WO2024116486A1 - Dispositif de suggestion de réglage, dispositif de dialyse et programme - Google Patents

Dispositif de suggestion de réglage, dispositif de dialyse et programme Download PDF

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Publication number
WO2024116486A1
WO2024116486A1 PCT/JP2023/029940 JP2023029940W WO2024116486A1 WO 2024116486 A1 WO2024116486 A1 WO 2024116486A1 JP 2023029940 W JP2023029940 W JP 2023029940W WO 2024116486 A1 WO2024116486 A1 WO 2024116486A1
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Prior art keywords
dialysis
patient
line
status data
setting
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PCT/JP2023/029940
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English (en)
Japanese (ja)
Inventor
正明 竹林
裕平 藤原
佑志 清水
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株式会社ジェイ・エム・エス
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Publication of WO2024116486A1 publication Critical patent/WO2024116486A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes

Definitions

  • the present invention relates to a setting suggestion device, a dialysis device, and a program.
  • hemodialysis treatment for dialysis patients is performed using a dialysis machine installed at the bedside of the dialysis patient.
  • dialysis treatment it is important to set appropriate conditions according to the patient's blood condition, in particular to control the water removal speed. Therefore, a hemodialysis device has been disclosed that can easily set hemodialysis treatment conditions adapted to each patient over time while monitoring the blood condition of each patient, in particular controlling the water removal rate (see, for example, Patent Document 1).
  • the present invention therefore aims to provide a setting suggestion device, dialysis device, and program that can easily configure settings in a dialysis device that has complex settings.
  • the present invention relates to a setting suggestion device for dialysis treatment, comprising: a patient dialysis status data storage unit that stores patient dialysis status data, including trend data showing trends in the patient's circulating blood volume change rate in at least one dialysis treatment, in association with the patient; a patient designation receiving means that receives designation of a patient to be dialysis; a threshold data setting means that sets an operation switching threshold line for controlling the change in water removal speed based on the past patient dialysis status data of the patient to be dialysis extracted from the patient dialysis status data storage unit; and a graph output means that outputs the operation switching threshold line set by the threshold data setting means and the patient dialysis status data used to set the operation switching threshold line to a display unit.
  • the threshold data setting means sets the operation switching threshold line based on the most recently stored previous patient dialysis status data as the past patient dialysis status data of the dialysis target patient.
  • the threshold data setting means sets the operation switching threshold line based on the average value of multiple times of the patient dialysis status data, including the most recently stored previous time, as the past patient dialysis status data of the dialysis target patient.
  • the threshold data setting means sets the operation switching threshold line based on past patient dialysis status data of the dialysis target patient that is at the same timing within a periodic dialysis cycle.
  • the threshold data setting means sets a value of a specific timing of the patient dialysis status data as the operation switching threshold line.
  • the setting suggestion device preferably includes a smoothing means for performing a smoothing process on the past patient dialysis status data of the dialysis target patient to generate a correction line
  • the graph output means preferably outputs the correction line generated by the smoothing means as the operation switching threshold line.
  • the graph output means outputs a value at a specific timing of the correction line generated by the smoothing means as the operation switching threshold line.
  • the setting suggestion device preferably includes a correction designation means for receiving a designation regarding whether or not to smooth the past patient dialysis status data of the dialysis target patient, and the smoothing means generates the correction line in response to receiving a designation to smooth the data from the correction designation means.
  • the present invention also relates to a dialysis machine including the above-mentioned setting suggestion device, and further comprising a water removal rate control means for controlling the water removal rate based on the relationship between the operation switching threshold line output by the graph output means and the progression data of the patient during dialysis.
  • the dialysis device further includes a line change receiving means for receiving a change operation for the operation switching threshold line output by the graph output means, It is preferable that the water removal speed control means controls the water removal speed based on the relationship between the operation switching threshold line after the change accepted by the line change accepting means and the transition data of the patient during dialysis.
  • the present invention also relates to a program for causing a computer to function as the above-mentioned setting suggestion device or dialysis device.
  • the present invention provides a setting suggestion device, a dialysis device, and a program that can easily configure settings in a dialysis device that has complex settings.
  • FIG. 2 is a diagram showing functional blocks of the dialysis device according to the present embodiment.
  • FIG. 2 is a diagram showing an example of a patient dialysis status data storage unit of the dialysis apparatus according to the present embodiment.
  • 10 is a flowchart showing a setting proposal process for a dialysis machine according to the present embodiment.
