Detecting blood flow degradation

• US 8,529,491 B2
• Filed: 12/31/2009
• Issued: 09/10/2013
• Est. Priority Date: 12/31/2009
• Status: Active Grant

• Current Assignee: Fresenius Medical Care Holdings Incorporated (Fresenius Medical Care AG)
• Original Assignee: Fresenius Medical Care Holdings Incorporated (Fresenius Medical Care AG)
• Inventors: Beiriger, Michael James
• Primary Examiner(s): HAND, MELANIE JO
• Application Number:
  US12/650,745
• Publication Number:
  US 20110160637A1
• Time in Patent Office: 1,349 Days
• Field of Search: 604/4.01, 604/5.01, 604/6.06, 604/6.07, 604/6.09, 604/6.1, 604/6.11, 604/6.16, 210645-647, 210/767
• US Class Current: 604/8
• CPC Class Codes: A61M 1/3609 Physical characteristics of the blood, e.g. haematocrit, urea
• CPC Class Codes: A61M 1/3653 Interfaces between patient blood circulation and extra-corporal blood circuit
• CPC Class Codes: A61M 1/3656 Monitoring patency or flow at connection sites; Detecting disconnections
• CPC Class Codes: A61M 1/3659 Cannulae pertaining to extracorporeal circulation

Abstract

A method for detecting blood flow degradation in a dialysis system. The method includes measuring a flow rate of blood in a blood line, calculating a current impedance value based on the measured flow rate, and comparing the current impedance value to a baseline impedance value.

Claims

1. A method for detecting blood flow degradation in a dialysis system, the method comprising:

calculating a current impedance value based on measured data, the measured data corresponding to a property of blood in a blood line;

comparing the current impedance value to a baseline impedance value; and

determining a cause of blood flow degradation indicated by the difference between the current impedance value and the baseline impedance value.

2. The method of claim 1, further comprising inferring blood flow degradation if the current impedance value differs from the baseline impedance value by more than a maximum limit.

3. The method of claim 1, further comprising:

transmitting a signal corresponding to the measured data to a controller; and

utilizing the controller to calculate the current impedance value based on the measured data.

4. The method of claim 3, further comprising utilizing the controller to compare the current impedance value to the baseline impedance value.

5. The method of claim 1, further comprising alerting a user if the current impedance value differs from the baseline impedance value by more than a maximum limit.

6. The method of claim 5, wherein alerting the user comprises activating an alarm.

7. The method of claim 6, wherein the alarm is an audible alarm.

8. The method of claim 6, wherein the alarm is a visual alarm.

9. The method of claim 5, wherein alerting the user comprises displaying information concerning a detected blood flow degradation on a display device.

10. The method of claim 9, wherein the displayed information comprises information regarding a cause of blood flow degradation.

11. The method of claim 9, wherein the displayed information comprises information regarding a location of a cause of blood flow degradation relative to the dialysis system.

12. The method of claim 1, further comprising administering a saline bolus if the current impedance value differs from the baseline impedance value by more than a maximum limit.

13. The method of claim 12, wherein the saline bolus is automatically administered at the direction of a controller of the dialysis system.

14. The method of claim 1, further comprising adjusting a needle at a patient access point if the current impedance value differs from the baseline impedance value by more than a maximum limit.

15. The method of claim 1, further comprising un-kinking kinked tubing if the current impedance value differs from the baseline impedance value by more than a maximum limit.

16. The method of claim 1, further comprising determining a location of a cause of blood flow degradation based, at least in part, on the difference between the current impedance value and the baseline impedance value.

17. The method of claim 1, wherein comparing the current impedance value to the baseline value comprises calculating a percent difference between the current impedance value and the baseline value.

18. The method of claim 17, wherein identifying the cause of blood flow degradation is based on the calculated percent difference.

40. The method of claim 1, wherein the measured data corresponds to a flow rate of blood in the blood line.

41. The method of claim 1, wherein the measured data corresponds to a pressure of blood in the blood line.

42. The method of claim 1, wherein the base line impedance value corresponds to an average impedance value of at least some preceding dialysis cycles over a given period of time.

46. The method of claim 1, wherein if the difference between the current impedance value and the baseline impedance value corresponds to an increase in the current impedance value of about 20 to 25 percent, a cause of blood flow degradation is determined to be clot formation.

47. The method of claim 1, wherein if the difference between the current impedance value and the baseline impedance value corresponds to an increase in the current impedance value of about 100 percent, a cause of blood flow degradation is determined to be at least partial occlusion of an access needle of a blood line.

