JP6131321B2 - 断片的バイオインピーダンスを使用した腹膜透析の際に限外濾過体積をモニタリングおよび制御するシステムおよび方法 - Google Patents
断片的バイオインピーダンスを使用した腹膜透析の際に限外濾過体積をモニタリングおよび制御するシステムおよび方法 Download PDFInfo
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Description
本願は、2012年6月8日に出願された米国仮特許出願第61,657,271号の利益を主張する。上記出願の全教示は、参照により本明細書に援用される。
腎臓機能不全または腎不全、特に末期腎臓疾患は、水および無機質を除去し、有害な代謝物を排出し、酸-塩基バランスを維持し、かつ電解質および無機質の濃度を生理学的範囲に制御する能力を身体から失わせる。尿素、クレアチニン、尿酸およびリンなどの毒性の***代謝排出物(uremic waste metabolite)は、体組織中に蓄積し、腎臓の濾過機能が戻らない場合はヒトの死を引き起こし得る。
本発明は一般的に、患者の腹膜透析に関する。
本発明は一般的に、患者の腹膜透析に関する。患者の腹膜透析の方法は、ある体積の腹膜透析流体を患者の腹膜腔に導入することを含む。当該技術分野において公知である任意の適切な腹膜透析液(すなわち腹膜透析流体)(例えば、Delflex(登録商標)、Fresenius Medical Care North America, Waltham MA)が使用され得る。PD流体の体積は、約1.5L〜約2.5L、好ましくは約2Lの範囲であり得る。この公知の体積を使用して、体積のバイオインピーダンス測定が較正される。該方法は、PD治療の際、例えば約1分、約5分、約30分等の間隔で、患者の腹膜腔内の流体の体積を定期的に測定する工程を含む。より頻度の高い測定により、より高い時間的分解がもたらされ、限外濾過体積における急速な変化の検出が可能になる。流体体積測定は、断片的バイオインピーダンス分光学(SBIS)によりなされる。Zhu F., Hoenich N. A., Kaysen G., Ronco C., Schneditz D., Murphy L., Santacroce S., Pangilinan A., Gotch F., and Levin N. W., Measurement of Intraperitoneal Volume by Segmental Bioimpedance Analysis During Peritoneal Dialysis、American Journal of Kidney Diseases、42:167-172、2003(以下「Zhu et al.」);およびLevin et al. 2008に対する米国特許第7,354,417号参照。このSBIS法において、図1に示されるように8個の電極110、120、130、140、150、160、170および180(例えば標準ECG電極)が体に配置される。4個の電極110、120、130および140は注入電流(injecting current)のための電極である。電極150と170、および160と180は、間隔Lの間の電圧の測定のための二組の電極である。注入電極と測定電極の間隔はDである。ケーブルホルダー185を使用して、電極ケーブル186をバンド187で固定し得る。腹膜腔内の流体の体積Vは、
上述のように改変したHydra 4200 Analyzerを使用して、標準PETの間に、仰向けの姿勢の患者で断片的バイオインピーダンス分光学(SBIS)を実施した。Zhu et al参照。注入電流について4個の電極を両腕および両足に設置した。体の両側の下部肋骨および臀部に4個の測定電極を設置した。腹膜腔における抵抗の変化と流体体積の関係を確立するためのSBIS法の較正は、治療の開始時に既知の体積の透析物を導入することにより行った。休止期間中の腹膜腔における流体体積の増加は、この期間に生じる正味の限外濾過体積(UFVSBIS)と等しいとみなされた。最後の排液体積を計量して排液体積(DVM)を測定した。透析物クレアチニン濃度(DCre)を0時間、2時間および終わりの時点で測定した。PETの開始時に血漿クレアチニン濃度(PCre)を測定した。D/PはDCre/PCreにより計算した。
腹部の両側面に二組の電極を設置した。断片的分光学(sBIS)を使用して、休止の間の流体変化を継続的にモニタリングした。2LのPD流体の点滴注入後、腹膜内の流体体積の変化からUFVを計算した。最適休止時間(ODT)は、PDの開始と、流体の再吸収が検出される時点の間の時間である。手動PDを使用して座っている姿勢で患者を2回試験した:1) 試験1、4時間の休止時間(DT)を有する規則的な手順、交換を通じてsBISでモニタリングした;2) 試験2、ODT手順、流体体積の変化の速度が、10分より長くマイナスになった(流体が吸収される)かまたは平坦になった(すなわち、変化しない)場合に透析物を排液した。実際のUFV(aUFV)は、排液体積と充填体積の重量差として規定した。
Claims (5)
- 断片的バイオインピーダンス分光学(segmental bioimpedance spectroscopy)(SBIS)により患者の腹膜腔内の流体の体積を測定して、患者の腹膜腔内の流体の限外濾過体積を決定する腹膜腔モニター(PCM);ならびに
患者の腹膜腔を充填するため、および限外濾過体積が経時的に変化しないか、有意に減少するかまたは有意な速度で減少している場合に、患者の腹膜腔から排液するための、PCMにより制御されるスイッチ
を含む、患者において腹膜透析(PD)を行うために、患者の腹膜腔に、ある体積のPD液を注入するための腹膜透析(PD)システム。 - 断片的バイオインピーダンス分光学(SBIS)により患者の腹膜腔内の流体の体積を測定して、患者の腹膜腔内の流体の限外濾過体積を決定する腹膜腔モニター(PCM);および
限外濾過体積が経時的に変化しないか、有意に減少するかまたは有意な速度で減少している場合に、患者の腹膜腔から排液されるべきときを指示するための、PCMにより制御されるアラーム
を含む、患者において腹膜透析(PD)を行うために、患者の腹膜腔に、ある体積のPD液を注入するための腹膜透析(PD)システム。 - スイッチが、ワイヤレス通信により、PCMにより制御される、請求項1記載の腹膜透析(PD)システム。
