Continuous flow peritoneal dialysis system and method

• US 4,747,822 A
• Filed: 05/02/1986
• Issued: 05/31/1988
• Est. Priority Date: 07/09/1984
• Status: Expired due to Term

• Current Assignee: Alan M. Peabody
• Original Assignee: Alan M. Peabody
• Inventors: Peabody, Alan M.
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): Macey, H.
• Application Number:
  US06/858,645
• Time in Patent Office: 760 Days
• Field of Search: 604/27-29, 604/31, 604/65, 604/67, 604/81, 604/131, 604/315, 604/44, 128/DIG. 12, 128/DIG. 13, 210/90
• US Class Current: 604/29
• CPC Class Codes: A61M 1/1686 by heat
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
• CPC Class Codes: A61M 1/281 Instillation other than by gravity
• CPC Class Codes: A61M 1/284 Continuous flow peritoneal dialysis [CFPD]
• CPC Class Codes: A61M 1/285 Catheters therefor
• CPC Class Codes: A61M 1/287 Dialysates therefor
• CPC Class Codes: A61M 1/74 Suction control underwater drainage A61M1/61
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: Y10S 128/13 Infusion monitoring

Abstract

A continuous flow peritoneal dialysis system and process is disclosed which includes a source of sterilized peritoneal dialysis system in the form of a gravity feed head vessel (32). A by-pass valve (34) connects the head vessel to an inflow/outflow directional valve 40 which controls the inflow and outflow of the sterilized dialysis fluid to a peritoneal catheter (12). The peritoneal catheter is implanted into the peritoneal membrane (14) of the peritoneal cavity (15). A connectable/disconnectable inflow line (42) and outflow line (48) are connected to an inflow catheter (44) and outflow catheter (46), respectively, of the double peritoneal catheter (12). A pressure monitor (50) in the outflow line (48) monitors the pressure within the cavity (15) and adjusts the inflow and outflow accordingly to maintain a predetermined volume and pressure of dialysis fluid in the cavity to maintain the membrane (14) properly distended at all times for maximum dialysis efficiency and patient comfort. Secondarily, an outflow monitor (54) monitors the outflow and if need be, increases or decreases the inflow to the directional valve (40) by controlling a by-pass valve 34. Control of the level of dialysis fluid in the head vessel (32) is maintained by a level monitor (38) which also can operate the by-pass valve (34) to by-pass fluid to a drain tank (36). Sterile dialysis fluid flows through the cavity (15) in an open single-pass circuit and flows into the disposal and drain tank (36) upon passing through the cavity.

Claims

1. A continuous flow peritoneal dialysis process comprising:

providing a source of sterilized dialysis fluid;

providing an inflow line for connection to a catheter adapted for implantation into the peritoneal cavity of a patient;

providing an outflow line for connection to said catheter;

delivering a flow of sterilized dialysis fluid from said course to said inflow line;

monitoring a function of the volume of said sterile dialysis fluid in said peritoneal cavity and controlling the inflow and outflow of said sterilized dialysis fluid so that a desired volume exists in said cavity in a manner that proper amount of fluid is maintained during dialysis; and

delivering said outflow of sterilized dialysis fluid to a disposal means so that a single flow of dialysis fluid is provided through the peritoneal cavity of said patient.

2. The process of claim 1 including providing a double catheter having an inflow catheter connected to said inflow line and an outflow catheter connected to said outflow line implanted in said peritoneal cavity;

and providing a valve means for controlling the flow of dialysis fluid in said inflow and outflow lines.

3. The process of claim 2 including providing said valve means in the form of an inflow valve in said inflow line and an outflow valve in said outflow line for controlling said inflow and outflow of said dialysis fluid from said peritoneal cavity:

and

providing a flow monitor in each said inflow and outflow line to monitor said function of the volume for controlling said inflow and outflow valve to maintain said desired volume of dialysis fluid in said cavity for proper cavity distension.

4. The process of claim 2 including monitoring the amount of said dialysis fluid in said peritoneal cavity for controlling said valve means and providing an alarm signal in response to the amount of fluid exceeding a prescribed level to avoid over distension of said cavity.

5. The process of claim 2 wherein monitoring a function of the volume of dialysis fluid in said peritoneal cavity includes monitoring the pressure of said sterile dialysis fluid in said peritoneal cavity and controlling the inflow and outflow of said sterilized dialysis fluid so that a desired pressure is maintained in said cavity.

6. The process of claim 5 including monitoring the outflow of said dialysis fluid from said peritoneal cavity and controlling the inflow of dialysis fluid into said peritoneal cavity in response thereto to make said inflow and outflow equal.

7. The process of claim 2 wherein

said valve means is provided by an inflow/outflow directional valve for controlling said inflow and outflow of said dialysis fluid from said peritoneal cavity;

and

providing a monitor in said outflow line for controlling said inflow/outflow directional valve responsive to the pressure in said peritoneal cavity.

8. The process of claim 1 wherein monitoring a function of the volume of dialysis fluid in said peritoneal cavity includes providing a flow monitor in each of said inflow and outflow lines and controlling the inflow ad outflow of sterilized dialysis fluid so that a desired volume of fluid exists in said peritoneal cavity.

