Hemofiltration system and method

• US 6,200,485 B1
• Filed: 03/04/1999
• Issued: 03/13/2001
• Est. Priority Date: 10/11/1991
• Status: Expired due to Fees

• Current Assignee: Children's Hospital & Medical Center
• Original Assignee: Children's Hospital & Medical Center
• Inventors: Hemasilpin, Nat, Bissler, John J., Kitaevich, Yuli, Benzing, George III, McEnery, Paul T., Marchevsky, J. Gabriel
• Primary Examiner(s): KIM, SUN U
• Application Number:
  US09/262,437
• Time in Patent Office: 740 Days
• Field of Search: 210/85, 210/90, 210/96.1, 210/97, 210/101, 210/134, 210/138, 210/143, 210/195.2, 210/257.1, 210/257.2, 210/258, 210/259, 210/321.71, 210/416.1, 210/433.1, 210/646, 210/645, 210/649, 210/739, 210/805, 210/929, 210/650, 604/4, 604/5, 604/6, 604/4.01, 604/5.01, 422/48, 177/45, 177/50
• US Class Current: 210/739
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/1611 Weight of the patient
• CPC Class Codes: A61M 1/1643 with weighing of fresh and used dialysis 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 1/341 by measuring the filtrate rate or volume
• CPC Class Codes: A61M 1/3427 back through the membrane, e.g. by inverted trans-membrane pressure [TMP]
• CPC Class Codes: A61M 1/3451 the difference in weight between both ultra-filtrate and substitution reservoir being used as control signal
• CPC Class Codes: A61M 1/3607 Regulation parameters
• CPC Class Codes: A61M 1/3623 Means for actively controlling temperature of blood
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/18 with alarm
• 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 2205/3393 by weighing the reservoir
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: Y10S 210/929 Hemoultrafiltrate volume measurement or control processes

Abstract

A multipurpose hemofiltration system and method are disclosed for the removal of fluid and/or soluble waste from the blood of a patient. The system and method are equally applicable to adult, pediatric and neonatal patients. In one embodiment, the system continuously monitors the weight of infusate in a first reservoir and drained fluid in a second reservoir and compares those weights to corresponding predetermined computed weights. When necessary, the pumping rates of the infusate, drained fluid and blood are adjusted in order to achieve a preselected amount of fluid removal from the patient'"'"'s blood in a preselected time period. Application of this system and method provide repeatable and highly precise results. Alternatively, predetermined patient parameters can be monitored and the adjustment of pumping rates may be responsive to these monitored parameters. Suitable patient parameters are arterial pressure, central venous pressure, pulmonary arterial pressure, mean arterial pressure, capillary wedge pressure, systemic vascular resistance, cardiac output, mixed venous O₂ saturation, arterial O₂ saturation, blood pressure, heart rate, patient weight, and hematocrit.

Claims

1. Continuous hemofiltration system for removal of fluid from the blood of a patient, comprising:

hemofiltration means;

means for pumping blood from a patient through said hemofiltration means and back to the patient;

a first reservoir for maintaining a supply of infusate;

first pumping means for pumping the infusate from said first reservoir to said hemofiltration means;

a second reservoir for receiving drained fluid from said hemofiltration means;

second pumping means for pumping the drained fluid from said hemofiltration means to said second reservoir;

weighing means for monitoring the weight of the infusate and the drained fluid and generating weight data signals correlated thereto; and

control means operably connected to said blood pumping means and to each of said first and second pumping means and said weighing means, said control means comprising a computer programmed to operate said first and second pumping means only when said blood pumping means is operating;

said blood pumping means and said first and second pumping means being responsive to signals generated by said control means;

said control means receiving said weight data signals generated by said weighing means,

determining from said weight data signals the weight of infusate and drained fluid in said first and second reservoirs, respectively, at regular intervals,

comparing those weights to corresponding predetermined computed weights, and

generating control signals to adjust and thereby automatically adjusting as necessary on an ongoing basis during hemofiltration the rates of pumping at least two of the following;

the infusate, drained fluid and blood, while the pumps are pumping during hemofiltration, so as to remove a preselected amount of fluid from the blood over a preselected time period.

2. The hemofiltration system of claim 1 wherein said hemofiltration means includes a hemofilter, input tubing through which blood is pumped to said hemofilter, output tubing through which blood is pumped from said hemofilter, feed tubing connecting said first pumping means to said hemofilter, and drain tubing connecting said second pumping means to said hemofilter.

