JP2019010503A - 光センサのオンライン線形化 - Google Patents
光センサのオンライン線形化 Download PDFInfo
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Abstract
Description
本発明は、透析液側ドレンラインの光センサと、シャントへの反復チェンジとによって、前記センサが線形域で提供されているか否か、及び前記センサが線形域で提供されている時のそれぞれ(resp.)を判定する方法と、更に、前記光センサを線形化する装置とに関する。線形域からのデータの後方(backward)外挿によって、非線形域で記録された初期データを訂正することができる。
透析の効率を測定する一つのパラメータはKt/V値である。この文脈において、K[ml/分]は、クリアランス(特定の物質を含まない、単位時間当たりの仮想血漿量、換言すると、物質の濃度)であり、これは、透析の前後の尿素含量を介して測定される。更に、t[分]は、有効透析時間、換言すると、治療の継続時間である。V[ml]は、尿素分布容積、換言すると、血液が循環可能な体(体液含量)の体重(重量)の60%を示している。或いは、前記クリアランスK又は前記分布容積に対する前記クリアランスの比率K/Vも進行中の透析治療の効率のインジケータを構成する。
現在のKt/V値の測定は、様々なオンライン処理によって実現される。先ず、「オンライン・クリアランス測定」の技術があげられる。そのコンセプトは、導電性測定の原理に基づく。透析装置の前後、即ち、透析液入口と透析液出口とにおいて、二つの導電性プローブが設置される。透析液中の導電性は、主としてナトリウム濃度によって規定される。その測定技法は、短時間、透析液入口の導電性を増加させ、透析液出口での導電性の変化を観察することによる。次に、透析装置の前と後ろとのプローブでの導電性によって、測定可能な導電性の差を介してナトリウムクリアランスを測定することができる。ナトリウムイオンと尿素とは非常に類似した拡散特性を有するので、ナトリウムクリアランスを直接、尿素クリアランスに変換することができ、これから、次に、Kt/V値を測定することができる。更に、計算には、分布容積Vと処理時間tとが含まれる。この技術では、±6%の測定精度が得られる。この技術の欠点は、Kt/V値を規則的間隔で連続的にモニタリングするためには、透析液入口の導電性を変える必要があることである。更に、電解溶液の導電性は、更に溶解される粒子(further dissolved particles)に強く依存し、それによってナトリウムの移動性が減少し、それによって導電性が減少し、これが今度は誤ったクリアランス計算をもたらす。この技法のもう一つの欠点は、導電性の変化によって患者のイオンの不注意な取り入れ、取出しが生じる可能性があることにある。更に、導電性の変化は遅く、それによって連続測定が不可能となる。
前記課題は、請求項1の光センサの線形化の方法と、透析装置、特に、光センサを線形化するための請求項15の装置、によってそれぞれ達成される。
1 患者
2 動脈管系
3 輸送ユニット
4 透析装置
5 静脈管系
6 供給ライン
7 ドレンライン
8 センサ
Claims (15)
- 透析装置において光センサ(8)を線形化するための方法であって、以下の工程、
透析液側ドレンラインに前記光センサ(8)を導入する工程、
前記光センサ(8)の線形域を決定する工程、
非線形域において記録された初期データを前記線形域からのデータによって後方外挿する工程、
前記非線形域から前記センサによって測定されたデータを補正又は置換する工程、を包含する方法。 - 前記後方外挿は、回帰曲線の非線形回帰によってさらに行われることを特徴とする請求項1に記載の方法。
- 前記方法は、シャント間隔と特定のシャント継続時間とを調節する工程をさらに包含することを特徴とする請求項1又は2に記載の方法。
- 前記線形域を決定する工程は、更に以下の工程、
好ましくは被減数としての局所シャント最大値と、好ましくは減数としての各シャントへのチェンジの直前の前記光センサ(8)の消光信号との差を、好ましくは横軸としての前記シャントへのチェンジ直前の消光信号に適用する工程、及び
最大転換点よりも小さな、少なくとも1つの消光、又はデータを決定する工程、を包含することを特徴とする請求項3に記載の方法。 - 前記シャントは、好ましくは18秒間以下である第1継続時間を有し、且つ、前記シャント間隔は前記第1継続時間よりも長い、好ましくは4分間の第2継続時間を有することを特徴とする請求項2〜4のいずれか1項に記載の方法。
- 前記シャント間隔は、時間において等距離又は非等距離に分布されていることを特徴とする請求項2〜5のいずれか1項に記載の方法。
- クリアランスKの決定が、好ましくは、2〜3分間であるシャント継続時間後のシャント最大値後の、血漿中の消光を計算することによって行われることを特徴とする請求項2〜6のいずれか1項に記載の方法。