- 患者の腹膜腔内の流体の限外濾過体積が経時的に変化しないか、有意に減少するかまたは有意な速度で減少している場合に、患者の腹膜腔から排液するためにスイッチを制御する工程を含む、腹膜透析(PD)システムの作動方法であって、
前記流体の限外濾過体積は、ある体積の腹膜透析液が導入された患者の腹膜腔内の流体の体積を、断片的バイオインピーダンス分光学(segmental bioimpedance spectroscopy)(SBIS)により定期的に測定することにより決定されるものである、腹膜透析(PD)システムの作動方法。
- 患者の腹膜腔を、さらなる体積の腹膜透析液で再充填するためにスイッチを制御する工程をさらに含む、請求項4記載の方法。
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PCT/US2013/044795 WO2013185080A1 (en) | 2012-06-08 | 2013-06-07 | System and method of monitoring and control of ultrafiltration volume during peritoneal dialysis using segmental bioimpedance |
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Families Citing this family (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9861733B2 (en) | 2012-03-23 | 2018-01-09 | Nxstage Medical Inc. | Peritoneal dialysis systems, devices, and methods |
EP3536361B1 (en) | 2011-03-23 | 2020-10-07 | NxStage Medical Inc. | Peritoneal dialysis systems, devices, and methods |
BR112014030611B1 (pt) | 2012-06-08 | 2022-02-22 | Fresenius Medical Care Holdings, Inc | Sistema e método de monitoramento e controle de volume de ultrafiltração durante diálise peritoneal usando bioempedância segmentar |
EP3539586B1 (en) | 2014-10-10 | 2022-08-24 | NxStage Medical Inc. | Flow balancing methods |
AU2015367198B2 (en) * | 2014-12-17 | 2019-10-10 | Newsol Technologies Inc. | System and method for peritoneal dialysis |
CN108055823A (zh) * | 2015-07-16 | 2018-05-18 | 伊派迪迈德公司 | 流体水平确定 |
EP4052737A1 (en) | 2016-07-18 | 2022-09-07 | NxStage Medical Inc. | Flow balancing devices, methods, and systems |
WO2018045102A1 (en) | 2016-08-30 | 2018-03-08 | Nxstage Medical, Inc. | Parameter monitoring in medical treatment systems |
US11179516B2 (en) | 2017-06-22 | 2021-11-23 | Baxter International Inc. | Systems and methods for incorporating patient pressure into medical fluid delivery |
CA3092575A1 (en) | 2018-02-28 | 2019-09-06 | Nxstage Medical, Inc. | Fluid preparation and treatment devices, methods, and systems |
GB2579673A (en) * | 2018-12-12 | 2020-07-01 | Haemair Ltd | Cell washing apparatus |
US20210106741A1 (en) * | 2019-10-10 | 2021-04-15 | Fresenius Medical Care Holdings, Inc. | Systems and methods for monitoring fluid volumes during peritoneal dialysis |
Family Cites Families (22)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4096859A (en) * | 1977-04-04 | 1978-06-27 | Agarwal Mahesh C | Apparatus for peritoneal dialysis |
CN87212650U (zh) * | 1987-12-19 | 1988-12-07 | 周国明 | 体外循环血泵安全控制器 |
US5902336A (en) * | 1996-10-15 | 1999-05-11 | Mirimedical, Inc. | Implantable device and method for removing fluids from the blood of a patient method for implanting such a device and method for treating a patient experiencing renal failure |
US6293921B1 (en) * | 1998-07-06 | 2001-09-25 | Jms Company, Ltd. | Automatic exchanger for peritoneal dialysis |
