Obtaining control settings for a dialysis machine

Patent metadata

Field	Value
Publication number	US-9345827-B2
Application number	US-201113825198-A
Country	US
Kind code	B2
Filing date	Sep 20, 2011
Priority date	Sep 20, 2010
Publication date	May 24, 2016
Grant date	May 24, 2016

Abstract

Prior to each treatment session for an individual patient, a machine controller in a dialysis machine obtains from a logic device a set of current control settings of the machine-related parameters to be applied in the treatment session. In generating the control settings, the logic device obtains a set of therapeutic targets comprising a target value that represents part of a desired status of the patient after the treatment session, in terms of one or more physiological parameters for the patient. The logic device also obtains status data that represents the current status of the patient prior to the treatment session, and computes the set of current control settings of the machine-related parameters, as a function of the set of therapeutic targets and the status data and at least partly based on a predictive model, which estimates the physiological response of the patient to the machine-related parameters during the treatment session.

First claim

The invention claimed is:

1. A dialysis system comprising:
a dialysis machine configured to perform treatment sessions of renal replacement therapy, and
a logic device for generating control settings of machine-related parameters of the dialysis machine,
wherein the dialysis machine is configured to obtain from the logic device, prior to each treatment session for an individual patient, a set of current control settings of the machine -related parameters to be applied in the treatment session, and wherein the logic device is configured to:
obtain a set of therapeutic targets comprising a target value of one or more physiological parameters for the patient, wherein the target value represents part of a desired status of the patient after the treatment session, and wherein the set of therapeutic targets includes a target value of (i) a measure of a property of the patient's blood including at least one of urea concentration, an electrolyte concentration, and an acid-base balance and (ii) a measure of a fluid balance of the patient;
obtain status data that represents a current status of the patient prior to the treatment session; and
compute, as a function of the set of therapeutic targets and the status data, the set of current control settings of the machine-related parameters, wherein the logic device is configured to compute at least part of the current control settings based on a predictive model that estimates the physiological response of the patient to the machine-related parameters during the treatment session, such that the set of current control settings of the machine-related parameters enable the dialysis machine to achieve said target value of one or more physiological parameters including the target value of (i) a measure of a property of the patient's blood including at least one of a urea concentration, an electrolyte concentration, and an acid-base balance and (ii) a measure of a fluid balance of the patient at the end of the treatment session.

2. The dialysis system of claim 1 , wherein the set of therapeutic targets represents the desired status of the patient after the treatment session.

3. The dialysis system of claim 1 , wherein the status data comprises a starting value of said one or more physiological parameters before the treatment session.

4. The dialysis system of claim 3 , wherein the logic device is configured to estimate the starting value of said one or more physiological parameters based on historic data for the patient.

5. The dialysis system of claim 4 , wherein the historic data indicates a rate of change for at least one physiological parameter.

6. The dialysis system of claim 4 , wherein the historic data comprises data related to one or more preceding treatment sessions, including at least one of a time between treatment sessions, a duration of one or more preceding treatment sessions, a clearance obtained in one or more preceding treatment sessions, a final value of said one or more physiological parameters in one or more preceding treatment sessions.

7. The dialysis system of claim 4 , wherein the logic device is configured to estimate the starting value of said one or more physiological parameters by means of a further predictive model that estimates the status of the patient based on the historic data.

8. The dialysis system of claim 3 , wherein the logic device is configured to calculate session targets as a difference between the target and starting values for each physiological parameter, and compute the current control settings as a function of the session targets.

9. The dialysis system of claim 1 , wherein the logic device is configured to compute said at least part of the current control settings by finding one solution to a set of functional relations, wherein each functional relation is based on the predictive model and links one of said one or more physiological parameters to one or more machine-related parameters.

10. The dialysis system of claim 9 , wherein the logic device is configured to find said one solution by computing the values of the machine-related parameters according to a predetermined priority order.

11. The dialysis system of claim 10 , wherein the logic device is further configured to obtain a data structure that defines the predetermined priority order.

12. The dialysis system of claim 9 , wherein the logic device is configured to find said one solution by computing the values of the machine-related parameters based on predetermined value definitions for the values of the machine-related parameters.

13. The dialysis system of claim 12 , wherein the logic device is further configured to obtain a data structure that contains the value definitions.

14. The dialysis system of claim 12 , wherein the value definitions comprise at least one of:
setting the value of at least one machine-related parameter to a predetermined value,
setting the value of at least one machine-related parameter to a minimum,
setting the value of at least one machine-related parameter to a maximum, and
setting the value of at least one machine-related parameter to any value.

15. The dialysis system of claim 12 , wherein the value definitions indicate a dialysis fluid flow rate to be set to achieve saturation, and wherein the priority order prioritizes the dialysis fluid flow rate over a duration of the treatment session.

16. The dialysis system of claim 12 , wherein the value definitions indicate a given amount of dialysis fluid to be utilized over the duration of the treatment session, and wherein the priority order prioritizes the amount of dialysis fluid and the duration of the treatment session over the dialysis fluid flow rate.

17. The dialysis system of claim 12 , wherein the value definitions indicate the duration of the treatment session to be set to a minimum, and wherein the priority order prioritizes the duration of the treatment session over other machine-related parameters.

18. The dialysis system of claim 1 , wherein the logic device is configured to set the duration of the treatment session to a predetermined value when computing the current control settings.

19. The dialysis system of claim 1 , wherein the logic device configured to separately compute a minimum duration of the treatment session to reach the target value for each physiological parameter, and set a duration of the treatment session to the maximum of the minimum durations, wherein the logic device is configured to compute the current control settings based on the thus-set duration.

20. The dialysis system of claim 1 , wherein the logic device is configured to compute the current control settings for the machine-related parameters without user intervention.

21. The dialysis system of claim 1 , wherein the dialysis machine is configured to perform the treatment session using the current control settings.

22. The dialysis system of claim 21 , which is configured to, before the dialysis machine performs the treatment session, present at least part of the current control settings for approval by a user.

23. The dialysis system of claim 22 , which is configured to, if a modification of one or more current control settings is received after presenting said at least part of the current control settings, cause the logic device to compute updated control settings based on the modification.

24. The dialysis system of claim 1 , which is configured to, if detecting a deviating value of a physiological or machine-related parameter durin

Assignees

• Hertz Thomas
• Gambro Lundia Ab

Inventors

• Hertz Thomas

Classifications

• A61M1/16 Primary

  with membranes · CPC title

• G16H50/20

  for computer-aided diagnosis, e.g. based on medical expert systems · CPC title

• A61M2205/52

  with memories providing a history of measured variating parameters of apparatus or patient · CPC title

• A61M2202/0498

  Urea · CPC title

• A61M1/1611

  Weight of the patient · CPC title