Method and apparatus for controlling an extra-corporeal blood treatment in a medical device

• US 9,162,020 B2
• Filed: 07/01/2011
• Issued: 10/20/2015
• Est. Priority Date: 07/08/2010
• Status: Active Grant

• Current Assignee: Gambro Lundia AB (Baxter International Inc.)
• Original Assignee: Gambro Lundia AB (Baxter International Inc.)
• Inventors: Vantard, Georges, Bene, Bernard
• Primary Examiner(s): DEAK, LESLIE R
• Application Number:
  US13/175,131
• Publication Number:
  US 20120010554A1
• Time in Patent Office: 1,572 Days
• Field of Search: 604/4.01, 604/5.04, 604/6.09, 604/6.1, 604/6.11, 210/645, 210/646, 422/44
• US Class Current: 1/1
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/1607 before use, i.e. upstream of dialyser
• CPC Class Codes: A61M 1/1609 after use, i.e. downstream of dialyser
• CPC Class Codes: A61M 1/3609 Physical characteristics of the blood, e.g. haematocrit, urea
• CPC Class Codes: A61M 2205/33 Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/60 with identification means

Abstract

Apparatus for controlling an extra-corporeal blood treatment in a medical device, comprising a blood treatment device (7), an extra-corporeal blood transport line (4), a fluid transport line (3) for a treatment fluid for the blood, at least a sensor adapted to provide a measure (M) correlated to at least a treatment parameter of the extra-corporeal blood treatment and/or of the treatment device (7) in the medical device (1), at least one storage memory (29), and at least a control device (28), operatively connected at least with the storage memory (29) and with the sensor, and configured for receiving the measure (M) from the sensor, correlating the measure (M) with referential data (R) of the treatment device for the treatment parameter provided by the at least one storage memory (29), and correlating the measure (M) with patient historical data (H) for the treatment parameter for obtaining an information representative of the quality of the extra-corporeal blood treatment.

Claims

1. Apparatus for controlling an extra-corporeal blood treatment in a medical device, comprising:

a blood treatment device, the blood treatment device being a dialyzer;

an extra-corporeal blood transport line, having at least an arterial line configured to bring blood from a first access of a patient under treatment to said blood treatment device, a venous line configured to bring blood from said blood treatment device to a second access of the patient, and at least a first pump for moving blood in said extra-corporeal blood transport line;

a fluid transport line for a treatment fluid for said blood, the fluid transport line adapted to bring the treatment fluid from a source to said blood treatment device and from said blood treatment device to an exit, and at least a second pump for moving the treatment fluid in the fluid transport line;

at least a sensor adapted to provide a measure correlated to at least a treatment parameter of the extra-corporeal blood treatment or of the treatment device in the medical device;

at least one storage memory; and

at least a control device operatively connected at least with said storage memory and with said sensor;

wherein said control device is configured for;

receiving said measure from said sensor,

correlating said measure at least with referential data of said treatment device for said treatment parameter provided from said at least one storage memory to obtain a first deviation value (DV1),

comparing said first deviation value (DV1) with a first threshold (T1) to determine when the first deviation value (DV1) is less than or greater than the first threshold (T1),

correlating said measure with patient historical data of said patient under treatment for said treatment parameter during an extra-corporeal blood treatment of said patient under treatment, provided from said at least one storage memory, to obtain a second deviation value (DV2),

comparing said second deviation value (DV2) with a second threshold (T2) to determine when the second deviation value (DV2) is less than or greater than the second threshold (T2),

detecting the occurrence of a first event when the first deviation value (DV1) is greater than the first threshold (T1) and the second deviation value (DV2) is less than the second threshold (T2),

detecting the occurrence of a second event when the first deviation value (DV1) is less than the first threshold (T1) and the second deviation value (DV2) is greater than the second threshold (T2),

determining that a first root-cause of the first deviation value (DV1) and the second deviation value (DV2) is related to delivery of the extra-corporeal blood treatment to the patient under treatment when the occurrence of the first event is detected,

determining that a second root-cause of the first deviation value (DV1) and the second deviation value (DV2) is related to a deviation in a clinical status of the patient under treatment when the occurrence of the second event is detected.

