Hemodiafiltration/hemofiltration cartridge

FIELD: clinical hematology.

SUBSTANCE: proposed cartridge is constructed in the form of single device allowing multistep hemofiltration and hemodiafiltration, wherein, disposed in the same cartridge, first hemodiafiltration step has first filter elements and second hemofiltration step has second filter elements. Cartridge can be used in a system with intermediate, preliminary or consecutive dilution.

EFFECT: increased degree of filtration and efficiency in removal of toxins.

26 cl, 3 dwg

 

Cross-reference to the application that are relevant to this application

The priority of this application is claimed in the prior application for U.S. patent No. 60/254741, filed December 11, 2000 and fully incorporated into the present description by reference.

The scope of the invention

The present invention relates to hemodiafiltration/hemofiltration devices and methods of filtering and in particular to an improved hemodiafiltration/hemofiltration cartridge and method of its application.

Background of the invention

Common at the present time the treatment of end-stage renal disease (TSPB) is essentially hemodialysis, in which the cleaned blood flows on one side of a semi-permeable membrane, and with her other hand runs a physiological solution (e.g., dialysate), which are in the blood toxins are transferred from one side of the membrane to the other. The main driving force behind this treatment is diffusion. This process is effective, as a rule, when removing toxins with low molecular weight, such as urea and creatinine. However, this process is much less effective in the removal of compounds with an average molecular weight of, for example substances, the molecular weight exceeds about 1 kDa, due to their neither is anyone diffusion coefficient.

To a much lesser extent as a method of treatment is applied hemofiltration. As with hemodialysis, in this case, the blood flows on one side of a semi-permeable membrane, but the other side of the stream dialysate missing. Instead, on either side of the membrane creates a pressure drop, so that part of the plasma water blood is filtered through the membrane. Together with plasma water from the blood by convection method removes toxins. In the blood prior to its introduction into hemofilter or after its introduction in it add sterile pyrogen free and no replacement fluid that replaces the plasma water is filtered through a semipermeable membrane during hemofiltration. This process compared with hemodialysis is generally less effective at removing toxins with low molecular weight, but more effective in the removal of compounds with an average molecular weight.

The HDF is a combination of dialysis and hemofiltration. Dialysis fluid flows on the other side of the semi-permeable membrane, resulting in the diffusion of toxins. Simultaneously supported by the differential pressure on either side of the membrane, which provides a high degree of filtration. As in hemofiltration, blood prior to its introduction in hemodiafiltration cartridge or after its introduction in the not-what about the add sterile pyrogen free and no replacement fluid. As a result of this combination HDF is effective at removing small molecules such as creatinine and urea, by diffusion, as well as the removal of a large number of substances with an average molecular mass by convection.

The design currently available hemodiafiltration filters essentially equivalent design dialyzers with high throughput. These filters consist of a bundle of hollow fibers located in the cylindrical housing. During system operation hemodiafiltration replacement fluid is injected into the blood before dialysator high-bandwidth (pre-dilution) or after it (further dilution).

Diafiltration devices that use the scheme with the prior or subsequent dilution, have their inherent limitations on effectiveness. Schemes with pre-dilution provide a relatively unrestricted filtering, however, because the blood is diluted before it enters the filter, the total mass transfer of dissolved substances with small molecular mass by diffusion decreases. Circuit with subsequent dilution have an advantage in maintaining a high concentration of toxins in the blood, resulting in are more effective on fuse and convection of dissolved substances, however, higher concentration of blood cells and the resulting increased viscosity of the blood during filtration creates a limit on the amount of plasma water that can be filtered. Even existing multistage dual filter dialysis system described in U.S. patent No. 5194157, due to its construction is such restrictions on the filter.

The invention

The aim of the present invention is to provide hemodiafiltration/hemofiltration cartridge, providing a higher degree of filtration and a higher efficiency of removal of toxins than in the present hemodiafiltration devices. The proposed cartridge reduces and/or eliminates the above disadvantages inherent in the known hemodiafiltration devices by creating a schema in which the blood is diluted after partial and not full of diafiltration. The present invention combines the advantages of systems with pre-dilution, such as a large degree of filtration, and the advantages of systems with further dilution, such as high diffusion and convection efficiency. The cartridge corresponding to one variant of implementation, can be adapted for use in combination with conventional devices for diability the AI, including, in particular, the apparatus Fresenius 4008 On-Line Plus and Gambro AK 200 Ultra. The cartridge can be used with conventional devices for hemodialysis, including in particular the apparatus Fresenius 2008H, Baxter SPS 1550, Kobe Centry System 3, and so forth, using a sterile replacement fluid supplied from an external source, such as a flexible packages containing normal saline or salt of lactic acid ringer, or Central feed system, described in the Centralized on-line hemodiafiltration system utilizing purified dialysate as substitution fluid, Sato & Coga, Artif Org 22:285, 1998. In addition, the standard device can be modified to create a source of replacement fluid, such as a pump or valve, which separates dialysate from the tee that is installed on the main line of dialysate, and passes through sterilizing filters, as described, for example, Influence of convection on small molecule clearances in on-line hemodiafiltration, Ficheux, et al., Kid Int. 57:1755, 2000.

Hemodiafiltration/hemofiltration cartridge corresponding to one exemplary variant execution has inlet and outlet connections for the blood and Vasishta. The cartridge contains a separate case, for example cylindrical, which is an internal dividing wall separating the housing into first and second branches, the first of which is connected with the first stage filter, and the second with the second stage Phi is Tracie. The first stage filter is communicated with the inlet for blood, and the second stage filter with the release to the blood. Therefore, hemodiafiltration/hemofiltration cartridge provides diafiltration and hemofiltration in a separate building by placing in the first part of the first filter elements (the first bundle of hollow fibers), and in the second branch of the second filter elements (second bundle of hollow fibers). Thus, the proposed cartridge by its appearance similar to conventional dialysator except that the nozzles for dialysate are located on opposite sides of the cartridge. Inlet and outlet connections for the blood is preferably located at the first end of the cartridge or near it. The intake and release of blood can be performed in two separate covers or in the form of one lid, separated by an internal wall or seal, which (who) divides these filter elements, the first and second on the first stage of hemodiafiltration and the second stage of hemofiltration.