9. The process of claim 1 including controlling said flow of dialysis fluid in said inflow and outflow lines so that dialysis fluid flows in and then out of said peritoneal cavity in a continuous cyclic manner.

10. The process of claim 1 wherein the provision of said sources of sterilized dialysis fluid includes providing a head vessel for containing said dialysis fluid, and maintaining the level of said sterilized dialysis fluid in said head vessel by delivering fluid to said disposal means when said level reaches a certain height.

11. The process of claim 1 including

providing a valve means in said inflow and outflow lines for selectively controlling said inflow and outflow of dialysis fluid;

and

providing a first flow monitor in said inflow line and a second flow monitor in said outflow line for controlling said valve means and flow of dialysis fluid in said inflow and outflow line.

12. The process of claim 11 including controlling said valve means in a cyclic manner so that sterilized dialysis fluid is delivered into said peritoneal cavity and then out of said cavity in continuous cycles through said single pass circuit.

13. The process of claim 12 including closing said outflow line when dialysis fluid is flowing into said peritoneal cavity and closing said inflow line while said fluid is flowing out of said cavity.

14. A continuous flow peritoneal dialysis system comprising:

a source of sterile dialysis fluid;

an inflow line adapted for connection to said source and to a peritoneal catheter implanted in the peritoneal cavity of a patient;

an outflow line adapted for connection to said peritoneal catheter;

valve means for controlling the flow of dialysis fluid in said inflow and outflow lines to thereby control the volume of dialysis fluid in said peritoneal cavity; and

disposal means connected to said outflow line for disposing of said outflow of dialysis fluid and establishing a single-pass open circuit through said peritoneal cavity of for dialysis;

flow monitoring means for sensing a function of the volume and amount of dialysis fluid in said peritoneal cavity; and

control means controlling said valve means in response to said flow monitoring means so that flow of said dialysis fluid through said peritoneal cavity is controlled in a manner that a desired amount of fluid exists in said peritoneal cavity for proper dialysis.

15. The system of claim 14 wherein said peritoneal catheter includes a double catheter having an inflow catheter connected to said inflow line and an outflow catheter connected to said outflow line.

16. The system of claim 15 wherein said flow monitoring means comprises:

pressure monitoring means in the outflow line for sensing the pressure of dialysis fluid in said peritoneal cavity, and

said control means controlling said valve means in response to said pressure monitoring means so that flow of said dialysis fluid through said peritoneal cavity is controlled to maintain a desired pressure of fluid in said cavity.

17. The system of claim 15 including a bypass valve connected between said source and said valve means and between said source and said disposal means, and means controlling said bypass valve to adjust the flow of sterile dialysis fluid delivered to said valve means.

18. The system of claim 15 wherein said flow monitor means includes a monitor for sensing the outflow of dialysis fluid from said outflow catheter and controlling said valve means so that said inflow and outflow of dialysis fluid are equal.

19. The system of claim 15 wherein said flow monitor means includes a flow monitor in each of said inflow and outflow lines for sensing the flow through said peritoneal cavity and said control means controls said valve means and the inflow and outflow of dialysis fluid to maintain a desired volume of fluid in said peritoneal cavity.

20. The system of claim 15 wherein said valve means includes:

an inflow/outflow valve having an inflow passage connected to said inflow line and an outflow passage connected to said outflow line;

a valve element for selectively occluding either said inflow passage or said outflow passage; and

said flow monitoring means comprises a pressure monitor for sensing the fluid pressure in said peritoneal cavity and controlling said inflow/outflow valve to occlude either said inflow or outflow passage to regulate the pressure in said peritoneal cavity within a desired range.

21. The system of claim 20 wherein said flow control means further includes a flow monitor for monitoring the outflow of said dialysis fluid from said inflow/outflow valve and controlling the inflow of dialysis to said valve when both said inflow and outflow passages are open so that the inflow of said dialysis fluid delivered through said valve to said peritoneal cavity and said outflow of dialysis fluid from said cavity are equal.

22. The system of claim 15 including:

said source including a head vessel in which said sterilized dialysis fluid is stored;

a bypass valve connected between said head vessel and said valve means;

a drain line connecting said bypass valve to a disposal means; and

flow level sensing means communicating with an interior of said head vessel and controlling said bypass valve to bypass said dialysis fluid from said head vessel to said disposal means should the level of said dialysis fluid reach a predetermined height in said head vessel.

23. The system of claim 14 including fluid level sensing means for sensing the amount of dialysis fluid in said cavity and producing an alarm signal in the event overfilling and overdistension of said cavity occurs.

24. The system of claim 14 wherein said inflow lines and outflow lines are connected to said valve means;

and said valve means selectively opens and closes said inflow and outflow lines to deliver a prescribed amount of dialysis fluid through said peritoneal cavity in a continuous cyclic manner.

25. The system of claim 14 wherein said valve means includes:

an inflow/outflow valve having an inflow passage connected to said inflow line and an outflow passage connected to said outflow line;

a valve element for selectively occluding either said inflow passage or said outflow passage; and

said flow monitoring means comprises a flow monitor in each of said inflow and outflow lines for sensing the fluid flow in said flow lines and controlling said inflow/outflow valve to occlude either said inflow or outflow passage in a manner that a prescribed amount of dialysis fluid is delivered into said peritoneal cavity and then removed through said outflow passage and line in a continuous cyclic manner.