2. Apparatus according to claim 1, wherein said at least one storage memory comprises at least said referential data of said treatment parameter at least for a disposable part of said treatment device and said patient historical data of said treatment parameter for at least a specific patient.

3. Apparatus according to claim 1, wherein said extra-corporeal blood treatment comprises ultrafiltration, haemodialysis, haemofiltration, haemodiafiltration, plasmapheresis, blood component separation or blood oxygenation.

4. Apparatus according to claim 1, wherein said treatment parameter is selected from the group consisting of a ionic dialysance of the dialyzer, a clearance of the dialyzer, a water permeability (UF coefficient) of the dialyser membrane, and a blood pressure drop of the dialyzer.

5. Apparatus according to claim 1, further comprising an auxiliary sensor configured to provide an auxiliary measure correlated to at least an auxiliary treatment parameter of the extra-corporeal blood treatment or of the treatment device in the medical device, said control device being configured for receiving said auxiliary measure from said auxiliary sensor and for selecting referential data, of said treatment device for said treatment parameter, correlated with said auxiliary measure, or being configured for receiving said auxiliary measure from said auxiliary sensor and for evaluating the result of the correlation between said measure and said referential data of said treatment device or between said measure and said patient historical data in view of said auxiliary measure.

6. Apparatus according to claim 1, comprising two of said storage memories operatively connected with said control device, a first storage memory comprising said referential data and a second storage memory comprising said patient historical data.

7. Apparatus according to claim 1, in which said control device is further configured for automatically recognizing the type of said treatment device or the type of a disposable part of said treatment device and for automatically selecting, from said storage memory, referential data of said treatment parameter for said type of said treatment device or of said disposable part or referential data of said treatment parameter for said type of said treatment device or of said disposable part when mounted to said medical device.

8. Apparatus according to claim 1, wherein the control device is further configured to generate a message to an operator regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the control device detects occurrence of the first event.

9. Apparatus according to claim 1, wherein the control device is further configured to generate a control signal regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the control device detects occurrence of the first event.

10. Apparatus according to claim 1, wherein the control device is further configured to generate a feedback signal regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the control device detects occurrence of the first event.

11. Apparatus according to claim 1, wherein the control device is further configured to generate an alarm signal regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the control device detects occurrence of the first event.

12. Apparatus according to claim 1, wherein the control device is further configured to generate a message to an operator regarding the deviation in a clinical status of the patient under treatment when the control device detects occurrence of the second event.

13. Apparatus according to claim 1, wherein the control device is further configured to generate a control signal regarding the deviation in a clinical status of the patient under treatment when the control device detects occurrence of the second event.

14. Apparatus according to claim 1, wherein the control device is further configured to generate a feedback signal regarding the deviation in a clinical status of the patient under treatment when the control device detects occurrence of the second event.

15. Apparatus according to claim 1, wherein the control device is further configured to generate an alarm signal regarding the deviation in a clinical status of the patient under treatment when the control device detects occurrence of the second event.

16. Method of controlling an extra-corporeal blood treatment in a medical device, the method comprising:

pumping blood of a patient under treatment through an extra-corporeal blood transport line and through a blood treatment device, connected to said extra-corporeal blood transport line and to a fluid transport line for a blood treatment fluid, said blood treatment device being a dialyzer,

sensing a measure correlated to at least a treatment parameter of the extra-corporeal blood treatment in the medical device,

obtaining referential data of said treatment device, or of a disposable part of said treatment device, for said treatment parameter,

obtaining historical data of said patient under treatment for said treatment parameter,

correlating said measure at least with said referential data of said treatment device to obtain a first deviation value (DV1),