3. The hemofiltration system of claim 2 further comprising:

first pressure monitoring means for monitoring the pressure in said input tubing to said hemofilter;

second pressure monitoring means for monitoring the pressure in said output tubing;

third pressure monitoring means for monitoring the pressure in said drain tubing; and

fourth pressure monitoring means for monitoring the pressure in said input tubing to said blood pump.

4. The hemofiltration system of claim 1 further comprising means for adding an anti-clotting medication to the blood prior to pumping the blood through said hemofiltration means.

5. Continuous hemofiltration system for removal of fluid from the blood of a patient, comprising:

hemofiltration means;

means for pumping blood from a patient through said hemofiltration means and back to the patient;

a first reservoir for maintaining a supply of infusate;

first pumping means for pumping the infusate from said first reservoir to the patient;

a second reservoir for receiving drained fluid from said hemofiltration means;

second pumping means for pumping the drained fluid from said hemofiltration means to said second reservoir;

weighing means for monitoring the weight of the infusate and the drained fluid and generating weight data signals correlated thereto; and

control means operably connected to said blood pumping means and to each of said first and second pumping means and said weighing means, said control means comprising a computer programmed to operate said first and second pumping means only when said blood pumping means is operating;

said blood pumping means and said first and second pumping means being responsive to signals generated by said control means;

said control means receiving said weight data signals generated by said weighing means,

determining from said weight data signals the weight of infusate and drained fluid in said first and second reservoirs, respectively, at regular intervals,

comparing those weights to corresponding predetermined computed weights, and

generating control signals to adjust and thereby automatically adjusting as necessary on an ongoing basis during hemofiltration the rates of pumping at least two of the following;

the infusate, drained fluid and blood, while the pumps are pumping during hemofiltration, so as to remove a preselected amount of fluid from the blood over a preselected time period.

6. Hemofiltration method for removal of fluid from the blood of a patient, comprising:

pumping blood from a patient through hemofiltration means and back to the patient;

maintaining a supply of infusate in a first reservoir;

pumping the infusate to the hemofiltration means;

monitoring the weight of the infusate and generating weight data signals correlated thereto;

pumping drained fluid from the hemofiltration means into a second reservoir;

monitoring the weight of the drained fluid and generating weight data signals correlated thereto; and

controlling the pumping of the blood, infusate and drained fluid by means of a computer programmed to operate the pumps for infusate and drained fluid only when the blood is being pumped;

said blood, infusate and drained fluid pumping operations being responsive to signals generated by said computer;

said computer

receiving said weight data signals,

determining from said weight data signals, at regular intervals, the weight of infusate in the first reservoir and the weight of drained fluid in the second reservoir,

comparing those weights to corresponding predetermined ideal weights, and

generating control signals to adjust and thereby automatically adjusting as necessary on an ongoing basis during hemofiltration the rates of pumping at least two of the following;

the infusate, drained fluid and blood, while the pumps are pumping during hemofiltration, so as to remove a preselected amount of fluid from the blood.

7. The method of claim 6 further comprising monitoring the fluid pressure in the hemofiltraton means to determine pressures and pressure differential and generating signals correlated thereto.

8. The method of claim 6 wherein said pumping of infusate to the hemofiltration means and said pumping of drained fluid from the hemofiltration means are controlled to occur only during said pumping of blood through the hemofiltration means.

9. Hemofiltration method for removal of fluid from the blood of a patient, comprising:

pumping blood from a patient through hemofiltration means and back to the patient;

maintaining a supply of infusate in a first reservoir;

pumping the infusate to the patient;

monitoring the weight of the infusate and generating weight data signals correlated thereto;

pumping drained fluid from the hemofiltration means into a second reservoir;

monitoring the weight of the drained fluid and generating weight data signals correlated thereto; and

controlling the pumping of the blood, infusate and drained fluid by means of a computer programmed to operate the pumps for infusate and drained fluid only when the blood is being pumped;

said blood, infusate and drained fluid pumping operations being responsive to signals generated by said computer;

said computer

receiving said weight data signals

determining from said weight data signals, at regular intervals, the weight of infusate in the first reservoir and the weight of drained fluid in the second reservoir,

comparing those weights to corresponding predetermined ideal weights, and

generating control signals to adjust and thereby automatically adjusting as necessary on an ongoing basis during hemofiltration the rates of pumping at least two of the following;

the infusate, drained fluid and blood, while the pumps are pumping during hemofiltration, so as to remove a preselected amount of fluid from the blood.

10. The method of claim 9 further comprising monitoring the fluid pressure in the hemofiltration means to determine pressures and pressure differential and generating signals correlated thereto.

11. The method of claim 9 wherein said pumping of infusate to the patient and said pumping of drained fluid from the hemofiltration means are controlled to occur only during said pumping of blood through the hemofiltration means.