In accordance with one exemplary option perform blood enters the inlet for the blood present in the cartridge and flows through the first filter elements located in the first part (first stage), the interstage connector, located on the opposite, the second t is RA cartridge. This connector provides the blood flow of the first filter elements in the second filtering elements and then release to the blood present in the cartridge. The issue for dialysate preferably also located on the first end of the cartridge or in the vicinity of and communicated with the second compartment. Dialysate enters through the inlet pipe for dialysate in the first compartment and flows countercurrent to the blood flow through the filtering elements of the first stage. Dialysate as it exits through the exhaust pipe for dialysate available through the restrictive hole in the dividing wall between the first and second branches.

Under this option the first step, therefore, is the degree of hemodiafiltration, and the second step is a step of hemofiltration, and both of these steps are in one cartridge. In another embodiment, the first stage is also the stage of hemodiafiltration, and the second step is a step of hemofiltration, however, the cartridge is either in the system with pre-dilution, either in the system with subsequent dilution in the system with pre-dilution replacement fluid replacement fluid) is added to the blood to dilute the latter before it is subjected to hamodia is istratii in the first stage, and in the system with subsequent dilution of the liquid added to the blood after she was subjected hemofiltration in the second stage.

Other properties and advantages of the present invention will become apparent from the subsequent detailed description in conjunction with the attached drawings.

Brief description of drawings

Figure 1 depicts the cross-section hemodiafiltration/hemofiltration cartridge with an intermediate dilution in accordance with the first variant of execution.

Figure 2 depicts the cross-section hemodiafiltration/hemofiltration cartridge with an intermediate dilution in accordance with a second embodiment of the execution.

Figure 3 depicts a cross-section hemodiafiltration/hemofiltration cartridge prior or subsequent dilution in accordance with the third variant of execution.

A detailed description of the preferred embodiments

1 schematically shows a cross-section hemodiafiltration/hemofiltration cartridge 10 with an intermediate dilution in accordance with one exemplary variant execution. The cartridge 10 includes a housing 12, limiting the first stage 13 and the second stage 14, as described in more detail below. The body 12, preferably made of hard plastic, is divided inside the second wall 15 of the first 17 and second 19 internal branches. Preferably, the wall 15 is made of the same hard plastic that is used for the manufacture of the housing 12, and can be made with him for one whole (e.g., formed as part of the molded). As described in more detail below, the first branch 17 in General corresponds to the first stage 13 and the second part 19 - the second stage 14.

In the housing 12 are longitudinal bundles of semipermeable hollow fibers, is divided into first and second longitudinal beams 16, 18. More specifically, the first longitudinal beam 16 semi-permeable hollow fibers is in the first part 17 and the second longitudinal beam 18 semi-permeable hollow fibers located in the second compartment 19. Fibers 16, 18 serve as means for the transmission of toxins, filter out of the blood. It is possible to use fibers 16, 18 of any type of those that are designed for these purposes and are available on the market. Fiber 16 may be called arterial fibers, and the fibers 18 - venous fibers.

In one exemplary embodiment, the cartridge 10 is designed to work in conjunction with installation for hemodiafiltration, for example with devices Fresenius 4008 On-Line Plus or Gambro AK 200 Ultra, or with a modified unit for hemodialysis, for example with devices Fresenius 2008H, Kobe Centry System 3 or Baxter SPS 1550.

During operation, blood is transferred from the patient using a pump is for pumping blood and blood lines (not shown), enters the first stage 13 of the cartridge 10 through the inlet pipe 20, preferably made in one piece with the reservoir cover 22 mounted on the first end 21 of the cartridge 10. Cover 22 limits the internal manifold cavity 24, which is actually divided into a first inner manifold cavity 25 and the second inner manifold cavity 26. The first cavity 25 may be referred to as a cavity for arterial blood, and the second cavity 26 - cavity for venous blood. As explained in more detail hereinafter, the first and second cavities 25, 26 are connected respectively with the first and second stages 13, 14 (first and second compartments 17, 19).

Both cavities 25, 26 can be separated from the rest of the cartridge 10, the first sealing compound 30, forming a seal around the outer surfaces of the fibers 16, 18 at the first end 21 of the housing 12. Cover 22 may be made removable, and in this case, the cavities 25, 26 are preferably isolated from the external environment and from each other sealing elements such as sealing rings 31, 32. As shown in the drawing, the ring 32 is connected with the first unit 17, and the ring 31 to the second compartment 19.

Blood enters through the pipe 20 into the first cavity 25 and then into the fibers 16 on the surface of section 34, which preferably includes a surface section that is formed GE is meticilous compound (for example, the polyurethane). The first cavity 25 can be separated from the second cavity 26 in several ways. For example, as shown in figure 1, the first cavity 25 can be separated from the second cavity 26 of the inner wall 35, which divides the cavity 24 of the first and second cavities 25, 26. Preferably, the wall 35 is made in one piece with the cover 22 and creates the seal rings 31, 32, effectively preventing the transmission of blood between the two collector cavities (cavities 25, 26). In the form shown in the drawing embodiment, the rings 31, 32 are located at the distal end 37 of the wall 35 opposite the proximal end 39, which is attached to the lid 22 or away from it. The rings 31, 32 act as a seal when the cover 22 is connected with the surface 34.

Fiber 16 located in the first compartment 17 (in the first stage 13), are communicated with the first cavity 25, and fiber 18 located in the second part 19 (the second stage 14), are communicated with the second cavity 26. Two beams 16, 18 fibers separated by an internal wall 15, the ends of which are sealed at the surface 34 in sealing beam fibers.

