Method and apparatus for bagless continuous ambulatory peritoneal dialysis

• US 4,950,230 A
• Filed: 03/20/1989
• Issued: 08/21/1990
• Est. Priority Date: 03/19/1987
• Status: Expired due to Fees

• Current Assignee: Delmed, Inc. (Fresenius SE & Co. KGaA)
• Original Assignee: Delmed, Inc. (Fresenius SE & Co. KGaA)
• Inventors: Kendell, Lamar C.
• Primary Examiner(s): NOT, DEFINED
• Assistant Examiner(s): NOT, DEFINED
• Application Number:
  US07/327,418
• Time in Patent Office: 519 Days
• Field of Search: 604/248, 604/27, 604/28, 604/29, 604/32, 604/49, 604/245, 137/625.47, 137/625.41
• US Class Current: 604/28
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
• CPC Class Codes: A61M 39/223 Multiway valves
• CPC Class Codes: Y10T 137/86823 Rotary valve

Abstract

A method and apparatus for bagless continuous ambulatory peritoneal dialysis comprising a valve having first, second and third fluid ports. The first and second fluid ports are secured to first and second fluid containers, respectively, through tubing and respective first and second connector assemblies. The third fluid port is connected through tubing to a catheter implanted in the abdominal wall of a user, also through a connector assembly. The valve includes an actuator moveable at least between four positions, a first position in which all of the fluid ports are blocked to prevent the flow of fluid through the valve, a second position in which the second and third fluid ports are interconnected, a third position in which the first and second fluid ports are interconnected, and a fourth position in which the first and third fluid ports are interconnected. The method employs the valve to provide bagless continuous ambulatory peritoneal dialysis by reversing the fluid containers and the direction of movement of the valve actuator for alternate cycles.

Claims

1. A system for continuous ambulatory peritoneal dialysis apparatus, comprising:

a valve having first, second and third fluid ports;

a first tube having one end secured to the first fluid port and the other end secured to a first connector member, the first connector member being connectable to a mating connector member associated with a first fluid container to provide fluid communication between the first fluid port and the first fluid container;

a second tube having one end secured to the second fluid port and the other end secured to a second connector member, the second connector member being connectable to a mating connector member associated with a second fluid container to provide fluid communication between the second fluid port and the second fluid container; and

a third tube having one end secured to the third fluid port and the other end secured to a third connector member, the third connector member being connectable to a mating connector member associated with a catheter which has been surgically implanted in the abdominal wall of a user to provide fluid communication between the third fluid port and the peritoneal cavity of the user,

the valve including an actuator moveable sequentially in either order between four positions, a first position in which all of the fluid ports are blocked to prevent the flow of fluid through the valve, a second position in which only the second and third fluid ports are interconnected to provide bi-directional fluid communication therebetween, a third position in which only the first and second fluid ports are interconnected to provide bi-directional fluid communication therebetween, and a fourth position in which only the first and third fluid ports are interconnected to provide bi-directional fluid communication therebetween, the location of the fluid ports and the structure of the actuator being established in a manner so that movement of the actuator between the second and third positions, in either direction, does not result in movement of the actuator through the fourth position and movement of the actuator between the third and fourth positions, in either direction, does not result in movement of the actuator through the second position, the system having a first configuration wherein said first connector member is located at a higher elevation than said third connector member, and wherein said second connector member is located at a lower elevation than said third connector member, such that fluid flows through the valve in a first direction only from said third port to said second port, from said first port to said second port and from said first port to said third port, the system having a second configuration wherein said second connector member is located at an elevation higher than said third connector member, and wherein said first connector member is located at a lower elevation than said third connector member, such that fluid flows through the valve in a second direction only from said third port to said first port, from said second port to said first port and from said second port to said third port.

2. The apparatus as recited in claim 1, wherein the actuator is rotatable between said four positions, the actuator being rotated generally 360 degrees in steps in a first direction for completion of a first dialysis cycle and the actuator being rotated generally 360 degrees in steps in the other direction for completion of a second dialysis cycle.

3. The apparatus as recited in claim 1, wherein the valve comprises a generally cylindrical housing, the fluid ports being positioned around the circumference of the housing and being spaced apart approximately 120°

.

4. A method for performing continuous ambulatory peritoneal dialysis utilizing a valve having first, second and third ports, the first port being in fluid communication with a first fluid container, the second port being in fluid communication with a second fluid container, and the third port being in fluid communication with the peritoneal cavity of the user, the valve including an actuator moveable between four positions, a first position in which all of the fluid ports are blocked to prevent flow of fluid to the valve, a second position in which the second and third fluid ports are interconnected to provide fluid communication therebetween, a third position in which the first and second fluid ports are interconnected to provide fluid communication therebetween, and a fourth position in which the first and third fluid ports are interconnected to provide fluid communication therebetween, the method comprising the steps of:

(a) supporting the first fluid container at a height above the peritoneal cavity of the user and providing the first fluid container with a supply of dialysate fluid;

(b) supporting the second fluid container at a position below the peritoneal cavity, the second fluid container being generally empty;

(c) connecting the valve with the actuator in the first position to the user after a dialysate dwell period;

(d) moving the valve actuator to the second position to permit used dialysate fluid to drain from the peritoneal cavity into the second fluid container;

(e) moving the valve actuator to the third position to permit dialysate fluid to flow from the first fluid container through the valve to the second fluid container to flush the valve;

(f) moving the valve actuator to the fourth position to permit dialysate fluid to flow from the first container into the peritoneal cavity;

(g) removing and disposing of the second fluid container with the used dialysate fluid and replacing it with a second fluid container having a supply of fresh dialysate fluid;

(h) moving the valve actuator to the first position to prevent fluid flow through the valve;

(i) supporting the second fluid container at a position above the height of the peritoneal cavity, and supporting the first fluid container at a position below the peritoneal cavity;

(j) disconnecting the valve from the user for a dialysate dwell period;

(k) reconnecting the valve to the user when the dialysate dwell period has been completed;

(l) moving the actuator to the fourth position to permit used dialysate fluid from the peritoneal cavity to drain into the first fluid container;

(m) moving the valve actuator to the third position to permit dialysate fluid to flow from the second fluid container through the valve to the first fluid container to flush the valve;

(n) moving the valve actuator to the second position to permit dialysate fluid to flow from the second fluid container into the peritoneal cavity;

(o) removing and disposing of the first fluid container with the used dialysate fluid and replacing it with a new first fluid container having a supply of fresh dialysate fluid;

(p) moving the valve actuator to the first position to prevent fluid flow through the valve; and

(q) disconnecting the valve from the user for a dialysate dwell period.

5. The method as recited in claim 4 wherein the valve is connected to the first and second containers utilizing connector assemblies.

6. The method as recited in claim 4 wherein the valve is connected to the peritoneal cavity of the user utilizing a surgically implanted catheter and a connector assembly.