Device for carrying out a peritoneal dialysis treatment

• US 8,500,676 B2
• Filed: 10/13/2004
• Issued: 08/06/2013
• Est. Priority Date: 10/13/2003
• Status: Active Grant

• Current Assignee: Fresenius Medical Care Deutschland GmbH (Fresenius Medical Care AG)
• Original Assignee: Fresenius Medical Care Deutschland GmbH (Fresenius Medical Care AG)
• Inventors: Jansson, Olof, Bernard, Pascal, Durand, Pierre-Yves, Hobro, Sture, Persson, Eva, Thell, Bengt-Olov
• Primary Examiner(s): BASS, DIRK R
• Application Number:
  US10/575,461
• Publication Number:
  US 20100137782A1
• Time in Patent Office: 3,219 Days
• Field of Search: None
• US Class Current: 604/29
• 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 1/282 Operational modes
• CPC Class Codes: A61M 2205/3393 by weighing the reservoir
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient

Abstract

A device and a method for a peritoneal dialysis treatment having several cycles include a cycler controlled by a processor. The cycler fills the abdominal cavity with dialysis fluid, and drains the abdominal cavity. A sensor senses a variable related to the draining of the dialysis fluid. The draining is interrupted when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving the residual volume of fluid.

Claims

1. A device for carrying out a tidal peritoneal dialysis treatment of a patient in a plurality of cycles, each cycle including a fill period (F), a dwell period (Dw) and a drain period (Dr), the device comprising:

A processor;

A cycler connected to the processor and adapted to fill the abdominal cavity of the patient with dialysis fluid, and to drain the abdominal cavity; and

A sensor connected to the processor and adapted to sense during the draining a variable related to the draining of the dialysis fluid from the abdominal cavity, said variable being a pressure in the abdominal cavity of the patient during the drain period,

The processor being adapted to initiate an interruption of the draining, at least for most of the cycles of the treatment, when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving a residual volume of the dialysis fluid in the abdominal cavity.

2. The device according to claim 1, further comprising an element for determining a first parameter associated with a desired target volume of the dialysis fluid to be contained in the abdominal cavity of the patient after each filled period of the treatment.

3. The device according to claim 2, further comprising an element for determining a second parameter associated with a total volume of the dialysis fluid to be used during a remaining part of the treatment.

4. The device according to claim 3, further comprising an element for determining a third parameter associated with a total length of time of the remaining part of the treatment.

5. The device according to claim 4, further comprising an element for determining a fourth parameter associated with the residual volume of dialysis fluid in the abdominal cavity after the drain period.

6. The device according to claim 5, wherein the processor is adapted to calculate for a next one of the cycles via the parameters a fill volume (VF) of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period.

7. The device according to claim 6, wherein the cycler is adapted to fill the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached, and to drain the abdominal cavity after the calculated fill/dwell time.

8. The device according to claims 6, wherein the processor is adapted to set the dwell period to a constant time value for substantially all cycles of the treatment at least for certain patients to be treated.

9. The device according to claim 5, further comprising an element for determining an initial, fifth parameter associated with an expected ultrafiltration volume, wherein the processor is adapted to account for the fifth parameter in the calculation of the fill volume (VF) of the dialysis fluid.

10. The device according to claims 6, wherein the processor is adapted to calculate a number of the cycles to be performed during a remaining part of the treatment.

11. The device according to claims 6, wherein the processor is adapted to make a relatively small adjustment of the target volume determined by the first element for the cycles following after the first cycle.

12. The device according to claim 9, wherein the sensor is adapted to sense a drain volume of the drained dialysis fluid after the drain period, and wherein the processor is adapted to calculate the residual volume via the drain volume, the expected ultrafiltration volume and the fill volume, and to determine a trend of the residual volume after at least two of the cycles.

13. The device according to claim 12, wherein the processor is adapted to adjust the expected ultrafiltration volume if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined first limit value.

14. The device according to claim 12, wherein the cycler is adapted to drain, during a following cycle, the abdominal cavity completely so that the residual volume is substantially zero if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined second limit value, and wherein the processor is adapted to calculate a new expected ultrafiltration volume based on the drain volume after the complete draining.

15. The device according to claim 1, wherein the sensor is adapted to detect an initial value of said variable at the beginning of the drain period and a critical value of said variable, and wherein the breakpoint is reached when the variable reaches the critical value.

16. A device for carrying out a tidal peritoneal dialysis treatment of a patient in a plurality of cycles, each cycle including a fill period (F), a dwell period (Dw) and a drain period (Dr), the device comprising:

An element for determining a first parameter associated with a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment;

An element for determining a second parameter associated with a total volume of a dialysis fluid to be used during a remaining part of the treatment;

An element for determining a third parameter associated with a total length of time of the remaining part of the treatment;

An element for determining a fourth parameter associated with a residual volume of the dialysis fluid in the abdominal cavity after the drain period;

A processor adapted to calculate for a next one of said cycles via the parameters a fill volume (VF) of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period;

A cycler connected to the processor and adapted to fill the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached, and to drain the abdominal cavity after the calculated fill/dwell time; and

A sensor connected to the processor and adapted to sense during the draining a variable related to the draining of the dialysis fluid from the abdominal cavity, said variable being a pressure in the abdominal cavity of the patient during the drain period,

The processor being adapted to initiate an interruption of the draining, at least for most of the cycles of the treatment, when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving a residual volume of the dialysis fluid in the abdominal cavity.