US-12616786-B2 - Dialysis machine and method of operating a balancing chamber system of a dialysis machine

US12616786B2US 12616786 B2US12616786 B2US 12616786B2US-12616786-B2

Abstract

A dialysis machine has a dialyzer having a first balancing chamber and a second balancing chamber, of which each has at least two first and second balancing chamber halves separated from one another by a movable wall. Each first balancing chamber half has a respective first inflow and a respective first outflow, with the first inflows of the first balancing chamber halves being in fluid communication with a source of fresh dialysate. The first outflow of the first balancing chamber half is in fluid communication with a dialyzer inflow, and the second inflows of the second balancing chamber halves are in fluid communication with a dialyzer outflow. The second outflows of the second balancing chamber halves are in fluid communication with one another so that consumed dialyzate is transferrable from a second balancing chamber half of one balancing chamber to a second balancing chamber half of the other balancing chamber.

Inventors

Tobias Irrgang

Assignees

FRESENIUS MEDICAL CARE DEUTSCHLAND GMBH

Dates

Publication Date: 20260505
Application Date: 20200709
Priority Date: 20190709

Claims (14)

1 . A dialysis machine comprising a dialyzer and a balancing chamber system, the dialyzer comprising a dialyzer inflow and a dialyzer outflow, the balancing chamber system comprising a first balancing chamber, a second balancing chamber, and a control unit, wherein the first balancing chamber has a first balancing chamber first half and a first balancing chamber second half that are separated from one another by a first movable wall, the first balancing chamber first half being provided with a first inflow and with a first outflow, the first balancing chamber second half being provided with a second inflow and with a second outflow, the second balancing chamber has a second balancing chamber first half and a second balancing chamber second half that are separated from one another by a second movable wall, the second balancing chamber first half being provided with a third inflow and with a third outflow, the second balancing chamber second half being provided with a fourth inflow and with a fourth outflow, each of the first, second, third, and fourth inflows and the first, second, third, and fourth outflows is provided with a respective valve that is configured to close or to open the respective inflow or outflow, the first and third inflows are in fluid communication with a source of fresh dialysate, the first outflow is in fluid communication with the dialyzer inflow, the second inflow and the fourth inflow are in fluid communication with the dialyzer outflow, the second outflow and the fourth outflow are in fluid communication with one another so that consumed dialyzate is transferrable from the first balancing chamber second half to the second balancing chamber second half or from the second balancing chamber second half to the first balancing chamber second half, and the control unit is configured to control the valves such that Configuration I is enabled, Configuration II is enabled, or both Configuration I and Configuration II are enabled, wherein, according to Configuration I: with the first inflow being open and the first outflow being closed, the first balancing chamber first half is filled with fresh dialysate with the second inflow being closed, the second outflow being open, and the fourth outflow being open, the first balancing chamber second half is emptied and consumed dialyzate is conveyed from the first balancing chamber second half of the first balancing chamber into the second balancing chamber second half of the second balancing chamber, and with the fourth outflow being open, the third outflow being open, and the third inflow being closed, fresh dialyzate is conveyed from the second balancing chamber first half to the dialyzer inflow; and according to Configuration II: with the third inflow being open and the third outflow being closed, the second balancing chamber first half is filled with fresh dialysate with the fourth inflow being closed, the fourth outflow being open, and the second outflow being open, the second balancing chamber second half is emptied and consumed dialyzate is conveyed from the second balancing chamber second half into the first balancing chamber second half and with the second outflow being open, the first outflow being open, and the first inflow being closed, fresh dialyzate is conveyed from the first balancing chamber first half to the dialyzer inflow; and wherein the control unit is configured to control the valves such that a volume of fresh dialyzate that is conveyed to the dialyzer inflow is restricted to volumes a volume of between 2 and 15 l/treatment liters per hemodiafiltration treatment.
2 . The dialysis machine in accordance with claim 1 , wherein the second outflow and the fourth outflow are in fluid communication with a drain line that leads to an outlet in which a drain valve is arranged and via which the drain line is openable and closeable.
3 . The dialysis machine in accordance with claim 1 , wherein the dialysis machine is free of a substituate pump for conveying a substitution solution.
4 . The dialysis machine in accordance with claim 2 , further comprising a drain control unit that is configured to close the drain valve when consumed dialysate is transferred from the first balancing chamber second half to the second balancing chamber second half or from the second balancing chamber second half to the first balancing chamber second half.
5 . The dialysis machine in accordance with claim 1 , wherein the control unit is further configured to control the valves of the first, second, third, and fourth inflows and of the first, second, third, and fourth outflows such that: consumed dialyzate is transferred from the first balancing chamber second half to the second balancing chamber second half or from the second balancing chamber second half to the first balancing chamber second half and such that, after the transfer, the second outflow and the fourth outflow are moved into fluid communication with a drain line.
6 . The dialysis machine in accordance with claim 5 , a wherein the balancing chamber system is configured to operate cyclically for cycles of operation, and the control unit is further configured to carry out a transfer of consumed dialyzate from the first balancing chamber second half to the second balancing chamber second half, or from the second balancing chamber second half to the first balancing chamber second half, at each nth cycle of operation of the balancing chamber system.
