METHOD, APPARATUS, AND SYSTEM FOR TREATMENT OF BLOOD OF A PATIENT

• US 20130267883A1
• Filed: 09/14/2012
• Published: 10/10/2013
• Est. Priority Date: 09/26/2011
• Status: Abandoned Application

• Current Assignee: Fresenius Medical Care Deutschland GmbH (Fresenius Medical Care AG)
• Original Assignee: Fresenius Medical Care Deutschland GmbH (Fresenius Medical Care AG)
• Inventors: MEDRANO, Guillermo
• Application Number:
  US13/618,778
• Publication Number:
  US 20130267883A1
• Time in Patent Office: Days
• US Class Current: 604/5.01
• CPC Class Codes: A61G 15/02 Chairs with means to adjust position of patient; Controls therefor
• CPC Class Codes: A61G 2203/40 for distance
• CPC Class Codes: A61G 2203/42 for inclination
• CPC Class Codes: A61G 7/00 Beds specially adapted for nursing; Devices for lifting patients or disabled persons stretchers with facilities for picking up patients or disabled persons A61G1/003
• CPC Class Codes: A61G 7/015 divided into different adjustable sections, e.g. for Gatch position
• CPC Class Codes: A61M 1/14 Dialysis systems; Artificial kidneys; Blood oxygenators semi-permeable membranes characterised by the material, manufacturing processes therefor B01D71/00; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
• CPC Class Codes: A61M 1/1603 Regulation parameters
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
• CPC Class Codes: A61M 1/34 Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
• CPC Class Codes: A61M 1/3403 Regulation parameters
• CPC Class Codes: A61M 1/341 by measuring the filtrate rate or volume
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2230/62 Posture

Abstract

The present invention relates to a method for treating the blood of a patient, comprising removing water from the blood of patients at a settable water removal rate, wherein the position of the patient is determined and the water removal rate is set, controlled, and/or regulated depending on the determined position of the patient. The invention further relates to an apparatus for treating the blood of a patient, comprising a blood treatment device for removing water from the blood of the patient at a settable water removal rate, wherein position-determining means for determining the position of the patient, wherein the water removal rate is settable, regulatable, and/or controllable depending on the determined position of the patient.

Claims

1. A method for treating blood of a patient (2), comprising removing water from the blood of the patient (2) at a settable water removal rate,

characterized in that

the position of the patient (2) is determined and the water removal rate is set, controlled, and/or regulated in dependence of the determined position of the patient (2).

2. The method according to claim 1, wherein determining the position of the patient (2) is performed on a patient bed (3), on a patient chair and/or on to the patient (2) himself/herself, preferably by the evaluation of sensors (40, 42, 44) mounted to the patient bed (3) and/or to the patient chair, of sensors arranged on the patient (2), and/or of sensors monitoring the patient (2), particularly by the evaluation of position sensors (40, 42, 44), optical sensors, and/or imaging sensors (46).

3. The method according to claim 1, wherein removing water from the blood is performed by means of a peritoneal dialysis and the water removal rate is set, controlled, and/or regulated by means of setting, controlling, and/or regulating the concentration of substances dissolved in the dialysis fluid, preferably of glucose and/or dextrin, prior to introducing the dialysis fluid into the abdominal cavity.

4. The method according to claim 3, wherein the dialysis fluid located in the abdominal cavity is replaced for a dialysis fluid, which has a different concentration of dissolved substances, when the position of the patient (2) changes.

5. The method according to claim 1, wherein removing water from the blood is performed by ultra-filtration, wherein the water removal rate is settable via the ultra-filtration rate (UFR), and the ultra-filtration rate (UFR) is set, controlled, and/or regulated in dependence of the determined position of the patient (2).

6. The method according to claim 5, wherein the setting, controlling, and/or regulation of the ultra-filtration rate (UFR) is achieved by means of setting, controlling, and/or regulating the pumping rate during the ultra-filtration, in particular by setting, controlling, and/or regulating the pumping rate of a hose reel pump, gear pump, diaphragm pump, and/or impeller arranged downstream of a dialysis filter.

7. The method according to claim 1, wherein the water removal rate, preferably the ultra-filtration rate, is set, controlled, and/or regulated at a higher level for a substantially lying patient (2) than for a patient (2) arranged in a position more upright with regard to the lying position.