US6287328B1 (en) * | 1999-04-08 | 2001-09-11 | Agilent Technologies, Inc. | Multivariable artifact assessment |
US7354417B1 (en) | 1999-10-05 | 2008-04-08 | Levin Nathan W | Methods and apparatus for measuring the volume of fluid in the peritoneal cavity |
US7228170B2 (en) | 2000-08-14 | 2007-06-05 | Renal Research Institute, Llc | Device and method for monitoring and controlling physiologic parameters of a dialysis patient using segmental bioimpedance |
US6615077B1 (en) * | 2000-08-14 | 2003-09-02 | Renal Research Institute, Llc | Device and method for monitoring and controlling physiologic parameters of a dialysis patient using segmental bioimpedence |
US20090182204A1 (en) * | 2001-10-04 | 2009-07-16 | Semler Herbert J | Body composition, circulation, and vital signs monitor and method |
US20060241543A1 (en) * | 2001-11-16 | 2006-10-26 | National Quality Care, Inc. | Method for installing and servicing a wearable continuous renal replacement therapy device |
US8029454B2 (en) * | 2003-11-05 | 2011-10-04 | Baxter International Inc. | High convection home hemodialysis/hemofiltration and sorbent system |
JP2007044065A (ja) * | 2005-08-05 | 2007-02-22 | Terumo Corp | 腹膜透析装置およびその制御方法、並びに制御プログラム |
WO2008086477A1 (en) * | 2007-01-10 | 2008-07-17 | The Regents Of The University Of Michigan | Ultrafiltration membrane, device, bioartificial organ, and related methods |
US8512553B2 (en) * | 2007-07-05 | 2013-08-20 | Baxter International Inc. | Extracorporeal dialysis ready peritoneal dialysis machine |
US8287724B2 (en) * | 2007-07-05 | 2012-10-16 | Baxter International Inc. | Dialysis fluid measurement systems using conductive contacts |
US7909795B2 (en) * | 2007-07-05 | 2011-03-22 | Baxter International Inc. | Dialysis system having disposable cassette and interface therefore |
US9078971B2 (en) * | 2008-01-23 | 2015-07-14 | Deka Products Limited Partnership | Medical treatment system and methods using a plurality of fluid lines |
MY152682A (en) | 2008-04-29 | 2014-10-31 | Danisco Us Inc | Swollenin compositions and methods of increasing the efficency of a cellulase |
US8182673B2 (en) * | 2009-01-29 | 2012-05-22 | Baxter International Inc. | Drain and fill logic for automated peritoneal dialysis |
US9020827B2 (en) | 2009-10-16 | 2015-04-28 | Baxter International Inc. | Peritoneal dialysis optimized using a patient hand-held scanning device |
US8337448B2 (en) * | 2010-01-29 | 2012-12-25 | Baxter International Inc. | Apparatus for monitoring and controlling peritoneal dialysis |
BR112014030611B1 (pt) | 2012-06-08 | 2022-02-22 | Fresenius Medical Care Holdings, Inc | Sistema e método de monitoramento e controle de volume de ultrafiltração durante diálise peritoneal usando bioempedância segmentar |
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