48. The method of claim 1, wherein if the difference between the current impedance value and the baseline impedance value corresponds to an increase in the current impedance value of about 500 percent, a cause of blood flow degradation is determined to be a kink in a blood line.

19. A computer-readable medium having encoded thereon software for detecting blood flow degradation in a blood circuit, the software comprising instructions for:

receiving information corresponding to measurement data from one or more sensors;

calculating a current impedance value based on the measurement data;

comparing the current impedance value to a baseline impedance value; and

determining a cause of blood flow degradation indicated by the difference between the current impedance value and the baseline impedance value.

20. The computer readable medium of claim 19, wherein the software further comprises instructions for calculating the baseline impedance value based, at least in part, on measurement data received from the one or more sensors.

43. The computer readable medium of claim 19, wherein the software further comprises instructions for calculating the baseline impedance value as an average impedance value of at least some preceding dialysis cycles over a given period of time.

21. A dialysis system comprising:

a blood circuit comprising;

a blood pump,

tubing for conveying blood between the blood pump and a patient;

one or more sensors for measuring a property of blood within the tubing; and

a controller in communication with the one or more sensors and configured to calculate a hydraulic impedance within the tubing based, at least in part, on signals received from the one or more sensors.

22. The dialysis system of claim 21, wherein the tubing comprises an arterial line for conveying blood from a patient to the blood pump, and a venous line for conveying blood from the pump back to the patient.

23. The dialysis system of claim 22,

wherein the one or more sensors comprise an arterial flow sensor arranged to measure a flow rate of blood flowing within the arterial line, and

wherein the controller is configured to calculate a hydraulic impedance within the arterial line based, at least in part, on signals received from the arterial flow sensor.

24. The dialysis system of claim 22,

wherein the one or more sensors comprise a venous flow sensor arranged to measure a flow rate of blood flowing within the venous line,

wherein the controller is configured to calculate a hydraulic impedance within the venous line based, at least in part, on signals received from the venous flow sensor.

25. The dialysis system of claim 21,

wherein the one or more sensors comprise one or more pressure sensors for measuring pressure within the tubing, and

wherein the controller is in communication with the one or more sensors.

26. The dialysis system of claim 21, wherein the controller is configured:

to compare the calculated hydraulic impedance to a baseline impedance value, and

to detect a blood flow degradation based on the comparison.

27. The dialysis system of claim 21, further comprising a display device in communication with the controller, wherein the controller is configured to display information concerning a detected blood flow degradation on the display device.

28. The dialysis system of claim 21, further comprising an audible alarm, wherein the controller is configured to sound the audible alarm in response to detecting a blood flow degradation.

29. The dialysis system of claim 21, wherein the controller is configured to control operation of the pump, and wherein the controller is configured to halt operation of the pump in response to detecting a blood flow degradation.

30. The dialysis system of claim 21, further comprising:

a saline source,

a saline line connecting the saline source to the tubing, and

a saline valve in electrical communication with the controller,

wherein the saline valve is operable to control a flow of saline from the saline source toward the tubing, and

wherein the controller is configured to administer a saline bolus, via operation of the saline valve, in response to detecting a blood flow degradation.

31. The dialysis system of claim 21, further comprising memory in communication with the controller.

32. The dialysis system of claim 31, wherein the memory includes stored data corresponding to a baseline impedance value.

33. The dialysis system of claim 31, wherein the controller is configured:

to calculate a baseline impedance value based, at least in part, on signals received from the sensors, and

to cause the baseline impedance value to be stored in the memory.

34. The dialysis system of claim 21, wherein the blood pump is a peristaltic pump.

35. The dialysis system of claim 21, further comprising a dialyzer, connected to the blood circuit, for separating waste from blood flowing within the blood circuit.

36. The dialysis system of claim 21, further comprising a dialysate circuit through which dialysate flows.

37. The dialysis system of claim 36, further comprising a sorbent cartridge in fluid communication with the dialysate circuit and configured so that the dialysate can pass therethrough, the sorbent cartridge being adapted to remove one or more substances from the dialysate as the dialysate passes through the sorbent cartridge.

38. The dialysis system of claim 21, wherein the dialysis system is a hemodialysis system.

39. The dialysis system of claim 21, wherein the dialysis system is a sorbent-based dialysis system.

44. The dialysis system of claim 26, wherein the base line impedance value corresponds to an average impedance value of at least some preceding dialysis cycles over a given period of time.

45. The dialysis system of claim 21, wherein the controller is configured to determine a likely cause of blood flow degradation indicated by the difference between the current impedance value and a baseline impedance value.