  • FIG. 13 is a diagram showing a display example of the dialysis device according to the embodiment.
  • FIG. 13 is a diagram showing a display example of the dialysis device according to the embodiment.
  • FIG. 13 is a diagram showing a display example of the dialysis device according to the embodiment.
  • FIG. 11 is a diagram showing an example of a smoothing process in the dialysis device according to the embodiment.
  • FIG. 11 is a diagram showing an example of a smoothing process in the dialysis device according to the embodiment.
  • 4 is a flowchart showing the dialysis and data storage process of the dialysis device according to the present embodiment.
  • FIG. 1 is a diagram showing functional blocks of a dialysis device 1 according to this embodiment.
  • FIG. 2 is a diagram showing an example of the patient dialysis status data storage unit 32 of the dialysis machine 1 according to this embodiment.
  • the dialysis machine 1 is installed at a medical institution, such as at the bedside of a patient undergoing dialysis treatment, and is a machine that performs dialysis treatment for the patient. As shown in FIG. 1 , the dialysis machine 1 includes a control unit 10 , a memory unit 30 , an operation display panel 36 (display unit), operation buttons 37 , various pumps 38 , and various measuring devices 39 .
  • the control unit 10 is a central processing unit (CPU) that controls the dialysis machine 1.
  • the control unit 10 appropriately reads and executes an operating system (OS) and application programs stored in the storage unit 30, thereby cooperating with the above-mentioned hardware and executing various functions.
  • OS operating system
  • the storage unit 30 is a storage area such as a hard disk, a semiconductor memory device, etc. for storing programs, data, etc. required for the control unit 10 to execute various processes.
  • the memory unit 30 includes a program memory unit 31 , a patient dialysis status data memory unit 32 , and a patient information memory unit 33 .
  • the program storage unit 31 is a storage area for storing various programs, such as programs for executing various functions of the control unit 10, which will be described later.
  • the programs stored in the program storage unit 31 include, for example, a BV (circulating blood volume) adjustment program, which will be described later.
  • the programs stored in the program storage unit 31 may be separate programs for each functional unit or multiple functional units of the control unit 10, or may be a single program.
  • the patient dialysis status data storage unit 32 is a storage area for storing patient dialysis status data indicating the dialysis status of the patient. Examples of items stored in the patient dialysis status data storage unit 32 are shown in FIG.
  • the patient dialysis status data memory unit 32 shown in Figure 2 has items including patient ID (IDentification), dialysis date and time, trend data, total amount of water removed at the end of dialysis, water removal rate at the start of dialysis, and set value.
  • the patient ID is identification information for identifying a patient.
  • the dialysis date and time is the date and time when the dialysis treatment started.
  • the transition data is, for example, transition data of blood parameters indicating the state of blood, such as transition data of the rate of change of the circulating blood volume of the patient (which can be expressed as % BV ⁇ , for example) and transition data of hematocrit measurements.
  • the transition data may include time series data indicating the transition of blood pressure, venous pressure, water removal amount, water removal speed, etc.
  • the total amount of water removed at the end of dialysis is the total amount of water removed measured at the end of dialysis.
  • the water removal rate at the start of dialysis is a preset water removal rate at the start of dialysis.
  • the set values are various patient-related values that are set in the dialysis device 1, and may include at least one of values related to the patient's weight, such as the patient's weight before and after dialysis, DW (dry weight), and target water removal volume, and may further include the treatment details, the patient's blood test results, etc.
  • the storage unit 30 also stores specified conditions that are set in advance for the dialysis device 1, for example, conditions that indicate the range of data to be used as past data.
  • the storage unit 30 may also store, for example, a patient information storage unit that stores basic information about a patient.
  • the patient information storage unit may store, for example, basic information about a patient, such as the patient's name and date of birth, and dialysis history, in association with a patient ID.
  • the control unit 10 includes a patient designation reception unit 11 (patient designation reception means), a setting proposal processing unit 12 (setting proposal device), a setting change reception unit 18 (line change reception means), a dialysis processing unit 19 (water removal speed control means), and a data storage processing unit 20.
  • the patient designation receiving unit 11 receives designation of a patient (a patient to be treated by dialysis) who will undergo dialysis treatment using the dialysis device 1.
  • the patient designation receiving unit 11 receives, via the operation display panel 36, for example, a patient ID.
  • the setting proposal processing unit 12 proposes settings related to dialysis treatment for the patient.