Blood after entering the first cavity 25 through the pipe 20 moves down inside the arterial fibers 16 of the first bundle of fibers along the filter cavity of the first compartment 17 of the first stage 13, with the outer side of the arterial volokna immersed in the flow of dialysis liquid, flowing through the first inner compartment 17. The pressure of the dialysis liquid in the compartment 17 is less than the pressure of blood flowing through the interior of the arterial fibers 16, so that in the first stage 13 through a semipermeable membrane (fiber 16) is the direct filtration of plasma water from where the blood flows, on the side, where there is an dialysate. The result is the first stage of hemodiafiltration toxins, namely filtering and diffusion, which take place in the Department of 17 along the entire length of the arterial fibers 16. In accordance with one variant perform a substantial part of the plasma water, for example, approximately 20-60%, preferably filtered through a semipermeable membrane during the passage of blood through the first stage 13. Blood, last partial HDF and out of the fiber 16 enters the interstage connector (manifold cavity) 46 associated (linked) with the other end 23 of the cartridge 10. Used in this application, the term "last partial HDF" refers to blood that has been hemodiafiltration, in which some of the toxins contained in the blood were removed.

The blood flowing in the interstage manifold cavity 46, is hemoconcentration condition compared to blood, topusa into the cartridge 10 through the inlet 20, that is, the hematocrit of blood flowing into the cavity 46, above the hematocrit of blood flowing through the inlet 20. The branch 17 of the first stage 13 and the branch 19 of the second stage 14 is preferably separated from the cavity 46, for example, the second sealing resin 49. Thus, compound 49 forms the second surface 61 of the partition.

The cavity 46, serving as a transition stage for the blood coming from the first stage 13 and coming into the second stage 14, is limited to the second reservoir cover 52, preferably made of hard plastic and attached to the second end 23 of the housing 12. The cavity 46 can be isolated from the environment third sealing ring 53. As shown in figure 1, the ring 53 is located between the compound 49 and the cover 52 with the creation of a seal between them. In one embodiment, the first and second cover 22, 52 are removable, that is, each of them can be easily attached to the housing 12 and charged with him. For example, the housing 12 and the cover 22, 52 may include complementary threads for a threaded connection of these elements with each other.

The blood prior to entering the second stage 14, which is in the interstage cavity 46, diluted with sterile physiological solution, which enters the cartridge 10 through the collector inlet pipe 51. Sterile races the thief can be produced continuously in online mode or fed from tanks, for example, packets with a saline solution that is known from the prior art. The blood in the cavity 46 is gamerzplanet compared to blood flowing into the cartridge 10 through the inlet 20, i.e., the hematocrit of the blood in the cavity is reduced in comparison with the hematocrit of blood flowing through the inlet 20.

Memorabilia blood then enters the fiber 18 located in the second stage 14, and then transferred these fibers to the first end 21 of the cartridge 10. Pressure gamerzplanet of blood flowing through the venous fiber 18, above the pressure of the fluid placed in the second compartment 19 from the outside of the fibers 18, so that the second stage 14 through a semipermeable membrane (venous fibers 18) is the direct filtration of plasma water from where the blood flows, on the side, where there is an dialysate. The volume of plasma water of the blood, filtered out gamerzplanet blood when it flows through the second stage filter, such that the rate of hemocrit blood coming out of the cartridge 10 through the release 55, essentially equal to the hematocrit of blood flowing through the inlet 20, except for some small differences that may be necessary as a means of regulation of the end ultrafiltration to maintain fluid balance of the patient. Plasma water is filtered in the second stage 14, flows in the direction of issue 58 for dialysate and is discharged from the cartridge 10 along with the used dialysate arising from the first stage 13 through the restrictive orifice 60. Thus, the HDF occurs along the length of the fibers 18 and until the blood would not come out in the second cavity 26 (venous cavity) of the first cover 22 and from this cavity through the outlet 55, made in the cover 22. Therefore, the nozzle 55 can be called venous connection, and it can be executed similarly to the pipe 20, for example in the form of a standard connector with fixing by tightening. It should be noted that the venous pipe 55 may be made in the form of a connector of another type.

Outwardly, this process flow dialysate and connections look the same as in the standard process of dialysis. However, the internal flow dialysate actually serves to regulate the relative degree of filtration between the two stages. Dialysate enters the cartridge 10 through the inlet pipe 57 for dialysate, for example through a standard connector Hansen, known in the art. Dialysis liquid in the present invention fills the first compartment 17, flows through it, flowing around the outside of the fibers 16 of the first stage, and out of the cartridge 10 through the outlet 58 for dialysate, the positioning on the opposite side wall 15 near the first sealing compound 30 of the second stage 14. Preferably the nozzles 57 and 58 are nozzles of the same type, such as connectors Hansen.

In one embodiment, the present invention dialysis liquid flows countercurrent to the blood flowing in the first stage 13. This fluid as it approaches the first end 21 of the cartridge 10 is manufactured through a slit or hole 60 in the dividing wall 15. Thus, the hole 60 creates a flow communication between the first 17 and second 19 internal departments (the first 13 and second 14 steps). The size of the hole 60 may vary depending on the particular application, as well as other parameters. Dialysate then is released through the exhaust pipe 58 for dialysate associated with the second stage 14. Preferably, the hole 60 is located in the vicinity of the pipe 58, so that the flow of dialysate in the second stage 14 (hemofiltration) is minimal, providing the desired effect. More specifically, the hole 60 in General, preferably located on the same axis with the pipe 58, so that the dialysis fluid simply flows through the second branch 19 to the pipe 58, through which it exits the cartridge.