comparing said first deviation value (DV1) with a first threshold (T1) to determine when the first deviation value (DV1) is less than or greater than the first threshold (T1),

correlating said measure with said patient historical data of said patient to obtain a second deviation value (DV2),

comparing said second deviation value (DV2) with a second threshold (T2) to determine when the second deviation value (DV2) is less than or greater than the second threshold (T2),

determining that a first root-cause of the first deviation value (DV1) and the second deviation value (DV2) is related to delivery of the extra-corporeal blood treatment to the patient under treatment when the first deviation value (DV1) is greater than the first threshold (T1) and the second deviation value (DV2) is less than the second threshold (T2),

determining that a second root-cause of the first deviation value (DV1) and the second deviation value (DV2) is related to a deviation in a clinical status of the patient under treatment when the first deviation value (DV1) is less than the first threshold (T1) and the second deviation value (DV2) is greater than the second threshold (T2).

17. Method according to claim 16, in which said sensing a measure correlated to at least a treatment parameter comprises sensing a measure correlated to a ionic dialysance of the dialyzer, or to a clearance of the dialyzer, or to a water permeability (UF coefficient) of the dialyser membrane, or to a blood pressure drop of the dialyzer.

18. Method according to claim 16, in which said referential data of said treatment device for said treatment parameter are defined with respect to the treatment device in combination with the specific medical device to which said treatment device is applied or with respect to an auxiliary measure of an auxiliary parameter influencing said treatment parameter.

19. Method according to claim 16, further comprising automatically recognizing the type of said treatment device or the type of a disposable part of said treatment device and of automatically selecting referential data of said treatment parameter for said type of said treatment device or of said disposable part or referential data of said treatment parameter for said type of said treatment device or of said disposable part when mounted to said medical device.

20. Method according to claim 16, wherein the method further comprises generating a message to an operator regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the first deviation value (DV1) is greater than the first threshold (T1) and the second deviation value (DV2) is less than the second threshold (T2).

21. Method according to claim 16, wherein the method further comprises generating a control signal regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the first deviation value (DV1) is greater than the first threshold (T1) and the second deviation value (DV2) is less than the second threshold (T2).

22. Method according to claim 16, wherein the method further comprises generating a feedback signal regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the first deviation value (DV1) is greater than the first threshold (T1) and the second deviation value (DV2) is less than the second threshold (T2).

23. Method according to claim 16, wherein the method further comprises generating an alarm signal regarding delivery of the extra-corporeal blood treatment to the patient under treatment when the first deviation value (DV1) is greater than the first threshold (T1) and the second deviation value (DV2) is less than the second threshold (T2).

24. Method according to claim 16, wherein the method further comprises generating a message to an operator regarding the deviation in a clinical status of the patient under treatment when the first deviation value (DV1) is less than the first threshold (T1) and the second deviation value (DV2) is greater than the second threshold (T2).

25. Method according to claim 16, wherein the method further comprises generating a control signal regarding the deviation in a clinical status of the patient under treatment when the first deviation value (DV1) is less than the first threshold (T1) and the second deviation value (DV2) is greater than the second threshold (T2).

26. Method according to claim 16, wherein the method further comprises generating a feedback signal regarding the deviation in a clinical status of the patient under treatment when the first deviation value (DV1) is less than the first threshold (T1) and the second deviation value (DV2) is greater than the second threshold (T2).

27. Method according to claim 16, wherein the method further comprises generating an alarm signal regarding the deviation in a clinical status of the patient under treatment when the first deviation value (DV1) is less than the first threshold (T1) and the second deviation value (DV2) is greater than the second threshold (T2).