- 透析液側クリアランスと血液側クリアランスの測定は非侵襲的であることを特徴とする請求項7に記載の方法。
- 前記方法は、前記光センサ(8)の線形化をチェックするためにKt/V値を決定する工程をさらに包含することを特徴とする請求項1〜8のいずれか1項に記載の方法。
- 前記Kt/V値の計算が、線形化された光センサによって順番に測定された、初期尿素含量と尿素濃度c(t)とを、時間tの所与の時点で測定することによって行われることを特徴とする請求項9に記載の方法。
- 決定された前記Kt/V値は、リバウンド効果を考慮するために前記モデルによって決定されることを特徴とする請求項9に記載の方法。
- 決定された前記Kt/V値は、治療中の尿素の発生を考慮するSingle−Poolモデルによって決定されることを特徴とする請求項9に記載の方法。
- 前記差のシャント最大値が記憶されることを特徴とする請求項4に記載の方法。
- 前記シャント間隔は、治療の所定継続時間の後に始まることを特徴とする請求項13に記載の方法。
- 現在の透析処理を測定するための光センサを有する透析装置であって、請求項1〜14のいずれかの方法に従う、前記光センサ(8)を線形化するように適合されたデータ補正ユニットによって特徴付けられる透析装置。
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DE102013101523A1 (de) * | 2013-02-15 | 2014-08-21 | B. Braun Avitum Ag | Fotometrische Messvorrichtung und Verfahren zum Messen einer optischen Absorbanz eines Fluids mit einer variablen Konzentration von mindestens einer Licht absorbierenden Substanz, sowie Blutbehandlungsvorrichtung mit einer derartigen Messvorrichtung |
DE102013103221A1 (de) | 2013-03-28 | 2014-10-02 | B. Braun Avitum Ag | Verfahren zur Erfassung einer Rezirkulation in einem arteriovenösen Shunt während laufender Hämodialyse und Dialysesystem |
DE102013103218A1 (de) * | 2013-03-28 | 2014-10-02 | B. Braun Avitum Ag | Verfahren und Vorrichtung zur Erkennung einer Rezirkulation in einem Shunt |
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JPH11137666A (ja) * | 1997-11-10 | 1999-05-25 | Toru Niisato | 血液透析評価方法 |
US20100213127A1 (en) * | 2007-06-20 | 2010-08-26 | Alex Castellarnau | METHOD FOR DETERMINING THE REDUCTION RATIO OR THE Kt/V VALUE OF A KIDNEY SUBSTITUTION TREATMENT AND APPARATUS FOR THE REALISATION OF THE METHOD |
EP2163271A1 (en) * | 2008-09-15 | 2010-03-17 | B. Braun Avitum AG | Method to determine the Kt/V parameter in kidney substitution treatments based on a non-linear fitting procedure |
US20110163034A1 (en) * | 2008-09-15 | 2011-07-07 | B. Braun Avitum Ag | METHOD AND DEVICE TO EARLY PREDICT THE Kt/V PARAMETER IN KIDNEY SUBSTITUTION TREATMENTS |
US20140326646A1 (en) * | 2013-05-02 | 2014-11-06 | B. Braun Avitum Ag | Device for extracorporeal blood treatment |
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