Filtration of blood in dialysate occurs through a semi-permeable walls of the fibers 16, 18. The total degree of filtering is a function of the flowing stream dialysate and the incoming stream of replacement of liquids and, and preferably substantially exceeds the level that can be achieved with conventional hemodiafiltration with further dilution. In accordance with one variant of the General degree of filtration is preferably about 25-85%, more preferably 40-60% of the flow of blood. These flows may be regulated by pumps that are part of a typical installation for hemodiafiltration (not shown).

The relative degree of filtering in the first 13 and second 14 levels can be adjusted using the relative balance of transmembrane pressure (TMW) between departments for blood and offices for the filtrate. The pressure on the side of the blood is a function of blood flow and blood viscosity in each Department for blood (which is a function of the value of hemoconcentration and memorabalia in each Department for the blood). Since blood flows sequentially from the first stage 13 in the second stage 14, the blood pressure in the first stage 13 higher blood pressure during the second stage 14. In conventional dialysis unit the pressure in the compartment dialysate is regulated by the pump, located behind the release for dialysate. In this embodiment, the pressure in the compartment 19 from the outside of venous fibers 18 of the second stage 14 is regulated in the same way. The pressure in the compartment 17 (first part) outside blood in the lock 16 of the first stage 13 is, primarily, the function of the pressure release 58 for dialysis fluid, flow of dialysis fluid through the hole 60, the viscosity of the liquid and the size of the holes 60 located between the two stages. In a first approximation, the pressure of the dialysis liquid in the first compartment 17 above the pressure of the dialysis liquid in the second compartment 19 by an amount equal pressure drop in the hole 60, the connecting branch of the cartridge.

The blood in the first stage 13 is hemoconcentration, but is under high pressure, while the blood in the second stage 14 is gamerzplanet and is under low pressure. To maximize the total filtration in both stages 13, 14 it is necessary that the pressure in the compartment 17 in the first stage 13 has exceeded the pressure in the compartment 19 in the second stage 14. This is achieved by proper choice of dimensions of the orifice 60. Pressure dialysate drops when the flow through the hole 60 of the first compartment 17 into the second compartment 19. Thus, the pressure dialysate in the first part 17 exceeds the pressure in the second compartment 19. At a given flow range of dialysate, which typically is approximately 500-1000 ml/min, the hole 60 may be dimensioned in such a way, which creates a pressure differential that provides the necessary relative degree of filtration between on uma steps 13, 14. For example, it may be necessary to maximize the overall degree of filtering both stages 13, 14. To implement this in each stage maintain a relatively high transmembrane pressure. Because the blood pressure in the first stage 13 exceeds the pressure of blood in the second stage 14 by a certain amount, dependent on the flow of blood, the size of the hole 60 should be such that the pressure drop in the hole 60 at a given flow rate dialysate was called transmembrane pressure in the filtering stages.

Reuse of the cartridge 10 is similar to the re-use of conventional dialyzers that the nozzles 20, 55, 57, 58 attached to the installation of reuse. During reuse inlet 51 for the replacement fluid is closed.

To illustrate by arrows 62 illustrates the flow of blood inside the cartridge 10 in accordance with one variant of execution.

It should be noted that the housing 12 and the cover 22, 52 can be made in one piece as a single item (casing), and this casing will be made of the inlet 20, issue 55, the inlet 57 and issue 58, and the inter-stage connecting portion, limiting the interstage cavity 46. The use of the term "end cover" is not limiting, and represents only an example of the nogo option run in which the end cap is attached to the casing, forming a cartridge 10. The term "housing" may be used for the name of the whole structure, which includes the housing 12 and the end caps 22, 52 and which can be either team or made in one piece.

Refer now to figure 2, which schematically shows a cross-section of a second variant implementation hemodiafiltration/hemofiltration cartridge, generally designated by the number 70 positions. The design of this variant is similar to the first variant of execution, except for the main difference consisting in the separation of the inlet and outlet for the blood to separate the first and second reservoirs 76, 77 unlike shown in figure 1 one manifold having a dividing wall. In this embodiment, the first manifold 76 may be called the intake manifold 76 to the blood, and the second collector 77 may be called the exhaust manifold 77 for blood.

The cartridge 70 includes a housing 72 having an internal partition wall 75, passing through the entire length of the housing 72. On the end face side of the inlet and outlet of the blood (the first end 21) or in the vicinity of the end wall 75 is divided into two separate walls with fasteners to the first and second reservoirs 76, 77. In other words, the wall 75 has a holding means, which provide attachment is their wall 75 to the first and second reservoirs 76, 77. The advantage of the second variant implementation is that the reservoir 76, 77 can be easily attached and removed in the manufacture of the device and for its reuse. The cartridge 70 is similar or essentially the same as the cartridge 10 which corresponds to the first variant of execution.

Obviously, in another embodiment, the flow dialysate can be directed in the direction of flow in the fibers 16 of the first stage 13, but in the preferred embodiment, where dialysate flows countercurrent to the fibers 16 of the first stage 13, the removal of toxins occurs more efficiently. The flow in the first stage 13 supports a maximum gradient of concentration of uremic toxins, providing a high diffusion purification of dissolved substances with low molecular weight. The concentration of these substances at the entrance to the second stage 14 is relatively low, and any increase purification by diffusion is likely to be minimal. However, after partial diafiltration concentration of dissolved substances with an average molecular mass is still quite high. As the increased destruction of substances with low and medium molecular weight is carried out mainly by convection, there is no need to stream dialysate in the second stage 14. His absence has on the Yan small impact on the overall efficiency of removal of toxins. The second stage 14, acting as hemofilter, also has the advantage of being able to control the relative degree of filtering the first and second stages 13, 14 through the holes 60 located between the compartments 17, 19 two steps 13, 14 near release 58.

