Apparatus for extracorporeal treatment of blood

• US 4,711,715 A
• Filed: 01/29/1986
• Issued: 12/08/1987
• Est. Priority Date: 04/13/1983
• Status: Expired due to Fees

• Current Assignee: Fresenius AG (Fresenius SE & Co. KGaA)
• Original Assignee: Fresenius AG (Fresenius SE & Co. KGaA)
• Inventors: Polaschegg, Hans-Dietrich
• Primary Examiner(s): CINTINS, IVARS C
• Application Number:
  US06/823,887
• Time in Patent Office: 678 Days
• Field of Search: 210/137, 210/205, 210/321.1, 210/321.2, 210/321.3, 210/321.4, 210/321.5, 210/929, 210/143, 210/90, 210/103, 210/105
• US Class Current: 210/103
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/30 Single needle dialysis ; Reciprocating systems, alternately withdrawing blood from and returning it to the patient, e.g. single-lumen-needle dialysis or single needle systems for hemofiltration or pheresis
• CPC Class Codes: A61M 1/302 having a reservoir for withdrawn untreated blood
• CPC Class Codes: A61M 1/306 Pressure control, e.g. using substantially rigid closed or gas buffered or elastic reservoirs
• CPC Class Codes: A61M 1/309 with trans-membrane pressure [TMP] increasing substantially continuously during arterial phase
• CPC Class Codes: A61M 1/341 by measuring the filtrate rate or volume
• CPC Class Codes: A61M 1/3413 Diafiltration
• CPC Class Codes: A61M 1/3437 downstream of the filter, e.g. post-dilution with filtrate
• CPC Class Codes: A61M 1/3465 using dialysate as substitution fluid
• CPC Class Codes: A61M 1/3609 Physical characteristics of the blood, e.g. haematocrit, urea
• CPC Class Codes: A61M 1/361 before treatment
• CPC Class Codes: A61M 1/3612 after treatment
• CPC Class Codes: A61M 1/3669 Electrical impedance measurement of body fluids; transducers specially adapted therefor
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3317 Electromagnetic, inductive or dielectric measuring means
• CPC Class Codes: A61M 2205/3324 PH measuring means
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3382 Upper level detectors
• CPC Class Codes: A61M 2205/3386 Low level detectors
• CPC Class Codes: A61M 2230/207 : hematocrit
• CPC Class Codes: B01D 61/22 : Controlling or regulating

Abstract

An apparatus for controlling the ultrafiltration rate in machines for the extracorporeal purification of blood in which the difference obtained in the blood circuit by an electromagnetic flow meter is used for controlling the ultrafiltration rate.

The ultrafiltration rate is controlled by controlling the transmembrane pressure across the membrane separating the blood chamber from the dialysis fluid chamber in a dialyzer. In one embodiment, the pressure in the blood circuit is varied to change the transmembrane pressure. In a second embodiment, the pressure in the dialysis solution circuit is varied.

Claims

1. In a hemodialysis apparatus comprising a first chamber, a second chamber, a dialysis solution circuit, a blood circuit, means for preparing a fresh dialysis solution, and means for withdrawing ultrafiltrate from said dialysis circuit, said first chamber being separated by means of a membrane from said second chamber, said first chamber being connected into said dialysis solution circuit, and said second chamber being connected into said blood circuit, said blood circuit including a first blood side upstream of said second chamber and a second blood side downstream of said second chamber, the improvement comprising:

a single sensor coupled between a single connection with a patient and a branch of said blood circuit into said first and second blood sides, said sensor alternately sensing inflowing blood quantities and outflowing blood quantities;

an ultrafiltrate controller coupled to said sensor for receiving signals from said sensor and being operative during a first time interval to recognize a first output signal from said sensor representing outflowing blood quantities and being operative during a second time interval to recognize a second output signal from said sensor representing inflowing blood quantities and being operative after said first and second time intervals to compare said first output signal with said second output signal to determine the actual ultrafiltration rate;

a control unit connected to said ultrafiltrate controller, said control unit having input means for inputting a predetermined ultrafiltration rate; and

a dialysis solution pump coupled in said dialysis circuit downstream of said first chamber and operatively coupled to said ultrafiltrate controller for changing the pressure in said dialysis solution circuit, thereby changing the transmembrane pressure to cause the actual ultrafiltration rate to approach said predetermined ultrafiltration rate.

2. The apparatus according to claim 1, the improvement further comprising:

a first blood pump connected in said first blood side and operatively coupled to said control unit;

a second blood pump connected in said second blood side and operatively coupled to said control unit; and

a pressure sensor connected to said first blood side downstream of said first blood pump and coupled to said control unit;

said control unit being operative during said first time interval to activate said first blood pump and to deactivate said second blood pump and said control unit being operative during said second time interval to activate said third pump and to deactivate said second pump, and said control unit being operative to effectuate a switchover from said first time interval to said second time interval when said pressure sensor indicates to said control unit a pressure value which matches a predetermined excess pressure value.

