Extracorporeal blood treatment apparatus having dialysis fluid parameter data entry

Patent metadata

Field	Value
Publication number	US-10434236-B2
Application number	US-201615575089-A
Country	US
Kind code	B2
Filing date	May 23, 2016
Priority date	May 25, 2015
Publication date	Oct 8, 2019
Grant date	Oct 8, 2019

Abstract

An extracorporeal blood treatment apparatus is provided comprising a filtration unit ( 2 ) connected to a blood circuit ( 17 ) and to a dialysate circuit ( 32 ), a preparation device ( 9 ) for preparing and regulating the composition of the dialysis fluid; a control unit ( 12 ) is configured for setting a sodium concentration value for the dialysis fluid in the dialysis supply line ( 8 ) at a set point; the setting of the sodium concentration includes the sub-step of calculating the sodium concentration value as an algebraic sum of a main contribution term based on the blood plasma conductivity and of an adjustment contribution term based on a concentration of at least a substance in the dialysis fluid chosen in the group including bicarbonate, potassium, acetate, lactate, citrate, magnesium, calcium, sulphate, and phosphate.

First claim

The invention claimed is:

1. An apparatus for extracorporeal blood treatment comprising:
a filtration unit having a primary chamber and a secondary chamber separated by a semi-permeable membrane;
a blood withdrawal line in fluid communication with an inlet of the primary chamber;
a blood return line in fluid communication with an outlet of the primary chamber, the blood lines configured for connection to a patient cardiovascular system;
a dialysis supply line in fluid communication with an inlet of the secondary chamber;
a dialysis effluent line in fluid communication with an outlet of the secondary chamber;
a preparation device for preparing dialysis fluid, the preparation device in fluid communication with the dialysis supply line and comprising a regulating device for regulating composition of the dialysis fluid; and
a control unit communicating with the regulating device and receiving a value representative of a first parameter, the first parameter chosen from a group including (i) a plasma conductivity, (ii) a plasma conductivity-related parameter, (iii) a concentration of at least sodium in blood, and (iv) a concentration-related parameter of at least sodium in blood, the control unit programmed to set a second parameter for the dialysis fluid in the dialysis supply line at a set point, the second parameter being at least one chosen from a group including (i) a conductivity of the dialysis fluid, (ii) a conductivity-related parameter of the dialysis fluid, (iii) a concentration of at least a substance in the dialysis fluid, and (iv) a concentration-related parameter of at least a substance in the dialysis fluid,
wherein setting the second parameter includes calculating the second parameter as a function of a main contribution term based on the first parameter and as a function of an adjustment contribution term based on a concentration of at least a substance in the dialysis fluid chosen from a group including bicarbonate, potassium, acetate, lactate, citrate, magnesium, calcium, sulphate and phosphate, and
wherein the adjustment contribution term is the sodium concentration set point adjustment to the sodium concentration set point for isoconductive dialysis, and wherein the adjustment contribution applied to the sodium concentration set point for the isoconductive dialysis provides a treatment chosen in the group including isotonic dialysis, isonatremic dialysis, isonatrikalemic dialysis and a treatment that removes from, or adds to, the plasma a defined amount of at least a substance.

2. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term based on a concentration of two or more substances in the dialysis fluid chosen from a group including bicarbonate, potassium, acetate, lactate, citrate, magnesium, calcium, sulphate, and phosphate.

3. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term as a function of a weighted difference in concentration of one or more substances in the dialysis fluid and the corresponding same substances in the blood, the substances being chosen from a group including bicarbonate, potassium, acetate, lactate, and citrate.

4. The apparatus according to claim 1 , wherein the second parameter is the conductivity of the dialysis fluid, or the concentration of sodium in the dialysis fluid.

5. The apparatus according to claim 1 , wherein the main contribution term is a dialysis fluid concentration of sodium at an isoconductive dialysis.

6. The apparatus according to claim 1 , wherein the control unit drives the regulating device for regulating the conductivity or the concentration of at least a substance in the dialysis fluid, the control unit setting the second parameter for the dialysis fluid in the dialysis supply line at the calculated set point.

7. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term as a function of molar conductivities of one or more substances in the dialysis fluid chosen from a group including sodium bicarbonate (NaHCO 3 ), sodium chloride (NaCl), sodium acetate (NaCH 3 COO), potassium chloride (KCl), sodium lactate (NaC 3 H 5 O 3 ), and trisodium citrate (Na 3 C 6 H 5 O 7 ).

8. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term as a function of a difference between a first molar conductivity of a substance chosen from a group including sodium bicarbonate (NaHCO 3 ), sodium acetate (NaCH 3 COO), trisodium citrate (Na 3 C 6 H 5 O 7 ), sodium lactate (NaC 3 H 5 O 3 ), potassium chloride (KCl), and a molar conductivity of sodium chloride (NaCl).

9. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term as a function of an estimated or measured plasma water concentration of one or more substances chosen from a group including bicarbonate, potassium, acetate, lactate, and citrate.

10. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term as an algebraic sum of at least two components, a first of the components being a function of a difference in concentration of at least a first substance in the dialysis fluid and the same substance in the blood plasma, and a second of the components being a function of a weighted difference in concentration of at least a second substance in the dialysis fluid and the same second substance in the blood plasma, wherein the first and second substances are chosen from a group including bicarbonate anions (HCO 3 − ), acetate anions (CH 3 COO − ), citrate anions (C 6 H 5 O 7 3− ), and potassium ions (K + ).

11. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term as an algebraic sum of at least two components, a first of the components being a function of a concentration of at least a first substance in the dialysis fluid and/or blood plasma, a second of the components being a function of a concentration of at least a second substance in the dialysis fluid and/or blood plasma, wherein the first and second substances are chosen from a group including bicarbonate anions (HCO 3 − ), acetate anions (CH 3 COO − ), citrate anions (C 6 H 5 O 7 3− ), and potassium ions (K + ).

12. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the adjustment contribution term as a function of at least a ratio between a dialysate flow rate at the outlet of the secondary chamber and an efficiency parameter of the filtration unit.

13. The apparatus according to the previous claim 12 , wherein the control unit is programmed to calculate the plasma conductivity as a function of the dialysate flow rate at the outlet of the secondary chamber and a blood flow rate in the blood lines.

14. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the plasma conductivity as a function of at least an efficiency parameter of the filtration unit.

15. The apparatus according to claim 1 , wherein the control unit is programmed to calculate the plasma conductivity as a function of at least an initial conductivity of dialysate in the dialysis effluent line and of at least a conductivity of the dialysis fluid in the dialysis supply line.

16. The apparatus according to claim 1 , wherein the control unit is programmed to allow selection of at least one treatment mode chosen from a group including isotonic dialysis, isonatre

Assignees

• Gambro Lundia Ab

Inventors

• Rovatti Paolo
• Surace Alessandro
• Lodi Carlo Alberto
• Wallenborg Anders
• Nilsson Anders
• Solem Kristian
• Sternby Jan
• Hertz Thomas

Classifications

• A61M2205/128

  with incorporated valves · CPC title

• A61M1/1666

  by dissolving solids · CPC title

• A61M1/3609

  Physical characteristics of the blood, e.g. haematocrit, urea · CPC title

• A61M1/1607

  before use, i.e. upstream of dialyser · CPC title

• A61M2230/005

  Parameter used as control input for the apparatus · CPC title