Figure 3 shows another exemplary embodiment of in which the cartridge 10' has a construction substantially similar to the design of the cartridge 10 shown in figure 1, except that the cartridge 10' is not hemodiafiltration/hemofiltration cartridge with an intermediate dilution, and is intended for use in a system with pre-dilution or further dilution. For clarity and ease of illustration, the elements of figure 3, the same elements shown in figure 1 are denoted by the same numbers of positions. In a system with pre-dilution, the diluted blood replacement fluid or the like before entering the diluted blood at the inlet 20. Then the diluted blood in the first stage 13 is exposed hemodiafiltration before entering into the cavity 46 after passing through the partial diafiltration. Due to the pressure difference between the first and second stages 13, 14 blood, last partial diafiltration, comes the second stage 14, where it is then subjected hemofiltration about when is canii second filter elements 18 before the final release through the release of 55. Characteristics of blood is released through the release of 55 in the system with pre-dilution, preferably the same as the characteristics of the blood, produced through the release of 55 in the system with an intermediate dilution shown in figures 1 and 2.

As noted above, the cartridge 10', shown in figure 3, can also be used in the system with subsequent dilution. In systems of this type, the blood enters through the inlet 20, is subjected in a first stage 13 of hemodiafiltration, flows into the cavity 46 and through it after passing the partial diafiltration, then enters the second stage 14, where blood, last partial diafiltration subjected to hemofiltration. Blood after hemofiltration in the second stage 14 is released through the release of 55. Produced blood diluted (for example, the replacement fluid is mixed with the produced blood) and thus returns to the desired state before it will be re-introduced into the patient's body.

Specialist in the art it is obvious that the present invention is not limited to the implementation described above with reference to the attached drawings. On the contrary, it is limited only by the attached claims.

1. Hemodiafiltration/hemofiltration cartridge with intermediate dilution contains:

a housing having a first the first end and the opposite second end and is connected with the inlet for blood, release for blood and inlet and outlet for dialysate,

the first stage of hemodiafiltration, including a first filter element located between the first and second ends of the housing of the cartridge and the inlet for the blood is connected with the first filter element at the first end with the provision of blood flow through the filter element toward the second end,

the second step hemofiltration comprising a second filter element located between the first and second ends of the housing of the cartridge, and the release of blood is communicated with the second filter element, and

the interstage connector located at the second end of the body of the cartridge and limiting the interstage manifold cavity, ensuring the flow of blood issued from the first stage of hemodiafiltration, through the second filter element to release for blood, and having an inlet pipe for the replacement of fluids intended for receiving solution for diluting the blood before entering the second filter element second stage

moreover, the indicated cartridge is made with the possibility of receiving dialysis fluid from the specified inlet for dialysate and flow through the first stage of hemodiafiltration and then escaping through the exhaust dialysate.

2. Hemodiafiltration the th/hemofiltration cartridge according to claim 1, optionally containing a dividing wall located in the housing and separating the first compartment associated with the specified first step, and the second part associated with the specified second stage.

3. Hemodiafiltration/hemofiltration cartridge according to claim 1, in which each of these filter elements, the first and the second contains a semi-permeable hollow fibers with high throughput.

4. Hemodiafiltration/hemofiltration cartridge according to claim 2 which includes the first and second filter elements are separated by a dividing wall along their entire length.

5. Hemodiafiltration/hemofiltration cartridge according to claim 2, in which the dividing wall has an opening to pass dialysate from the first compartment through the second half before exiting through the exhaust dialysate.

6. Hemodiafiltration/hemofiltration cartridge according to claim 5, in which the indicated hole is located essentially on the same axis with the release of dialysate.

7. Hemodiafiltration/hemofiltration cartridge according to claim 1, in which the first end of the housing is closed first manifold cover, in which the inlet and release to the blood.

8. Hemodiafiltration/hemofiltration cartridge according to claim 7, in which the first manifold cover has an internal degree the new element to separate the inner manifold cavity to the first manifold cavity and a second collector cavity.

9. Hemodiafiltration/hemofiltration cartridge of claim 8, in which the first manifold cavity provides the blood flow in the first filtering elements of the first stage only from the specified inlet pipe for blood, and the second manifold cavity provides the blood flow in the outlet for blood only from the second filter elements.

10. Hemodiafiltration/hemofiltration cartridge of claim 8, in which due to internal stenosoma element that prevents blood flow into the second manifold cavity, excluded from entering the second filter elements of blood flowing in the first manifold cavity through the inlet for blood.

11. Hemodiafiltration/hemofiltration cartridge according to claim 2, in which the first end of the housing is closed first manifold cover, which has an inner wall member that restricts the first manifold cavity and a second manifold cavity and aligned with the dividing wall.

12. Hemodiafiltration/hemofiltration cartridge according to claim 11, in which the inner wall element made in one piece with the first reservoir lid and contains two o-rings to create a seal between the said cover and the body of the cartridge in the place of fastening the junction of these elements.

13. Hemodiafiltration/hemo is intravalley cartridge according to claim 1, in which the first end of the housing is closed first and second reservoir covers, the first cover includes an inlet for blood and restricts the first manifold cavity chamber connected only with the first filter element and the second cover includes a release for blood and restricts the second manifold cavity chamber connected only with the second filter element.

14. Hemodiafiltration/hemofiltration cartridge according to claim 5, in which the dimensions of said hole has such a value that dialysate in the first compartment is below the first pressure and the second part he is under a second pressure exceeding the first specified pressure.

15. Hemodiafiltration/hemofiltration cartridge with an intermediate dilution containing casing, in the first stage of the HDF, and the second stage is hemofiltration, the first stage of hemodiafiltration has the first filter element, and the second step hemofiltration has a second filter element, and both stages are located in the same casing, including the interstage portion in which the inlet for the replacement of fluids intended for receipt of a solution for diluting the blood produced from the first stage of hemodiafiltration, before entering the blood in the second filtering the th element of the second stage hemofiltration, the casing includes an inlet for blood which is connected with the first step, the release of blood which is connected with the second stage, and the suction and discharge for the dialysis liquid.