3. In the apparatus of claim 2, the improvement further comprising:

a supply line connected to said single connection with said patient;

a discharge line connected to said single connection with said patient;

a tube section connecting said discharge line and said supply line to said sensor;

a supply line clip in said supply line operatively coupled to said control unit;

a discharge line clip in said discharge line operatively coupled to said control unit; and

a tube clip in said second blood side downstream of said second blood pump and operatively coupled to said control unit;

said control unit being operative during said first time interval to open said discharge line clip, and to close said supply line clip and to close said tube clip, said control unit being operative during said second time interval to close said discharge clip and to open said supply line clip and to open said tube clip.

4. The apparatus according to claim 1 wherein said sensor includes a flow meter.

5. The apparatus according to claim 1 wherein said sensor includes an electromagnetic flow meter.

6. In the apparatus of claim 1, the improvement further including a drip chamber, a substitution fluid reservoir and a substitution fluid pump, said drip chamber being disposed in said second blood side and being operative to receive fluid from said second chamber, said substitution fluid reservoir being coupled to said drip chamber for providing substitution fluid into said drip chamber via said substitution fluid pump, said control unit being operatively coupled to said substitution fluid pump for coordinating the pumping rates of said substitution fluid pump and said dialysis solution pump.

7. In the apparatus according to claim 1, the improvement further comprising a drip chamber, a dialysis solution reservoir, and a filter, said drip chamber being coupled in said second blood side and said dialysis solution reservoir being connected to said drip chamber via said filter.

8. In a hemodialysis apparatus comprising a first chamber, a second chamber, a dialysis solution circuit, a blood circuit, means for preparing a fresh dialysis, solution, and means for withdrawing ultrafiltrate from said dialysis circuit, said first chamber being separated by means of a membrane from said second chamber, said first chamber being connected into said dialysis solution circuit, and said second chamber being connected into said blood circuit, said blood circuit including a first blood side upstream of said second chamber and a second blood side downstream of said second chamber, the improvement comprising:

a single sensor coupled between a single connection with a patient and a branch of said blood circuit into said first and second blood sides, for alternately sensing inflowing blood quantities and outflowing blood quantities;

an ultrafiltrate controller coupled to said sensor for receiving signals from said sensor and being operative during a first time interval to recognize a first output signal representing outflowing blood quantities and being operative during a second time interval to recognize a second output signal representing inflowing blood quantities and being operative to compare said first output signal with said second output signal to determine the actual ultrafiltation rate;

a control unit connected to said ultrafiltrate controller, said control unit having input means for inputting a desired ultrafiltration rate;

a first pump connected in said first blood side and operatively coupled to said control unit;

a second pump connected in said second blood side and operatively coupled to said control unit; and

a pressure sensor connected in said first blood side downstream of said first pump and coupled to said control unit;

said control unit being operative during said first time interval to activate said first pump and to deactivate said second pump and being operative during said second time interval to deactivate said first pump and to activate said second pump, said control unit being operative to effectuate a switchover from said first time interval to said second time interval when said pressure sensor indicates to said control unit a pressure value which matches an excess pressure value, said control unit being further operative to determine said excess pressure value by comparing said actual ultrafiltration rate and said desired ultrafiltration rate.

9. In the apparatus of claim 8, the improvement further comprising:

a supply line connected to said single connection with said patient;

a discharge line connected to said single connection with said patient;

a tube section connecting said discharge line and said supply line to said sensor;

a supply line clip in said supply line operatively coupled to said control unit;

a discharge line clip in said discharge line operatively coupled to said control unit; and

a tube clip in said second blood side downstream of said second pump and operatively coupled to said control unit;

said control unit being operative during said first time interval to open said discharge clip, and to close said supply line clip and to close said tube clip, said control unit being operative during said second time interval to close said discharge clip and to open said supply line clip and to open said tube clip.

10. The apparatus according to claim 8 wherein said sensor includes a flow meter.

11. The apparatus according to claim 8 wherein said sensor includes an electromagnetic flow meter.

12. In the apparatus of claim 8, the improvement further including a drip chamber, a substitution fluid reservoir and a substitution fluid pump, said drip chamber being disposed in said second blood side and being operative to receive fluid from said second chamber, said substitution fluid reservoir being coupled to said drip chamber for providing substitution fluid into said drip chamber via said substitution fluid pump, said control unit being operatively coupled to said substitution fluid pump for controlling the pumping rate of said substitution fluid pump.

13. In the apparatus according to claim 8, the improvement further comprising a drip chamber, a dialysis solution reservoir, and a filter, said drip chamber being coupled in said second blood side and said dialysis solution being connected to said drip chamber via said filter.