28. Apparatus for controlling an extra-corporeal blood treatment in a medical device, comprising:

a blood treatment device;

an extra-corporeal blood transport line having at least an arterial line configured to bring blood from a first access of a patient under treatment to the blood treatment device, a venous line configured to bring blood from the blood treatment device to a second access of the patient, and at least a first pump for moving blood in the extra-corporeal blood transport line;

a fluid transport line for a treatment fluid for the blood, the fluid transport line configured to bring the treatment fluid from a source to the blood treatment device and from the blood treatment device to an exit, and at least a second pump for moving the treatment fluid in the fluid transport line;

at least a sensor configured to provide a measure correlated to at least a treatment parameter of the extra-corporeal blood treatment or of the blood treatment device;

an auxiliary sensor configured to provide an auxiliary measure correlated to the blood treatment device in the medical device;

at least one storage memory; and

at least a control device operatively connected at least with the storage memory, the sensor; and

the auxiliary sensor, wherein the control device is configured to;

receive the measure from said sensor,

correlate the measure at least with referential data of the blood treatment device of said patient under treatment for the treatment parameter provided from the at least one storage memory, and

correlate the measure with patient historical data for the treatment parameter during the extra-corporeal blood treatment to obtain information representative of quality of the extra-corporeal blood treatment;

receive the auxiliary measure from the auxiliary sensor;

select the referential data of the blood treatment device for the treatment parameter depending on the auxiliary measure; and

obtain information representative of quality of the extra-corporeal blood treatment based on said correlations.

29. Apparatus for controlling an extra-corporeal blood treatment in a medical device, comprising:

a blood treatment device;

an extra-corporeal blood transport line having at least an arterial line configured to bring blood from a first access of a patient under treatment to the blood treatment device, a venous line configured to bring blood from the blood treatment device to a second access of the patient, and at least a first pump for moving blood in the extra-corporeal blood transport line;

a fluid transport line for a treatment fluid for the blood, the fluid transport line configured to bring the treatment fluid from a source to the blood treatment device and from the blood treatment device to an exit, and at least a second pump for moving the treatment fluid in the fluid transport line;

a sensor configured to provide a measure correlated to at least a treatment parameter of the extra-corporeal blood treatment or of the blood treatment device;

an auxiliary sensor configured to provide an auxiliary measure correlated to an auxiliary treatment parameter of the extra-corporeal blood treatment or of the blood treatment device in the medical device;

storage memory; and

at least a control device operatively connected at least with the storage memory the auxiliary sensor, and the sensor;

wherein the control device is configured to;

receive the measure from said sensor,

receive the auxiliary measure from the auxiliary sensor,

correlate the measure at least with referential data of the blood treatment device to obtain a first deviation value (DV1,

compare the first deviation value (DV1) with a first threshold (T1),

correlate the measure with patient historical data of the patient under treatment to obtain a second deviation value (DV2),

compare the second deviation value (DV2) with a second threshold (T2),

evaluate the result of said correlations based on the auxiliary measure.

30. The apparatus of claim 29, wherein the control device is configured to alter the first and second threshold values based on the auxiliary measure.

31. Method of controlling an extra-corporeal blood treatment in a medical device, the method comprising:

pumping blood of a patient under treatment through an extra-corporeal blood transport line and through a blood treatment device connected to said extra-corporeal blood transport line and pumping a blood treatment fluid through a fluid transport line to the blood treatment device to perform an extracorporeal blood treatment on the blood;

sensing a measure correlated to at least a treatment parameter of the extra-corporeal blood treatment;

sensing an auxiliary measure correlated to an auxiliary treatment parameter of the extra-corporeal blood treatment or of the blood treatment device in the medical device;

obtaining referential data of the blood treatment device or of a disposable part of the blood treatment device for the treatment parameter;

obtaining historical data of the patient under treatment for the treatment parameter;

correlating the measure at least with the referential data to obtain a first deviation value (DV1);

comparing the first deviation value (DV1) with a first threshold (T1);

correlating the measure with the historical data of the patient under treatment to obtain a second deviation value (DV2);

comparing said second deviation value (DV2) with a second threshold (T2);

evaluating the result of said correlations based on the auxiliary measure.

32. The method of claim 31 comprising altering the first and second threshold values based on the auxiliary measure.