  • the setting proposal processing unit 12 includes a past data extraction unit 13, a threshold line setting unit 14 (threshold data setting means), a proposed graph output unit 15 (graph output means), a smoothing receiving unit 16 (correction designation means), and a smoothing processing unit 17 (smoothing means).
  • the past data extraction unit 13 extracts the patient dialysis status data of the patient stored in the patient dialysis status data storage unit 32 based on the patient ID accepted by the patient designation acceptance unit 11.
  • the past data extraction unit 13 extracts the patient dialysis status data according to the designated conditions set in advance in the dialysis machine 1 and stored in the storage unit 30.
  • the past data extraction unit 13 may extract, for example, patient dialysis status data from the previous dialysis treatment that was stored in the past (most recently) in accordance with the specified conditions.
  • the past data extraction unit 13 may extract, for example, multiple sets of patient dialysis status data stored in the past (most recently) including the previous set, according to the specified conditions.
  • the past data extraction unit 13 may extract past (most recent) patient dialysis status data that have the same timing in a periodic dialysis cycle according to the specified conditions.
  • the same timing in a periodic dialysis cycle corresponds to, for example, the same day of the week.
  • the threshold line setting unit 14 sets an alarm 1 line (operation switching threshold line) for controlling the change of the water removal speed based on the patient dialysis status data extracted by the past data extraction unit 13.
  • the alarm 1 line refers to a target line for the transition of the rate of change of circulating blood volume during dialysis treatment.
  • the threshold line setting unit 14 may also set values at specific timings of the patient dialysis status data (specifically, for example, 60 minutes, 120 minutes, 180 minutes, and 240 minutes from the start of dialysis) as the alarm 1 line.
  • the proposal graph output unit 15 generates a proposal graph including the alarm 1 line set by the threshold line setting unit 14 and a line indicating the patient dialysis status data used to set the alarm 1 line. Then, the proposal graph output unit 15 outputs the generated proposal graph to the operation display panel 36. Furthermore, when a correction line is generated by the smoothing processing unit 17, the proposed graph output unit 15 outputs the generated correction line to the operation display panel 36 as an alarm 1 line.
  • the smoothing reception unit 16 receives, via the operation display panel 36, a designation as to whether or not smoothing is to be performed on the alarm 1 line.
  • the smoothing processing unit 17 performs a smoothing process (smoothing process) on the alarm 1 line to generate a correction line.
  • the setting change receiving unit 18 receives a change operation for the alarm 1 line output by the proposal graph output unit 15 via the operation display panel 36 .
  • the dialysis processing unit 19 executes dialysis processing. More specifically, the dialysis processing unit 19 performs processing for performing blood purification treatment using a blood purification circuit (not shown) having an arterial blood circuit and a venous blood circuit constituting at least a blood circuit for circulating the patient's blood extracorporeally, and a blood purifier (not shown) having a plurality of connectors connectable to the blood purification circuit for purifying the blood circulating extracorporeally in the blood circuit.
  • the dialysis processing unit 19 controls the water removal speed based on the relationship between the transition data of the circulating blood volume change rate, which can be measured by a hematocrit measuring device, which is one of various measuring devices 39 described later and expressed as %BV ⁇ , and the alarm 1 line.
  • the dialysis processing unit 19 controls the water removal speed based on the relationship between the transition data of the circulating blood volume change rate and the alarm 1 line after the change.
  • the data storage processing unit 20 stores various data related to the patient resulting from dialysis treatment by the dialysis processing unit 19 in the patient dialysis status data storage unit 32.
  • the various data related to the patient include, for example, data on the progression of blood parameters, as well as weight and DW before dialysis treatment, and may also include details of treatment during dialysis treatment.
  • the operation display panel 36 functions as an input device that is operated by touching with the operator's finger, and also functions as a display device.
  • the operation button 37 is, for example, provided on a housing of the dialysis device 1 different from the operation display panel 36, and is a member used when performing operations related to the dialysis treatment.
  • the various pumps 38 are pumps used in dialysis treatment, and include, for example, a blood pump, a fluid replacement pump, and a water removal pump.
  • the various measuring devices 39 acquire values related to the state of blood in the patient's body, and include a hematocrit measuring device, etc.
  • the hematocrit measuring device measures values such as the rate of change in circulating blood volume, a hematocrit measurement value, oxygen saturation, and PRR (Plasma Refilling Rate).
  • a computer refers to an information processing device equipped with a control unit, a storage device, etc.
  • the dialysis device 1 is an information processing device equipped with a control unit, a storage device, etc., and is included in the concept of a computer.
