Automated hemodialysis control based upon patient blood pressure and heart rate

• US 4,718,891 A
• Filed: 05/06/1986
• Issued: 01/12/1988
• Est. Priority Date: 05/03/1984
• Status: Expired due to Fees

• Current Assignee: Henry Ford Hospital
• Original Assignee: Henry Ford Hospital
• Inventors: Lipps, Ben J.
• Primary Examiner(s): Coven, Edward M.
• Application Number:
  US06/860,083
• Time in Patent Office: 616 Days
• Field of Search: 128/DIG. 12, 128/DIG. 13, 128/DIG. 3, 604/65, 604/66, 604/67, 604/4, 604/5, 604/6, 604/31
• US Class Current: 604/31
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/1605 Physical characteristics of the dialysate fluid
• 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 1/3607 Regulation parameters
• CPC Class Codes: A61M 1/3639 Blood pressure control, pressure 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 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/65 Impedance, e.g. conductivity, capacity
• CPC Class Codes: Y10S 128/13 Infusion monitoring

Abstract

A method and system for continuously monitoring patient heart rate and blood pressure during hemodialysis and for automatically controlling fluid extraction rate and/or dialysate sodium concentration in the event that blood pressure and/or heart rate indicate onset or impending onset of a patient hypotensive episode. A decrease in patient blood pressure below preselected systolic and/or diastolic low alarm limits automatically initiates a second mode of therapeutic intervention wherein sodium concentration in the dialysate is increased for a predetermined time duration. Upon detection of such low blood pressure alarm, or upon detection of an increase in patient heart rate above a preselected alarm limit, the extraction rate of fluids from the patient through the ultrafiltration membrane is reduced in a first mode of therapeutic intervention by reducing such fluid extraction rate to a minimum level. Blood pressure and heart rate are thereafter monitored during this second mode of intervention to return ultrafiltration flow rate to its desired or goal level as blood pressure and heart rate indicate return of patient vital signs toward their initial levels.

Claims

1. A method of controlling hemodialysis as a continuous function of vital signs of a patient connected to a hemodialysis machine which includes means for controlling dialysate composition and rate of fluid extraction from the patient, said method comprising the steps of:

(a) intially maintaining sodium electrolyte concentrations in said dialysate at 140 meq/l,

(b) intermittently sampling patient blood pressure at predetermined first sample intervals,

(c) detecting decrease in patient blood pressure below a first alarm limit to initiate a first alarm mode of operation and provide a first alarm signal, and

(d) responsive to said first alarm signal, automatically increasing sodium electrolyte concentration in said dialysate to 180 meq/l for a first predetermined time duration, and thereafter reducing said concentration to 140 meq/l.

2. The method set forth in claim 1 comprising the additional steps of:

(e) responsive to said first alarm signal, automatically sampling patient blood pressure after said first time duration, and

(f) providing a second alarm signal if patient blood pressure remains below said first alarm limit.