16. Hemodiafiltration/hemofiltration the cartridge 15 in which the inlet for dialysate communicates with the first step, and release for dialysate is communicated with the second stage, while the casing has a partition wall, separating the specified first and second stages, and the specified cartridge is made with the possibility of a leakage of dialysis fluid from the first stage to the second through hole made in the dividing wall.

17. Hemodiafiltration/hemofiltration cartridge according to clause 16, in which the blood through the first filter element flows under the first hydrostatic pressure, and through the second filter element under the second hydrostatic pressure, which is less than the first specified pressure, and the pressure in the first compartment, limiting the first step exceeds the pressure in the second compartment, limiting second step.

18. Hemodiafiltration/hemofiltration the cartridge 17, in which the dimensions of said hole has such a value that the pressure in the first compartment exceeds the pressure in the second compartment.

19. Hemodiafiltration/hemofiltration cartridge containing:

to bus, having a first end and an opposite second end and is connected with the inlet for the blood, the release of blood and inlet and outlet for dialysate,

the first stage of hemodiafiltration, including a first filter element located between the first and second ends of the housing of the cartridge and the inlet for the blood is connected with the first filter element at the first end with the provision of blood flow through the filter element toward the second end,

the second step hemofiltration comprising a second filter element located between the first and second ends of the housing of the cartridge, and the release of blood is communicated with the second filter element, and

the interstage connector located at the second end of the body of the cartridge and limiting the interstage manifold cavity, ensuring the flow of blood issued from this first stage of hemodiafiltration, through the second filter element to release to the blood,

moreover, the indicated cartridge is made with the possibility of receiving dialysis fluid into the body of the cartridge through the inlet dialysate and flow through the first stage of hemodiafiltration and then escaping through the exhaust dialysate.

20. Hemodiafiltration/hemofiltration cartridge according to claim 19, additionally containing the separator is s wall located in the housing and separating the first compartment associated with the specified first step hemodiafiltration, and the second part associated with the specified second hemofiltration stage, and the dividing wall has a hole, is arranged to flow through him dialysis fluid from the first stage of hemodiafiltration second hemofiltration stage.

21. Hemodiafiltration/hemofiltration cartridge according to claim 19, in which the specified suction and discharge for blood is made in the first manifold cover, located on the first end of the body, and the interstage connector is limited to the second reservoir cap located on the second end of the body, and the first manifold cover is made to ensure communication of the inlet for the blood only the first step hemodiafiltration and messages release for blood only with the second hemofiltration stage.

22. Hemodiafiltration/hemofiltration cartridge according to claim 20, in which the indicated hole on the merits is located on the same axis with the release of dialysate to limit the area of the second branch, is arranged to flow through it of dialysis liquid.

23. How hemodiafiltration/hemofiltration in one cartridge, including:

the incoming flow of blood,

diafiltration the decree is sent to the steering flow in the first stage with obtaining leaky blood flow, last partial diafiltration and having a first concentration of toxins

mixing the specified discharge flow of blood replacement fluid in the interstage part with the formation of a mixture of blood and replacement fluid,

hemofiltration of this mixture in the second stage of obtaining blood having a second concentration of toxins which is less than the first specified concentration, and diafiltrate and hemofiltration happen in one cartridge, and

passing a dialysis fluid through the inlet to dialysate in the first stage, and a dialysis fluid flows in a first stage before passing through the restrictive orifice and through a separate zone of the second stage to release for dialysate.

24. The method according to item 23, which further divide the specified cartridge with a separating wall on the first and second stages, the first of which includes the first filter element, and the second includes the second filter element, and by passing a dialysis fluid from the first stage through the second step includes passing the liquid through a hole made in the dividing wall.

25. The method according to paragraph 24, in which hole do such size that the area around the first filter elements has a first pressure, and in the area around the second filtrowa the elements has a second pressure, which is less than the first pressure.

26. How hemodiafiltration/hemofiltration in one cartridge, including:

the incoming flow of blood,

diafiltration the specified stream in the first stage, ensuring stemming the flow of blood, last partial diafiltration and having a first concentration of toxins

hemofiltration specified blood, last partial diafiltration, in the second stage of obtaining blood, held the HDF/hemofiltration and having a second concentration of toxins, which is the smaller of the specified first concentration, and diafiltrate and hemofiltration happen in one cartridge, and

passing a dialysis fluid through the inlet to dialysate in the first stage, and a dialysis fluid flows in a first stage before passing through the restrictive orifice and through a separate zone of the second stage to release for dialysate.



 

Same patents:

FIELD: medicine.

SUBSTANCE: device can be used for removing of leucocytes from donor's blood or from its components, namely, erythrocyte-mass and plasma. Device has filter and connecting tubes. There are protrusions on case and cap of device to place inlet and outlet openings for fluid. Protrusions are provided with connecting members. Connecting tubes are connected to inlet and outlet openings for fluid by means of two-step bushing. Two cylinders of different sizes are made outside bushing. Cylinder with bigger diameter is connected with connecting member, disposed inside openings of protrusions of case and cap. Cylinder of smaller diameter is connected with connecting tubes, which has internal diameter to be smaller than internal diameter of bushing. Glue is not used for fastening.

EFFECT: reliable fastening of tubes to filter; reduced cost of device.

4 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: device can be used for removing of leucocytes from donor's blood or from its components, namely, erythrocyte-mass and plasma. Device has filter with filtering material disposed between cap and case. Connecting members are disposed inside protrusions to place inlet and outlet openings for fluid. Case and cap are provided with flanges along their contours. Flanges are connected along their total length by sealing item in form of channel. Projections of protrusions onto plane, which is parallel to surfaces of case and cap, belong to clearance limits of case and cap. Filter and filtering material are sealed without usage of glue and welding.

EFFECT: reduced cost due to usage of low-cost materials; improved productivity at mounting of filter.

