Surgery – Means for introducing or removing material from body for... – Material introduced into and removed from body through...
Patent
1996-09-17
1998-03-03
Buiz, Michael
Surgery
Means for introducing or removing material from body for...
Material introduced into and removed from body through...
128DIG12, 128DIG13, 604 67, A61M 100
Patent
active
057229473
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The present invention relates to an apparatus for administering peritoneal dialysis solution to a patient, such apparatus being known as a PD-cycler.
STATE OF THE ART
The invention starts out from the technology which is used by the applicant in the GAMBRO PD 100 system. This system comprises of a stand which is about 2 meters high. At a first upper level, at the upper end of the stand, there are hooks for hanging bags containing ready-mixed supply solution for peritoneal dialysis. The supply bags are connected via tubes to a heat bag positioned just below the supply bags at a second intermediate level. The heat bag is positioned on a heating surface of a weighing device.
The heat bag is filled, under control of valves, from the supply bags and may have a volume of about 2 liters or slightly more. When the contents in the heat bag has obtained the correct temperature, this is fed by gravity to a catheter terminating in the abdominal cavity of the patient. The catheter and the abdominal cavity are at a third level which is below the second level.
When the dialysis solution has fulfilled its task it is drained to a discharge bag positioned on a fourth level. The discharge bag is attached to a hook arrangement which hangs on the weighing device for the heat bag. In this way the same weight measuring element or load cell is used for weighing the heat bag as well as the discharge bag. The contents of the discharge bag is finally drained either directly to a drain or to collection bags which are situated on a fifth and lowest level. All transport of solution occurs by means of gravity between the five different levels. It is obviously important that the patient is situated at a particular level below the heat bag and above the discharge bag.
A tube-set intended for use in the GAMBRO PD 100 system is shown in EP-A1-499 718.
A similar cycler system is described in U.S. Pat. No. 5,141,492 in which only three levels are used. In this case the input amount is not weighed but only determined by the size of the supply bags. The supply bags are heated directly to the appropriate temperature. The discharge bag is also used for collection and is dimensioned to be sufficiently large. Only the collection bag is weighed.
In order to avoid dependence on gravity for feeding the dialysis solution it has been suggested that pump arrangements be used for this purpose. Such a pump arrangement is disclosed in U.S. Pat. No. 4,412,917 in the form of a peristaltic pump for feeding dialysis solution to a patient from a supply container positioned at floor level. A pressure monitoring arrangement insures that the pressure to the catheter does not exceed a predetermined value. The supply container as well as the collection container are positioned on a weighing device for monitoring the inlet and outlet of dialysis solution to and from the patient.
U.S. Pat. No. 4,560,472 discloses a pump arrangement for pumping supply solution from a first level to a heat bag positioned at a higher level. The continued transport of the dialysis solution occurs thereafter by means of gravity. In this way the need to lift the heavy supply bags up to a high level is avoided.
U.S. Pat. No. 5,004,459 discloses an even more automated system for administering PD-solution. The apparatus comprises i.a. a separate filling pump for filling the abdominal cavity and a separate outlet pump for extraction from the abdominal cavity. Two pressure and/or flow sensors detect and limit the pressure and/or flow for the supply and extraction. The apparatus further comprises mixing of dialysis concentrates with pure water, possibly with the addition of glucose.
U.S. Pat. No. 4,311,587 discloses a supply arrangement for dialysis solution through a sterile filter. The object is to avoid peritonitis by filtering the incoming solution. Since the sterile filter implies a large flow resistance, a higher pressure is required than that which can practically be achieved by means of gravity. Thus a bag containing dialysis solution is placed in a belt under th
REFERENCES:
patent: 4412917 (1983-11-01), Ahjopalo
patent: 4413988 (1983-11-01), Handt et al.
Jeppsson Jan-Bertil
Nordlie Tor
Buiz Michael
Gambro AB
Mendez Manuel
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