  • step S (hereinafter, "step S" will be simply referred to as "S") 11 in FIG. 3, the control unit 10 (patient designation receiving unit 11) receives a patient ID by an operation on the dialysis device 1 by an operator.
  • the control unit 10 (past data extraction unit 13) extracts the past patient dialysis status data of the patient from the patient dialysis status data storage unit 32.
  • the control unit 10 extracts the past patient dialysis status data of the patient based on a specified condition that is set in advance in the dialysis machine 1 and indicates the range of data to be used as past data.
  • the control unit 10 judges whether or not the predetermined patient dialysis status data based on the specified conditions has been extracted. If the predetermined patient dialysis status data has been extracted (S13: YES), the control unit 10 proceeds to S14. On the other hand, if the predetermined patient dialysis status data has not been extracted (S13: NO), the control unit 10 proceeds to S19.
  • FIG. 5A shows an example of the operation display panel 36 that displays a screen 41 after a patient ID has been input.
  • the screen 41 has a patient name 41a and a program designation area 41b.
  • the patient name 41a displays the name of a patient identified by a patient ID.
  • the program designation area 41b is an area for designating a program that can be easily set when the program is executed.
  • the operator checks the patient name 41a, confirms that the patient name is correct, and then selects the program designation area 41b.
  • the control unit 10 then outputs a program selection screen (not shown). The operator selects a BV adjustment program that can set the alarm 1 line and control the water removal speed.
  • the control unit 10 outputs the selection screen 42 shown in FIG. 5(B).
  • the control unit 10 may output the selection screen 42 so that it is overlaid on the screen 41, or may output it instead of the screen 41.
  • the control unit 10 outputs a normal setting screen (not shown).
  • the control unit 10 performs normal setting processing and then terminates this processing.
  • the normal setting processing is performed when the specified patient dialysis status data cannot be extracted, that is, when the patient's past dialysis status data has not been saved. Therefore, the operator needs to set it up from the beginning, taking into account the patient's condition. Therefore, in this case, it is desirable for the operator to be a skilled medical professional who sets it up from scratch.
  • the control unit 10 measures the trend data of the rate of change in circulating blood volume, which is measured by a hematocrit measuring device, one of the various measuring devices 39, and can be expressed as %BV ⁇ , and stores this data in the patient dialysis status data storage unit 32 as the current patient dialysis status data. In this way, from the next dialysis onwards, simple settings can be made based on the patient's past dialysis status data stored in the patient dialysis status data storage unit 32.
  • the control unit 10 performs a condition setting process.
  • the selection screen 42 is a selection screen for making simple settings.
  • the selection screen 42 illustrated in FIG. 5(B) has a simple setting button 42a.
  • the button 42a is a button for enabling simple settings.
  • the selection screen 42 also shows four icons with different circulating blood volume change rates (%). The proposed graphs corresponding to these four icons are preset.
  • the condition setting screen 43 is a screen for setting the target water removal volume and water removal time for the current dialysis treatment.
  • the control unit 10 then outputs a condition setting screen 44 shown in FIG. 5(D).
  • the condition setting screen 44 is a screen for setting the water removal rate and the maximum water removal rate in the current dialysis treatment.
  • control unit 10 (threshold line setting unit 14) sets an alarm 1 line using the patient dialysis status data extracted in the process of S12.
  • control unit 10 (proposal graph output unit 15 ) generates a proposal graph including the set alarm 1 line, and outputs it to the operation display panel 36 .
  • Fig. 6(A) shows an example of a screen 45 including a proposed graph and output to the operation display panel 36.
  • the control unit 10 accepts the selection of the button 44a on the condition setting screen 44 of Fig. 5(D), it outputs the screen 45 to the operation display panel 36.
  • the proposed graph shown in Fig. 6(A) is an example of a case where patient dialysis status data from the previous dialysis treatment stored in the past (most recently) is extracted.
  • the screen 45 has a graph area 45a, adjustment buttons 45b to 45d, a selection area 45e, and a setting button 45f.
  • the graph area 45a is an area for outputting a proposed graph, and includes graphs 51a to 51e.
  • the solid line in graph 51a indicates the change in the rate of change in circulating blood volume related to the previous dialysis status data of the patient.
  • Graph 51b is the alarm 1 line set during the previous dialysis treatment.
  • the thick dotted line in graph 51c is a candidate for the alarm 1 line to be used in the current dialysis treatment.
  • the dotted lines 51d and 51e are lines showing the adjustment range of the alarm 1 line that can be adjusted by the adjustment buttons 45b and 45d.