2 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: device can be used for removing of leucocytes from donor's blood or from its components, namely, erythrocyte-mass and plasma. Device has filter with filtering materials disposed between cap and case. Recess is made in bottom of cap along its contour, which recess is formed by wall and sealing protrusion. Technological protrusion is made in case of filter along its contour; protrusion has internal sealing site. Technological protrusion of case is disposed in recess of cap and filtering material is pressed between sealing protrusion of cap and sealing site of case. Filtering material is sealed due to pressurization along contour which does not result in change of characteristics of filtering material.

EFFECT: reliable sealing of filtering material.

4 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out leukocytic plasmapheresis with at least 100 ml patient blood in two-stage sequential centrifuging at 800 rpm during 10 min and 2000 rpm during 10 min. Antimicrobial preparation is added to autoleukocytes. The autoleukocytes are irradiated with helium-neon laser with 2.2 mW power, wavelength of 0.63 mcm and exposure time of 10 min. The autoleukocytes with the antimicrobial preparation adsorbed thereon are intravenously introduced introduced to the patient every day once a day during 7 days.

EFFECT: enhanced effectiveness of treatment; retained antimicrobial properties with increased adsorption on leukocytes.

FIELD: medical engineering.

SUBSTANCE: device has connection unit, connection tubes and filter having inlet opening connected to the connection unit, and outlet opening connected to container for collecting filtered blood product, in its casing, an opening for liquid and an opening for gas to pass. The opening for gas to pass is connected to the connection unit and one of containers for collecting filtered blood product allowing the connection tubes to be closed. The opening for liquid to pass is connected to two containers for collecting filtered blood product, allowing the connection tubes to be closed. It is also connected, via a cavity available in one of the containers, to the connection unit and inlet opening for liquid to pass.

EFFECT: reduced blood component losses.

2 cl, 1 dwg

FIELD: medicine, gynecology.

SUBSTANCE: in women with herpes viral infection before pregnancy one should successively perform 7 procedures of endovascular laser blood irradiation at 1 mW power, 0.63 mcm wave length and exposure time being 15 min. Then, starting since the 5th -6th d of the next menstrual cycle one should fulfill 3 seances of curative plasmapheresis along removing about 30-50% volume of circulating plasma and plasma substitution with physiological solution at the ratio of 1:1.2-1.5, and then - 2 seances of intravenous injection of immunoglobulin at the dosage of 50 mg/kg. At the onset of pregnancy - in trimesters I, II and III it is necessary to carry out per 3 seances of uninterrupted plasmapheresis along removing about 30-50% volume of circulating plasma and plasma substitution with physiological solution at the ratio being 1:1.2-1.5, and, also, 2 seances of intravenous injection of immunoglobulin at the dosage of 50 mg/kg. The innovation provides activation of inspecific reactions of anti-infectious immunity and preventing the relapse of viral infection during the pregnancy.

EFFECT: higher efficiency.

3 ex

FIELD: medicine, nephrology.

SUBSTANCE: invention proposes a method for treatment of patients with chronic renal insufficiency and receiving treatment by renal dialysis or hemodiafiltration. Increase concentration of blood homocysteine in such patients causes the severe disturbances in vessels function and represents risk factor for vascular diseases. Method involves prescription of dithiothreitol or 2,3-dimercaptopropane sodium sulfonate (unithiol) before or during hemodialysis or hemofiltration. Method provides reducing blood level of homocysteine in patients in case of its increased content (in these patients the concentration of low- and mean-molecular metabolic products is increased sharply due to damage or complete ceasing formation of urine) to practically normal values that is based on release of homocysteine from its bound form with proteins.

EFFECT: improved treatment method of patients.

1 tbl, 5 ex

FIELD: medicine, in particular provision and treatment of donor blood.

SUBSTANCE: claimed method includes whole blood centrifugation, component separation, filtration of erythrocyte mass and plasma, and storage under sterile conditions, wherein leuko-platelet layer id separated. Firstly plasma is filtered, part of plasma is kept in filter, and erythrocyte mass is filtered through plasma-containing filter. Residual plasma is removed before erythrocytes begin to pass though filter, followed by blending with filtered plasma.

EFFECT: economy method for separation and storage of leuko-platelet layer; decreased losses of blood components.

1 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: before onset of treatment or in the process of treatment patient is administrated 2,3-dimercaptopropane sodium sulfonate in the dose 50-500 mg by subcutaneous or intramuscular route depending on the patient mass and the expression degree of hyperhomocysteinemia. Method provides normalization of blood level homocysteine due to its elimination from body as reduced homocysteine after its complete release from blood protein-bound form and with retention of these proteins in circulation. Invention can be used in treatment of patients with renal insufficiency with the enhanced blood content of homocysteine who have increased concentration of low- and mean-molecular metabolites due to disturbance in urine formation and when carrying out heme-dialysis or heme-filtration is required.

EFFECT: improved treatment method.

5 ex

FIELD: medical engineering.

SUBSTANCE: device has sealed reservoir for magnetically controlled binder, chamber for mixing the magnetically controlled binder with biological fluid and settling the magnetically controlled binder from this fluid and filtering device, chambers for mixing and settling the magnetically controlled binder and reservoir containing the magnetically controlled binder of variable volume, connected to valves mounted thereon by means of hoses. The filtering device is connected to outlet nipple via system inlet duct. The nipple is connected to system inlet duct. The chambers for mixing and settling the magnetically controlled binder are reservoirs having common bottom and cover and have drive. The chambers have common wall attached to the bottom as partition between chambers. The reservoirs are connected to each other via duct in the partition having a valve. The other lateral walls have corrugations forming bellows. Chamber cover rotatable about the hinge axis is pivotally fixed on the common wall. The reservoir for containing the magnetically controlled binder is mounted in the chamber for mixing the magnetically controlled binder with biological fluid and is cylindrical. The cylinder has one part manufactured as bellows and is fixed on the bottom with one of its ends and the cover attached to cover of the chamber for mixing the magnetically controlled binder with biological fluid is mounted on the other end. Magnets are mounted on the bottom area to which the chamber for settling the magnetically controlled binder is attached. The inlet system nipple is at the same time connected to internal cavities for mixing the magnetically controlled binder and the reservoir containing the magnetically controlled binder connected to internal cavity of the chamber for mixing the magnetically controlled binder.

