Gambro Lundia Ab

Gambro Ab

Hospal Industrie

Gambro Aktiebolag

Jan P Sternby

Kristian Solem

Thomas Hertz

Bo Olde

Anders Wieslander

Anders Nilsson

Lennart Jönsson

Anders Wallenborg

Eddie Nilsson

Olof Jansson

Paolo Rovatti

Mattias Holmer

Carlo Alberto Lodi

Per Hansson

Alessandro Surace

Sture Hobro

Berit Sternby

Perry Asbrink

Gary Mishkin

Björn Ericson

Helena Jeppsson

Bengt-Ake G Gummesson

Evi Martinson

Martin Furmanski

Anders Roslund

Petra Åhl

Preben A Petersen

Gabriela Godaly

Bernard Bene

Torbjorn Linden

Roger Nilsson

Sven A Jonsson

Henrik Lindgren

Ragnar Tryggvason

Nicolas Goux

Roland Persson

Per Kjellstrand

Jonas Fors

Anders Felding

Torbjörn Linden

Annmargret Håkansson

Bjorn A Bjare

Anders G Eckerbom

Lennart Joensson

Annmargret HÅKANSSON

Lennart JÖNSSON

Petra ÅHl

Torbjörn LINDÉN

An apparatus () for extracorporeal blood treatment, comprising an infusion control arrangement () arranged for infusing a pre-dilution flow rate upstream a blood treatment unit () and a post-dilution flow rate downstream the blood treatment unit (), an ultrafiltration, UF, arrangement () arranged for ultrafiltration of a liquid through a semipermeable membrane () of the blood treatment unit () and a control unit (). The control unit () is configured to configure the infusion control arrangement () to obtain a plurality of different configurations of the pre-dilution flow rate and/or post-dilution flow rate. For each of the plurality of different configurations, the control unit () is configured to change an operating situation of the UF arrangement (), to detect a plurality of ultrafiltration flow rate values through the membrane () as a function of TMP, on changing said operating situation, and to evaluate an optimal ultrafiltration flow rate value from a comparison of the detected ultrafiltration flow rates. The apparatus () is also configured to estimate a clearance value for a certain solute at the optimal ultrafiltration flow rate value and to evaluate a preferred configuration of the pre-dilution flow rate and/or post-dilution flow rate from a comparison of the corresponding estimated clearance values.

Apparatus and method for controlling infusion rate of pre- and post-dilution in extracorporeal blood treatment

A method of treating blood withdrawn from patient including: simultaneously withdrawing blood and infusing withdrawn blood from and to the patient by flowing the withdrawn blood through an extracorporeal dialysis circuit including a dialyzer having a semi-permeable dialysis membrane and a dialysate side adjacent the membrane; feeding a dialysate containing 1 to 5 mM total calcium and 2 to 8 mM citrate to the dialysate side of the dialyzer, and introducing an anticoagulation fluid including at least 8 mM citrate into the withdrawn blood upstream of the dialyzer.

Multipart fluid system and a system for regional citrate anticoagulation in an extracorporeal blood circuit

A monitoring system performs a method for detecting a disruption of a fluid connection between a first fluid containing system and a second fluid containing system. The monitoring system generates a monitoring signal which is representative of a fluid pressure in respect of the first fluid containing system and which is responsive to the disruption of the fluid connection, and a tracking signal which corresponds to and is more smoothed over time than the monitoring signal. The monitoring system further sets a detection range in a given relation to the tracking signal so that the detection range follows changes in the tracking signal, and detects a condition indicative of the disruption by comparing a current pressure value of the monitoring signal to the detection range. The monitoring system may be connected to or part of an apparatus for blood treatment and operable to detect a disconnection of an extracorporeal blood circuit from a vascular system of a patient, e.g. downstream of a blood pump in the extracorporeal blood circuit.

Detection of a disruption of a fluid connection between two fluid containing systems

A device for determining the access flow rate of a patient when connected to a blood treatment machine performs a measurement phase (), in which the blood treatment machine is caused () to operate in first and second operating states, wherein the second operating state at least differs from the first operating state by a change of flow direction of blood or treatment fluid through a dialyzer of the blood treatment machine. Based on sensor values representing a fluid property () of the treatment fluid in the first and second operating states, the device computes () a measurement value of comparison parameter (e.g. a ratio or a difference) that compares treatment efficiency in the first operating state to treatment efficiency in the second operating state, and determines (), based on the measurement value, an estimated value of the access flow rate.