  • the graphs 51d and 51e are schematic diagrams showing the results of adjusting the graph 51c (a candidate for the alarm 1 line used in the current dialysis treatment) when the adjustment buttons 45b and 45d, which will be described next, are pressed. Therefore, the graphs 51d and 51e are not actually displayed in the graph area 45a.
  • the adjustment buttons 45b to 45d are buttons for adjusting the alarm 1 line.
  • the adjustment button 45b is a button for moving the graph 51c showing the alarm 1 line to the graph 51e.
  • the adjustment button 45c is a button for returning the moved alarm 1 line to its original position on the graph 51c.
  • the adjustment button 45d is a button for moving the graph 51c showing the alarm 1 line to the graph 51d.
  • the operator adjusts the tightness (-) or looseness (+) of the alarm 1 line using the adjustment buttons 45b and 45d based on the past dialysis results (e.g., the patient's physical condition during the past dialysis) and the patient's condition, such as the patient's condition being better in the future than in the past when the dialysis is performed.
  • the selection area 45e is an area for selecting whether or not to make the alarm 1 line a correction line that has been smoothed. "With smoothing” is when smoothing is performed, and “without smoothing” is when smoothing is not performed. As an initial value, the screen 45 that is first output may be "without smoothing.”
  • the setting button 45f is a button for confirming the graph 51c set in the graph area 45a as an alarm 1 line.
  • the control unit 10 outputs a graph screen 46 shown in FIG. 6B.
  • the graph screen 46 is a screen for confirming and saving a graph including the set alarm 1 line.
  • the graph screen 46 has a graph display area 46a and buttons 46b to 46d.
  • the graph display area 46a includes a graph 52c and graphs 52f to 52h.
  • Graph 52c is the alarm 1 line set on screen 45 in FIG. 6(A).
  • Graph 52f is the alarm 2 line
  • graph 52g is the alarm 3 line
  • graph 52h is the alarm 4 line.
  • Graph 52f is a line drawn at a position "-3" away from graph 52c
  • graphs 52g and 52h are lines drawn at positions "-4" and "-7" away from the final point value of graph 52c, respectively.
  • the alarm 2 line is a line that is a reference for lowering the water removal speed.
  • the alarm 3 line and the alarm 4 line are lines that set the water removal speed to a preset ratio (water removal change rate) of the initial water removal speed. Note that if the value falls below the alarm 2 line or the alarm 4 line, fluid replacement may be performed.
  • the values of "-3", "-4", and "-7" that are the amount of change from the alarm 1 line are only examples, and are not limited to these values.
  • Button 46b is a button for saving the set conditions.
  • the saved conditions are displayed as icon 42-2x when setting up the next dialysis treatment for that patient, as shown in the selection screen 42-2 illustrated in FIG. 7(A). This makes it easier to set up the next and subsequent dialysis treatments for that patient.
  • Button 46c is a button for changing the set conditions, and when selected, transitions to a change screen 47 shown in Fig. 7(B).
  • Change screen 47 shown in Fig. 7(B) is a change screen for enabling fine adjustment of the alarm 1 line to the alarm 4 line individually. The operator can fine-tune the alarm 1 line, etc., using change screen 47 and change screen 48 that is output by selecting the "Set” button on change screen 47. After fine adjustment, when the operator selects the "Set” button on change screen 48, control unit 10 outputs graph screen 46 shown in Fig. 6(B).
  • Button 46d is a button for setting the set conditions only for the current dialysis treatment.
  • the control unit 10 judges whether or not a designation regarding the presence or absence of smoothing has been received. If a designation regarding the presence or absence of smoothing has been received (S21: YES), the control unit 10 proceeds to S22. On the other hand, if a designation regarding the presence or absence of smoothing has not been received (S21: NO), the control unit 10 proceeds to S23. In S22, the control unit 10 (proposal graph output unit 15) outputs the processed proposal graph corresponding to the designation to the operation display panel 36. After that, the control unit 10 shifts the process to S21.
  • the control unit 10 determines that a designation regarding the presence or absence of smoothing has been received. Then, the control unit 10 (smoothing processing unit 17) performs a smoothing process on the extracted patient dialysis status data from the past dialysis treatment to generate a correction line, and the control unit 10 (proposal graph output unit 15) outputs the generated correction line to the operation display panel 36 as an alarm 1 line (S22 in Fig. 4).