EFFECT: enhanced effectiveness in purifying biological fluid without additional reagents being applied.

23 cl, 8 dwg

FIELD: medical engineering.

SUBSTANCE: device has the first canal having gas-impermeable membrane as wall part. Reservoir communicates with the first canal and is intended for storing oxygen. The first inlet opening serves for introducing anesthesia gas directly into the first canal. The reservoir allows oxygen to flow into the first canal from the reservoir when the first canal pressure is lower than in comparison to the ambient medium pressure.

EFFECT: reduced respiratory gas overhead.

17 cl, 4 dwg

FIELD: medicine, toxicology, resuscitation.

SUBSTANCE: one should introduce preparations due to transmembranous wound dialysis: from the 1st to the 3d d after chemical burn one should introduce dialyzate of the following composition: solution of rheopolyglukin 100 ml, 2%-lidocaine 4 ml, 1%-dioxidine 10 ml, dexamethasone 8 mg, and from the 4th to the 7th d of the disease mentioned it is useful to introduce dialyzate including: solution of rheopolyglukin 100 ml, 1%-dioxidine 10 ml, 5%-ascorbic acid 5 ml; moreover, transmembranous wound dialysis should be carried out once daily. The present innovation enables to conduct local treatment of chemical esophageal burns due to taking into consideration the phases of wound process of burn trauma that, in its turn, favors for alleviating and accelerating clinical flow of the disease in question and preventing the development of complications.

EFFECT: higher efficiency of therapy.

1 cl, 2 ex

FIELD: medicine, obstetrics, perinatology.

SUBSTANCE: therapy course consists of 4 stages: during the first stage one should indicate dalargin per 2 mg intramuscularly daily for 10-d-long course, 1 mo later, at the second stage it is necessary to apply polyvalent immunoglobulin per 25 ml intravenously by drops every other day thrice, 1 mo later at the third stage one should indicate thymalin per 1 ml intramuscularly daily for 10-d-long course and 1 mo later at the fourth stage one should perform discrete plasmapheresis every other day thrice. The innovation provides such immunocorrection that enables to remove herpes virus and excludes fetal abortion.

EFFECT: higher efficiency of therapy.

3 ex, 1 tbl

FIELD: medical engineering.

SUBSTANCE: device has line for taking blood and returning erythrocytic mass with air trap, line for supplying anticoagulant and hemodilution agent and forceps. Dosing member is mounted on anticoagulant line being chamber manufactured from plastic film-like material having an opening on one side for anticoagulant to be supplied and another opening for discharging it. Pump segment is set on line collecting blood as a flexible tube having an opening for supplying blood and another opening for delivering the blood to plasma filter connected to pressure control line having valve filter mounted thereon. Unit for supplying drug and discharging air is mounted on the air trap. It is manufactured as a tube with clamp.

EFFECT: enhanced effectiveness in applying continuous and safe plasmapheresis.

1 dwg

Artificial kidney // 2245724

FIELD: medical engineering.

SUBSTANCE: device has reference voltage source, comparison unit, unit for analyzing signs, unit for selecting module, analog-to-digital converter, NOT-gate, clock pulse oscillator, 3 AND-gates of the first and the second group, sodium concentration gage (in patient blood), syringe, outgoing arteriovenous shunt, the first and the second connection members, blood circuit, hemodialysis unit, blood unit, semipermeable membrane, compartment for collecting dialysis liquid, discharge line, means for collecting wasted dialysis liquid and ultrafiltrate, weighing unit, movable supporting member, incoming arteriovenous shunt, inlet line, unit for measuring discharge rate, dialysis component reservoir, clamp and sterile connection member. The dialysis component reservoir has the first, the second and the third reservoir, dosing units of the first and the second group, controlled valves of the first and the second group and mixer unit.

EFFECT: enhanced effectiveness in selecting individual sodium concentration in dialysis liquid; wide range of functional applications.

2 cl,2 dwg

The invention relates to a membrane or matrix designed to regulate the speed of penetration of the medicinal product, where this membrane or the matrix contains an elastomeric composition based on siloxane, and to a method for producing such elastomeric compositions

The invention relates to medicine

The invention relates to medicine and medical technology and can be used in clinical Transfusiology and for the manufacture of membrane devices intended for oxygenation of the blood and dialysis

The invention relates to medical equipment and can be used for extrapulmonary oxygenation or dialysis of the blood of humans and animals

The invention relates to medicine and medical technology, in particular to the extraction of detoxification of biological fluids

Artificial kidney // 2245724

FIELD: medical engineering.

SUBSTANCE: device has reference voltage source, comparison unit, unit for analyzing signs, unit for selecting module, analog-to-digital converter, NOT-gate, clock pulse oscillator, 3 AND-gates of the first and the second group, sodium concentration gage (in patient blood), syringe, outgoing arteriovenous shunt, the first and the second connection members, blood circuit, hemodialysis unit, blood unit, semipermeable membrane, compartment for collecting dialysis liquid, discharge line, means for collecting wasted dialysis liquid and ultrafiltrate, weighing unit, movable supporting member, incoming arteriovenous shunt, inlet line, unit for measuring discharge rate, dialysis component reservoir, clamp and sterile connection member. The dialysis component reservoir has the first, the second and the third reservoir, dosing units of the first and the second group, controlled valves of the first and the second group and mixer unit.

EFFECT: enhanced effectiveness in selecting individual sodium concentration in dialysis liquid; wide range of functional applications.

2 cl,2 dwg

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