7 . The dialysis machine in accordance with claim 1 , wherein the control unit is further configured to carry out a transfer of consumed dialyzate from the first balancing chamber second half to the second balancing chamber second half, or from the second balancing chamber second half to the first balancing chamber second half, evenly in time over a treatment duration.
8 . The dialysis machine in accordance with claim 1 , wherein the dialyzer is a high-flux dialyzer.
9 . The dialysis machine in accordance with claim 1 , wherein the control unit is configured to control the valves such that a volume of fresh dialyzate that is so conveyed to the dialyzer is restricted to a volume of between 5 and 12 liters per four-hour hemodiafiltration treatment.
10 . The dialysis machine in accordance with claim 9 , wherein the control unit is configured to control the valves such that a volume of fresh dialyzate that is conveyed to the dialyzer inflow is restricted to a volume of between 5 and 10 liters per four-hour hemodiafiltration treatment.
11 . The dialysis machine in accordance with claim 1 , wherein the control unit is configured to carry out a transfer of consumed dialyzate from the first balancing chamber second half to the second balancing chamber second half, or from the second balancing chamber second half to the first balancing chamber second half, unevenly in time over the treatment duration.
12 . The dialysis machine in accordance with claim 1 , wherein the dialyzer is a medium cut-off dialyzer.
13 . The dialysis machine in accordance with claim 1 , wherein the control unit is configured to control the valves such that Configuration I is enabled.
14 . The dialysis machine in accordance with claim 1 , wherein the control unit is configured to control the valves such that Configuration II is enabled.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a dialysis machine having a dialyzer and having a first balancing chamber A and having a second balancing chamber B of which each has at least two first and second balancing chamber halves separated from one another by a movable wall, wherein each first balancing chamber half is provided with a respective first inflow and with a respective first outflow, wherein each second balancing chamber half is provided with a respective second inflow and with a respective second outflow, wherein the inflows and outflows are each provided with valves that are configured to close or to open the respective inflow or outflow, wherein the respective first inflow of the first balancing chamber halves is in fluid communication with a source of fresh dialyzate and the respective first outflow of the first balancing chamber halves is in fluid communication with a dialyzer inflow, and wherein the respective second inflow of the second balancing chamber halves is in fluid communication with a dialyzer outflow. 2. Description of Related Art Such a dialysis machine is known from the prior art and is shown by way of example in FIG. 2. FIG. 2 shows a dialysis machine in the state of “normal” hemodialysis without substituate conveying. As can be seen from FIG. 2, two balancing chambers A and B are provided of which each has a first balancing chamber half 100, 102 and a second balancing chamber half 200, 202. The balancing chamber halves are each separated from one another by a movable wall W. It furthermore results from FIG. 2 that each balancing chamber half 100, 200, 102, 202 has a respective first inflow Z1 and Z3 for fresh dialyzate that is supplied via the line 10 and a respective second inflow Z2 and Z4 for consumed dialyzate that is supplied from the dialyzer D via the line 20. The inflows Z1 and Z2 of the first balancing chamber A are closable by means of the valves 1.1 and 1.3; the outflows A1 and A2 of the first balancing chamber A are closable by means of the valves 1.2 and 1.4. The inflows Z3 and Z4 of the second balancing chamber B are closable by means of the valves 1.5 and 1.7 and the outflows A3 and A4 of the second balancing chamber B are closable by means of the valves 1.6 and 1.8. The lines in which consumed dialyzate is conveyed are shown dashed in the Figures. Lines in which fresh dialyzate is conveyed are shown by solid lines. The line 30 is in fluid communication with the outflows A1 and A3 and serves the conveying of fresh dialyzate to the dialyzer D or to its inflow DZ. The latter is divided by the membrane M into two or more than two chambers of which one is flowed through by dialyzate and the other is flowed through by blood B. The consumed dialyzate D including the ultrafiltrate moves on the outflow side DA of the dialyzer D into the secondary air separator S that has a valve V for leading off air. A portion of the consumed dialyzate is conveyed by means of the ultrafiltration pump UF by means of the line 60 from the secondary air separator S into the drain 1. The remaining portion of the consumed dialyzate moves in a cycled manner via the inflows Z2 and Z4 to the two second balancing chamber halves 200, 202 of the balancing chambers A and B. The line 40 is in fluid communication with the outflows A2 and A4 of the second balancing chamber halves 200, 202 and serves the conveying of consumed dialyzate to the drain 1. The balanced conveying of the dialyzate is configured as follows in accordance with FIG. 2: First, fresh dialyzate is conveyed via the line 10 into the first balancing chamber half 100 of the first balancing chamber A. The valve 1.1 is open and the valve 1.2 is closed for this purpose. Consumed dialyzate is simultaneously removed from the second balancing chamber half 200 of the first balancing chamber A via the line 40 into the drain 1 by the wall W moving to the right here. The valve 1.3 is closed and the valve 1.4 is open here. Exactly one balancing chamber volume is thus conveyed, for example 30 ml. The second balancing chamber B works in a counter-cycle, i.e. valve 1.5 is closed, valve 1.6 is open, valve 1.7 is open, and valve 1.8 is closed. Overall, consumed dialyzate is conveyed from the first balancing chamber A through the first balancing chamber A in this cycle and fresh dialyzate is conveyed out of the second balancing chamber B. Subsequently, a new cycle of the balancing chamber system takes place in which fresh dialyzate is conveyed from the first balancing chamber half 100 of the first balancing chamber A and consumed dialyzate is conveyed from the second balancing chamber half 202 of the second balancing chamber B. The above-described procedure is repeated in a constant sequence. It is always the same amount of fresh dialyzate and consumed dialyzate that is conveyed and exactly balanced. Due to the removal of fluid from the patient, ultrafiltrate is additionally produced on the side of the cons