  • control unit 10 determines that a designation regarding the presence or absence of smoothing has been received. Then, the control unit 10 (proposal graph output unit 15) outputs the alarm 1 line set by the threshold line setting unit 14 to the operation display panel 36 (S22 in FIG. 4).
  • Fig. 8(A) is a graph 60 showing an original waveform 60a when a fluid replacement step is included.
  • Fig. 9(A) is a graph 70 showing an original waveform 70a when a fluid replacement step is not included.
  • the original waveforms 60a and 70a both correspond to extracted patient dialysis status data from past dialysis treatments.
  • the horizontal axis of each graph is the time axis, and the vertical axis is the rate of change in circulating blood volume.
  • the smoothing process is a process of performing various noise removal processes on the original waveforms 60a and 70a to generate a correction line.
  • Fig. 8B is a graph 61 including a correction line 61b from which a specific frequency has been removed.
  • 9B is a graph 71 including a correction line 71b from which a specific frequency has been removed. Both of the correction lines 61b and 71b form smoother lines compared to the original waveforms 60a and 70a, since the specific frequency has been removed.
  • Fig. 8C is a graph 62 including a correction line 62b obtained by taking a moving average.
  • Fig. 9C is a graph 72 including a correction line 72b obtained by taking a moving average. The moving average is calculated, for example, in units of 30 minutes.
  • Fig. 8D is a graph 63 including a correction line 63b represented by a cubic approximation curve
  • Fig. 9D is a graph 73 including a correction line 73b represented by a cubic approximation curve.
  • Fig. 8(E) is a graph 64 including a correction line 64b traced with a lower limit
  • Fig. 9(E) is a graph 74 including a correction line 74b traced with a lower limit
  • Fig. 8F is a graph 65 including a correction line 65b formed by tracing the lower limit and approximating a third-order curve
  • Fig. 9E is a graph 75 including a correction line 75b formed by tracing the lower limit and approximating a third-order curve.
  • the control unit 10 performs any one of the above-mentioned noise removal processes on the original waveform to perform smoothing and generate a correction line.
  • the correction line can be a smooth line regardless of the noise removal process performed.
  • control unit 10 may not select it as a target for smoothing. Furthermore, if the original waveform is short, the control unit 10 may complement a specific time (for example, up to 240 minutes) by maintaining the value of the circulating blood volume change rate at the end of dialysis of the original waveform.
  • the control unit 10 judges whether or not a change operation of the alarm 1 line has been received. If a change operation of the alarm 1 line has been received (S23: YES), the control unit 10 proceeds to S24. On the other hand, if a change operation of the alarm 1 line has not been received (S23: NO), the control unit 10 proceeds to S25. In S24, the control unit 10 (setting change receiving unit 18) changes the alarm 1 line in response to the change operation. Then, the control unit 10 outputs the changed alarm 1 line to the operation display panel 36. After that, the control unit 10 shifts the process to S21.
  • the control unit 10 determines that an operation to change the alarm 1 line has been accepted. Then, the control unit 10 (setting change accepting unit 18) performs a process to move the graph 51c showing the alarm 1 line to the graph 51e, and the control unit 10 (proposal graph output unit 15) outputs the moved alarm 1 line to the operation display panel 36 (S24 in Fig. 4). 6A (S23: YES in FIG. 4), the control unit 10 also determines that an operation to change the alarm 1 line has been accepted.
  • control unit 10 (setting change accepting unit 18) performs a process to move the graph 51c showing the alarm 1 line to the graph 51d, and the control unit 10 (proposal graph output unit 15) outputs the moved alarm 1 line to the operation display panel 36 (S24 in FIG. 4).
  • the control unit 10 judges whether or not a setting confirmation operation has been received. For example, when a selection operation of the setting button 45f is received on the screen 45 of Fig. 6 (A), the control unit 10 judges that a setting confirmation operation has been received. When a setting confirmation operation has been received (S25: YES), the control unit 10 shifts the process to S26. On the other hand, when a setting confirmation operation has not been received (S25: NO), the control unit 10 shifts the process to S21. In S26, the control unit 10 performs a process of confirming the settings. For example, when the button 46b is selected on the graph screen 46 in FIG.
  • the control unit 10 saves the setting values obtained by the setting proposal process so that they can be used in the next and subsequent settings, and then saves them so that they can be used in the current dialysis process.
  • the control unit 10 outputs a change screen 47, as shown in FIG. 7B, to the operation display panel 36 and performs fine adjustments to the graph.
