. -37. (canceled)

38. A hemodialysis or hemo(dia)filtration apparatus, comprising:

a blood treatment device having a blood chamber and a fluid chamber which are separated from one another by a semipermeable membrane;

an extracorporeal blood circuit having an arterial line for blood removal from an individual and a venous line for blood return to the individual, the arterial line and the venous line being connected to an inlet and, respectively, to an outlet of the blood chamber;

a blood moving device configured for moving the blood along the extracorporeal circuit;

at least a venous pressure sensor configured for emitting a venous pressure signal indicating a pressure in the venous line;

a fluid circuit having at least a discharge line connected to an outlet of the fluid chamber;

an ultrafiltration device configured for ultrafiltering plasmatic liquid from the blood chamber to the fluid chamber across the semipermeable membrane;

an infusion circuit having at least a first supply line of an infusion fluid connected to the extracorporeal blood circuit;

an infusion fluid supply device configured to supply the infusion fluid along the first supply line;

a control unit programmed to perform following operations;

determining an occurrence of a halt or slow-down or start or speed-up of the infusion fluid supply to the extracorporeal blood circuit; and

passing from a first command mode of the blood movement device to a second command mode of the blood movement device by effect of said occurrence of a halt or slow-down or start or speed-up, the blood movement device being, in the second command mode, controlled on a basis of a comparison between said venous pressure signal and at least a set point value.

39. The apparatus of claim 38, wherein the infusion circuit and the infusion fluid supply device are configured to supply a replacement fluid during a hemo(dia)filtration treatment.

40. The apparatus of claim 38, wherein the infusion circuit and the infusion fluid supply device are configured to supply a replacement fluid during an infusion bolus.

41. The apparatus of claim 38, wherein the first supply line is connected to the venous line or to the arterial line.

42. The apparatus of claim 38, wherein the determining of an occurrence of a halt or, slow-down or start or speed-up comprises determining a halt or slow-down or start or speed-up of the infusion fluid supply device.

43. The apparatus of claim 38, wherein the control unit is programmed to cause a halt or slow-down or start or speed-up of the ultrafiltration across the semipermeable membrane, by effect of an occurrence of the halt or slow-down or start or speed-up of supply of the infusion fluid.

44. The apparatus of claim 38, wherein the second command mode comprises retroactively controlling the blood movement device such that the venous pressure is comprised in a predetermined value range.

45. The apparatus of claim 38, wherein the second command mode is started up at a moment comprised in a predetermined time period which includes an occurrence of the halt or slow-down or start or speed-up of the supply of the infusion fluid.

46. The apparatus of claim 45, wherein the second command mode is started at a same moment of said halt or slow-down or start or speed-up.

47. The apparatus of claim 45, wherein the second command mode is started at a after a predetermined interval following said halt or slow-down or start or speed-up.

48. The apparatus of claim 45, wherein the second command mode is started before a predetermined time interval preceding of said halt or slow-down or start or speed-up.

49. The apparatus of claim 38, wherein the determining of a halt or slow-down or start or speed-up of the infusion fluid supply comprises actively commanding the infusion fluid supply device.

50. The apparatus of claim 49, wherein the commanding is operated consequently of a preset program or as a consequence of a detecting of a faulty situation.

51. The apparatus of claim 38, wherein the determining of a halt or slow-down or start or speed-up of the infusion fluid supply comprises detecting a signal supplied by a sensor and indicating said halt or slow-down or start or speed-up.

52. The apparatus of claim 51, wherein said halt or slow-down or start or speed-up sensor is operatively associated to the infusion circuit and/or the infusion fluid supply device and/or the venous line and/or the extracorporeal blood circuit.

53. The apparatus of claim 51, wherein said halt or slow-down or start or speed-up sensor is configured to detect an operating parameter of the infusion fluid supply device.

54. The apparatus of claim 51, wherein said halt or slow-down or start or speed-up sensor is configured to detect a characteristic parameter of the infusion fluid and/or a mixture of the infusion fluid and the blood in the venous line or in the arterial line.

55. The apparatus of claim 38, wherein the first command mode comprises controlling the blood movement device in accordance with a second signal which is different from the venous pressure signal.

56. The apparatus of claim 55, wherein the second signal comprises a signal indicating the blood flow rate along the extracorporeal blood circuit.

57. The apparatus of claim 56, wherein the flow rate signal comprises a signal indicating an operating parameter of the blood movement device.

58. The apparatus of claim 38, wherein the fluid circuit has at least a supply line of a dialysis fluid connected to an inlet of the fluid chamber, and wherein the control unit is programmed to pass from the first command mode to the second command mode in consequence of a passage from a hemo(dia)filtration treatment mode to a hemodialysis treatment mode.

59. The apparatus of claim 38, wherein the set point value corresponds to a value of venous pressure measured on or before said halt or slow-down or start or speed-up of the infusion fluid supply.