Measuring access flow rate by use of blood treatment machine

A system and a method for renal replacement therapy includes a blood treatment unit connected to a blood circuit and a dialysis fluid circuit, the system further including a control unit configured to control the system according to control instructions during a treatment, so as to determine a system parameter value and an indication of membrane fouling of the membrane, and activate an automatic anti-fouling measure that includes a temporary change of the flow rate in the blood circuit and a temporary decrease of the ultrafiltration rate wherein a timing of the temporary change and a timing of the temporary reduction are synchronized.

System and a method for renal replacement therapy

Dialysis machines comprising a feed arrangement to supply a dialysis fluid to a dialyzer during dialysis treatment and a return arrangement to remove the dialysis fluid from the dialyzer during dialysis treatment and forward it to an exit; a feed recirculation circuit to allow a fluid of the feed arrangement to be re-circulated in a fluid loop path comprising, at least a portion of, the feed arrangement and the feed recirculation circuit and a return recirculation circuit to allow a fluid of the return arrangement to re-circulate in an auxiliary fluid loop path comprising, at least a portion of, the return arrangement and the return recirculation circuit. A controller configured to perform disinfection by re-circulating a disinfectant and/or a heated fluid through said fluid loop path and/or through said auxiliary fluid loop path. The dialysis machine further comprises a feed forward arrangement connected to the fluid loop path and arranged to enable a fluid of the feed arrangement to be forwarded to the exit by-passing the auxiliary fluid loop path.

Dialysis machines and methods of disinfecting a dialysis machine

An extracorporeal blood treatment apparatus includes a filtration unit () connected to a blood circuit () and a dialysate circuit (), a preparation device () for preparing and regulating the composition of the dialysis fluid, and a sensor () for measuring conductivity of the dialysate (i.e. spent dialysis fluid); a control unit () configured for setting a sodium concentration in the dialysis fluid and after setting the dialysis fluid at the initial set point, circulating the dialysis fluid and blood through the filtration unit (), measuring an initial conductivity value of the dialysate at the beginning of the treatment, and calculating, based on the measured initial conductivity value and on the corresponding conductivity value of the dialysis fluid, the value of the initial plasma conductivity, said circulating of the dialysis fluid up to the calculating of the initial plasma conductivity performed by maintaining the dialysis fluid conductivity substantially constant.

Apparatus for extracorporeal blood treatment

A control device for a blood treatment machine performs a connection test () by causing the blood treatment machine to switch () between a first and a second operating state by reversing a blood pump so as to change a flow direction of blood through both a dialyzer and access devices connected to a patient. Based on an output signal of at least one sensor in the blood treatment machine (), the control device computes () an efficiency change parameter that represents a change in in-vivo clearance of the blood treatment machine during the switch of the blood treatment machine between the first and second operating states. The control device evaluates () the efficiency change parameter to jointly detect connection errors at the dialyzer, resulting in co-current flow of treatment fluid and blood through the dialyzer, and at the access devices, resulting in access recirculation of blood.

Connection test for blood treatment machines

An extracorporeal blood treatment apparatus is provided comprising a filtration unit () connected to a blood circuit () and to a dialysate circuit (), a preparation device () for preparing and regulating the composition of the dialysis fluid, and a sensor () for measuring conductivity of the dialysate (i.e. spent dialysis fluid); a control unit () configured for setting a sodium concentration in the dialysis fluid and after setting the dialysis fluid at the initial set point, circulating the dialysis fluid and/or the substitution fluid, measuring an initial conductivity value of the dialysate at the beginning of the treatment, and calculating, based on the measured initial conductivity value of the spent dialysis fluid and on the corresponding conductivity value of the dialysis fluid, the value of the initial plasma conductivity, said circulating the dialysis fluid up to the calculating of the initial plasma conductivity being performed maintaining the dialysis fluid conductivity substantially constant.