  • the control unit 10 saves the setting values so that they can be used in the current dialysis process. After that, the control unit 10 ends this process.
  • FIG. 10 is a flowchart showing the dialysis and data storage process of the dialysis machine 1 according to this embodiment.
  • the operator inputs the patient's target water removal amount, water removal speed, etc., and selects a dialysis start button (not shown) of the dialysis device 1. By doing so, in S31 of Fig. 10, the control unit 10 of the dialysis device 1 accepts the dialysis start operation.
  • the control unit 10 (dialysis processing unit 19) starts the dialysis process based on the settings (specifically, the target water removal amount, water removal time, water removal speed, maximum water removal speed, etc.) that are stored and can be used in the current dialysis process.
  • the control unit 10 controls the water removal speed based on the rate of change in circulating blood volume measured by the various measuring devices 39 so that it follows the set alarm 1 line. In this way, the dialysis device 1 can perform dialysis that is gentle on the patient.
  • the control unit 10 judges whether the dialysis treatment is completed. If the dialysis treatment is completed (S33: YES), the control unit 10 proceeds to S34. On the other hand, if the dialysis treatment is not completed (S33: NO), the control unit 10 remains in this process until the dialysis treatment is completed.
  • control unit 10 (data storage processing unit 20) stores the patient dialysis status data obtained in the current dialysis process in the patient dialysis status data storage unit 32. Thereafter, the control unit 10 ends this process. In this way, the control unit 10 stores the patient dialysis status data obtained during each dialysis treatment, so that the stored patient dialysis status data can be used when setting up the next dialysis treatment.
  • the dialysis device 1 has the following advantages.
  • an alarm 1 line is set to control the change of the water removal rate based on the past patient dialysis status data of the patient to be dialysis extracted from the patient dialysis status data memory unit 32, and the set alarm 1 line and the patient dialysis status data used to set the alarm 1 line are output to the operation display panel 36.
  • the alarm 1 line is set using the patient's dialysis status data, which is the patient's past performance data, so the water removal speed for the patient can be changed based on the alarm 1 line.
  • the alarm 1 line which is one of the setting suggestion data for the dialysis device 1 for that patient, is output. Therefore, even non-expert medical personnel can set the alarm 1 line, making the setting easy.
  • the alarm 1 line is set based on the most recently stored previous patient dialysis status data as the patient's past patient dialysis status data. This makes it possible to conveniently set the alarm 1 line for any patient who has previously undergone dialysis treatment with the dialysis machine 1 at least once.
  • a correction line is generated by performing a smoothing process on the extracted patient dialysis status data during past dialysis treatment, and the generated correction line is output as a warning 1 line.
  • a correction line is generated in response to receiving a designation to perform smoothing. This allows the operator to set the alarm 1 line to a smooth line and to set the alarm 1 line according to the patient's condition. Also, by setting the alarm 1 line to a smooth line, the water removal speed can be changed smoothly.
  • the water removal speed is changed based on the changed alarm 1 line. This allows the operator to make fine adjustments or other changes to the alarm 1 line, which is set based on the patient's past dialysis status data, and allows the line to be changed according to the patient's condition before dialysis treatment begins.
  • the present invention is not limited to this embodiment, and any modifications or improvements that can achieve the object of the present invention are included in the present invention.
  • the dialysis device is described as setting an alarm 1 line based on the most recently stored previous patient dialysis status data as the patient's past patient dialysis status data, but this is not limited to this.
  • the dialysis device may set the alarm 1 line based on the average value of the patient's dialysis status data including the most recent data stored as the patient's past dialysis status data. By using the average value, even if a special circumstance occurs during dialysis treatment, the alarm 1 line can be set to level the condition.
  • the dialysis device may set the alarm 1 line based on the past patient dialysis status data with the same timing in the periodic dialysis cycle as the past patient dialysis status data of the patient.
  • the alarm 1 line is set based on the most recently stored previous patient dialysis status data for Monday.
  • the alarm 1 line can be set taking into account changes in the patient's physical condition depending on the day of the week.
  • the dialysis machine may set the alarm 1 line using a value at a specific timing of the patient dialysis status data.
  • the correction line generated by smoothing processing is output as the alarm 1 line, but the value of a specific timing of the generated correction line may be output as the alarm 1 line.
  • the value of the specific timing refers to, for example, values at 60 minutes, 120 minutes, 180 minutes, and 240 minutes from the start of dialysis.
  • the patient dialysis status data of each patient is stored in the memory unit of the dialysis machine, but this is not limiting.