8. The method according to claim 1, wherein the patient (2) adjusts his/her position himself/herself, especially by means of actuators acting on a patient bed (3) and/or a patient chair.

9. The method according to claim 1, wherein the water removal rate, preferably the ultra-filtration rate, is set, controlled, and/or regulated at a higher level at the start of treatment than at a subsequent section of the treatment.

10. The method according to claim 1, wherein the water removal rate, preferably the ultra-filtration rate, is controlled and/or regulated in dependence of the position of the patient (2) only in a first treatment phase;

in a second treatment phase, however, it is kept constant, wherein the first treatment section preferably ends by withdrawing half of the planned amount of liquid (UFG/2).

11. The method according to claim 1, wherein the water removal rate, preferably the ultra-filtration rate, for setting, controlling, and/or regulating in dependence of the position of the patient (2) is raised and/or lowered from a predetermined water removal rate, preferably ultra-filtration rate (UFR_SET), by a predetermined difference (UFR+), wherein the predetermined difference (UFR+) is preferably derived from the expected change in plasma volume between a substantially lying and a substantially upright position of the patient (2).

12. The method according to claim 1, wherein the water removal rate, preferably the ultra-filtration rate (UFR), is initially raised for a period (t_UFR±

) of the treatment, preferably by a predetermined value (UFR+), and, in the event of a change in position of the patient towards a more upright position, is then lowered for the same period (t_UFR±

), preferably by the same predetermined value (UFR+), wherein, preferably initially an increased water removal rate, preferably ultra-filtration rate (UFR=UFR_SET+UFR+), and then a reduced water removal rate, preferably ultra-filtration rate (UFR=UFR_SET−

UFR+), is set, regulated, and/or controlled.

13. The method according to claim 1, wherein the method is employed in hemodialysis, hemofiltration, hemodiafiltration, peritoneal dialysis, apheresis and/or plasmapheresis.

18. An apparatus for treating the blood of a patient (2), comprising a blood treatment apparatus (1) for removing water from the blood of the patient (2) at a settable water removal rate, characterized by position determining means (40, 42, 44, 46) for determining the position of the patient (2), wherein the water removal rate is settable, regulatable, and/or controllable in dependence of the determined position of the patient, wherein control means for performing a method according to claim 1 is provided.

14. An apparatus for treating the blood of a patient (2), comprising a blood treatment apparatus (1) for removing water from the blood of the patient (2) at a settable water removal rate,

characterized by

position determining means (40, 42, 44, 46) for determining the position of the patient (2), wherein the water removal rate is settable, regulatable, and/or controllable in dependence of the determined position of the patient.

15. The apparatus according to claim 14, wherein the position determining means are configured as sensors (40, 42, 44) mounted to the patient bed (3) and/or to the patient chair, as sensors arranged at the patient (2) and/or as sensors monitoring the patient and preferably configured as position sensors, optical sensors, and/or imaging sensors (46).

16. The apparatus according to claim 14, wherein actuators acting on a patient bed (3) and/or on a patient chair are provided, by means of which the patient (2) is capable of independently setting his/her position.

17. The apparatus according to claim 14, wherein a data processing device (5) for evaluating the signals of position determining means (40, 42, 44, 46) is provided, wherein the data processing apparatus (5) is configured for setting, regulating, and/or controlling the water removal rate, preferably the ultra-filtration rate (UFR), corresponding to the determined position of the patient (2).

19. The apparatus according to claim 14, wherein the blood treatment apparatus (1) is configured for performing hemodialysis, hemofiltration, hemodiafiltration, peritoneal dialysis, apheresis and/or plasmapheresis.

20. A system for treating blood, comprising a blood treatment apparatus (1) for removing water from the blood of a patient (2) at a settable water removal rate, and a patient bed (3) and/or a patient chair for supporting the patient (2) during the blood treatment,

characterized in that

position-determining means (40, 42, 44) for determining the position of the patient (2) are provided, and a data processing device (5) for evaluating the signals of the position-determining means (40, 42, 44) is provided, wherein the data processing device (5) is configured for setting, regulating, and/or controlling the water removal rate according to the determined position of the patient (2).