An extracorporeal blood treatment apparatus is provided comprising a filtration unit () connected to a blood circuit () and to a dialysate circuit (), a preparation device () for preparing and regulating the composition of the dialysis fluid; a control unit () is configured for setting a sodium concentration value for the dialysis fluid in the dialysis supply line () 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.

A method of monitoring the integrity of a fluid connection between first and second fluid containing systems based on at least one time-dependent measurement signal from a pressure sensor in the first fluid containing system. The pressure sensor detects first pulses originating from a first pulse generator in the first fluid containing system and second pulses originating from a second pulse generator in the second fluid containing system. A parameter value representing a distribution of signal values within a time window is calculated by analyzing the measurement signal in the time domain and/or by using information on the timing of the second pulses in the measurement signal. The parameter value may be calculated as a statistical dispersion measure of the signal values, or from matching the signal to a predicted temporal signal profile of the second pulse. The integrity of the fluid connection is determined from the parameter value.

Methods and devices for monitoring the integrity of a fluid connection

Dialysis machines comprising a feed arrangement () to supply a dialysis fluid to a dialyzer () during dialysis treatment and a return arrangement () to remove the dialysis fluid from the dialyzer during dialysis treatment and forward it to an exit (); a feed recirculation circuit () to allow a fluid of the feed arrangement to be re-circulated in a fluid loop path comprising, at least a portion of, the feed arrangement and the feed recirculation circuit and a return recirculation circuit () to allow a fluid of the return arrangement to re-circulate in an auxiliary fluid loop path comprising, at least a portion of, the return arrangement and the return recirculation circuit. A controller () configured to perform disinfection by re-circulating a disinfectant and/or a heated fluid through said fluid loop path and/or through said auxiliary fluid loop path. The dialysis machine () further comprises a feed forward arrangement () connected to the fluid loop path and arranged to enable a fluid of the feed arrangement () to be forwarded to the exit () by-passing the auxiliary fluid loop path.

A filtering device receives a pressure signal (P) from a pressure sensor in a fluid containing system, the pressure signal (P) comprising first pulses originating from a first periodic pulse generator and second pulses. The device acquires a reference signal which is indicative of a current operating frequency of the first periodic pulse generator. The device identifies, based on the reference signal, a plurality of harmonics (-) associated with the current operating frequency, computes correlation values (&#x3bb;-&#x3bb;) between the harmonics and the pressure signal (P) within a time window in the pressure signal (P), and generates a filtered signal by subtracting, as a function of the correlation values (&#x3bb;-&#x3bb;), the harmonics from the pressure signal (P). The use of correlation values is a direct, fast, robust and computation-efficient approach for estimating the signal contribution (d) from first pulses in the pressure signal (P).

Filtering of pressure signals for suppression of periodic pulses

An extracorporeal blood treatment apparatus is provided comprising a filtration unit () connected to a blood circuit () and to a dialysis fluid circuit (), a preparation device () for preparing and regulating the composition of the dialysis fluid; a control unit () is configured for determining or receiving a proposed value (Cond) of a conductivity for the dialysis fluid in the dialysis supply line () and to determine a set value (Cond) for the conductivity in the dialysis fluid as a function of the proposed value (Cond) and as a function of at least one of a second parameter (UF volume/W; WL/W) indicative of a patient fluid overload and a third parameter (g) chosen in the group including: a glucose concentration in the patient and a concentration-related parameter of at least glucose in the patient.

A monitoring system () performs a method for detecting a disruption of a fluid connection between a first fluid containing system and a second fluid containing system. The monitoring system generates a monitoring signal (M) which is representative of a fluid pressure in respect of the first fluid containing system and which is responsive to the disruption of the fluid connection, and a tracking signal (T) which corresponds to and is more smoothed over time than the monitoring signal (M). The monitoring system () further sets a detection range (ML, MH) in a given relation to the tracking signal (T) so that the detection range (ML, MH) follows changes in the tracking signal (T), and detects a condition indicative of the disruption by comparing a current pressure value of the monitoring signal (M) to the detection range (ML, MH). The monitoring system () may be connected to or part of an apparatus for blood treatment and operable to detect a disconnection of an extracorporeal blood circuit from a vascular system of a patient, e.g. downstream of a blood pump in the extracorporeal blood circuit.

Growing community of inventors

Lund, Sweden

Jan P Sternby