  • the patient dialysis status data of each patient may be stored in a storage medium such as a USB that is detachable from the dialysis machine, so that the patient dialysis status data of the patient in question can be extracted from the storage medium even when a different dialysis machine is used.
  • the patient dialysis status data of each patient may be stored in a data storage device such as a database that is communicatively connected to the dialysis machine, so that the patient dialysis status data of the patient in question can be extracted by accessing the data storage device from the dialysis machine.
  • the setting suggestion device performs processing on the dialysis device, but this is not limiting.
  • the setting suggestion device may be a device separate from the dialysis device, in which case it is sufficient that the dialysis device is able to obtain the settings made by the setting suggestion device.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Urology & Nephrology (AREA)
  • Anesthesiology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Emergency Medicine (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention concerne un dispositif de suggestion de réglage, un dispositif de dialyse et un programme qui permettent de configurer facilement des réglages pour un dispositif de dialyse pour lequel les réglages sont compliqués. Un dispositif de dialyse (1) comprend : une unité de traitement de dialyse (19) qui fait varier le taux d'élimination de fluide en fonction de changements de transition liés au taux de changement de volume sanguin en circulation ; une unité de stockage de données d'état de dialyse de patient (32) qui stocke des données d'état de dialyse de patient en association avec des patients, les données d'état de dialyse de patient comprenant des données de transition indiquant la transition associée à chaque taux de changement de volume sanguin en circulation du patient dans au moins un traitement de dialyse ; une unité de réception de spécification de patient (11) qui reçoit une spécification d'un patient soumis à une dialyse ; une unité de réglage de ligne de seuil (14) qui définit, sur la base de données d'état de dialyse de patient passées du patient soumis à une dialyse extraite de l'unité de stockage de données d'état de dialyse de patient (32), une ligne pour une alarme 1 pour effectuer une commande pour faire varier le taux d'élimination de fluide ; et une unité de sortie de graphique de suggestion (15) qui délivre, à un panneau d'affichage d'opération (36), la ligne pour l'alarme 1 réglée par l'unité de réglage de ligne de seuil (14) et les données d'état de dialyse de patient utilisées pour régler la ligne pour l'alarme 1.
PCT/JP2023/029940 2022-11-28 2023-08-21 Dispositif de suggestion de réglage, dispositif de dialyse et programme WO2024116486A1 (fr)

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JP2022-188926 2022-11-28
JP2022188926A JP2024077090A (ja) 2022-11-28 2022-11-28 設定提案装置、透析装置及びプログラム

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004154348A (ja) * 2002-11-06 2004-06-03 Jms Co Ltd 血液透析装置およびその制御方法
WO2007055075A1 (fr) * 2005-11-11 2007-05-18 Nikkiso Company Limited Appareil et procede de dialyse sanguine
JP2015013189A (ja) * 2014-09-01 2015-01-22 株式会社ジェイ・エム・エス 血液透析監視システム
WO2020004672A1 (fr) * 2018-06-29 2020-01-02 株式会社アドバンス Terminal percutané d'hémodialyse et système d'hémodialyse individualisé
JP2022500182A (ja) * 2018-09-19 2022-01-04 フレセニウス メディカル ケア ホールディングス インコーポレーテッド 相対血液量に基づく透析のための技法
WO2022210898A1 (fr) * 2021-03-30 2022-10-06 株式会社ジェイ・エム・エス Dispositif de proposition de réglage, dispositif de dialyse, dispositif d'apprentissage, et système d'informations de dialyse

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004154348A (ja) * 2002-11-06 2004-06-03 Jms Co Ltd 血液透析装置およびその制御方法
WO2007055075A1 (fr) * 2005-11-11 2007-05-18 Nikkiso Company Limited Appareil et procede de dialyse sanguine
JP2015013189A (ja) * 2014-09-01 2015-01-22 株式会社ジェイ・エム・エス 血液透析監視システム
WO2020004672A1 (fr) * 2018-06-29 2020-01-02 株式会社アドバンス Terminal percutané d'hémodialyse et système d'hémodialyse individualisé
JP2022500182A (ja) * 2018-09-19 2022-01-04 フレセニウス メディカル ケア ホールディングス インコーポレーテッド 相対血液量に基づく透析のための技法
WO2022210898A1 (fr) * 2021-03-30 2022-10-06 株式会社ジェイ・エム・エス Dispositif de proposition de réglage, dispositif de dialyse, dispositif d'apprentissage, et système d'informations de dialyse

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