Method and apparatus for performing peritoneal ultrafiltration

Abstract

Method and apparatus for ultrafiltration of a patient being overhydrated due to congestive heart failure, comprising a cassette having four inlets/outlets. A patient tube is connected to a patient connector, intended to be connected to a patient line for access to a peritoneal cavity of the patient. The patient tube comprises a flow pump for addition and removal of a peritoneal fluid between the cassette and the peritoneal cavity. The fluid is introduced into an intermittent bag controlled by an intermittent valve and then returned the same way back to the peritoneal cavity. Glucose is metered into the fluid entering the peritoneal cavity by means of a glucose pump. Glucose is replenished continuously or intermittently for keeping a concentration of the osmotic agent substantially constant in the peritoneal cavity. After treatment, the peritoneal fluid is drained to a drain bag, wherein the drain tube comprises a drain valve and an albumin filter.

1 . An apparatus for ultrafiltration of a patient, comprising:
 a patient tube configured to be connected to a patient line for access to a peritoneal fluid in a peritoneal cavity of the patient,   a flow pump;   an intermittent bag configured for receiving a portion of said peritoneal fluid, said portion of said peritoneal fluid being removed from the peritoneal cavity using said patient tube by said flow pump and said portion of said peritoneal fluid being returned to the peritoneal cavity using said patient tube by said flow pump;   a glucose tube for connection of a glucose bag configured to provide concentrated glucose to said portion of said peritoneal fluid before or during being returned to the peritoneal cavity, whereby the concentrated glucose is diluted in said portion of said peritoneal fluid;   whereby the apparatus is configured to replenish glucose to said portion of said peritoneal fluid being returned to the peritoneal cavity to maintain a concentration of glucose substantially constant in the peritoneal cavity; wherein   the apparatus is arranged without any adsorbent material.   
     
     
         2 . The apparatus according to  claim 1 , further comprising:
 a glucose pump arranged in said glucose tube and configured for pumping concentrated glucose to said portion of said peritoneal fluid.   
     
     
         3 . The apparatus according to  claim 1 , further comprising:
 a mixing space having a first port connected to said glucose tube for adding concentrated glucose to said space; and a second port connected to said intermittent bag and a third port connected to said patient tube for removing and returning said portion of said peritoneal fluid between the intermittent bag and the mixing space and the peritoneal cavity.   
     
     
         4 . The apparatus according to  claim 1 , wherein the intermittent bag is smaller than 200 ml. 
     
     
         5 . The apparatus according to  claim 4 , wherein the intermittent bag is 160 ml. 
     
     
         6 . The apparatus according to  claim 1 , wherein said mixing space comprises:
 a cassette having first, second, third and fourth ports; wherein   said patient tube is connected to said first port;   said intermittent bag is connected to said second port via an intermittent tube;   a drain tube is connected to said third port, said drain tube being arranged for connection to a drain bag,   said glucose tube is connected to said fourth port.   
     
     
         7 . An apparatus for ultrafiltration of a patient, comprising:
 a patient tube configured to be connected to a patient line for access to a peritoneal fluid in a peritoneal cavity of the patient,   a flow pump;   an intermittent bag configured for receiving a portion of said peritoneal fluid, said portion of said peritoneal fluid being removed from the peritoneal cavity using said patient tube by said flow pump and said portion of said peritoneal fluid being returned to the peritoneal cavity using said patient tube by said flow pump;   a glucose tube for connection of a glucose bag configured to provide concentrated glucose to said portion of said peritoneal fluid before or during being returned to the peritoneal cavity, whereby the concentrated glucose is diluted in said portion of said peritoneal fluid;   whereby the apparatus is configured to replenish glucose to said portion of said peritoneal fluid being returned to the peritoneal cavity to maintain a concentration of glucose substantially constant in the peritoneal cavity; and wherein   the apparatus is arranged without any dialyzer.   
     
     
         8 . The apparatus according to  claim 7 , further comprising:
 a glucose pump arranged in said glucose tube and configured for pumping concentrated glucose to said portion of said peritoneal fluid.   
     
     
         9 . The apparatus according to  claim 7 , further comprising:
 a mixing space having a first port connected to said glucose tube for adding concentrated glucose to said mixing space; and a second port connected to said intermittent bag and a third port connected to said patient tube for removing and returning said portion of said peritoneal fluid between the intermittent bag and the mixing space and the peritoneal cavity.   
     
     
         10 . The apparatus according to  claim 7 , wherein the intermittent bag is smaller than 200 ml. 
     
     
         11 . The apparatus according to  claim 10 , wherein the intermittent bag is 160 ml. 
     
     
         12 . The apparatus according to  claim 7 , wherein said mixing space comprises:
 a cassette having first, second, third and fourth ports; wherein   said patient tube is connected to said first port;   said intermittent bag is connected to said second port via an intermittent tube;   a drain tube is connected to said third port, said drain tube being arranged for connection to a drain bag;   said glucose tube is connected to said fourth port.   
     
     
         13 . A method for ultrafiltration of a patient, which patient has a peritoneal fluid in a peritoneal cavity, comprising:
 removing a portion of said peritoneal fluid from peritoneal cavity to an intermittent bag by a flow pump;   subsequent to said removing, returning said portion of said peritoneal fluid to said peritoneal cavity from said intermittent bag;   before or during returning of said portion of said peritoneal fluid, adding concentrated glucose to said portion of said peritoneal fluid for dilution of said concentrated glucose in said portion of said peritoneal fluid;   repeating said removing and returning of said portion of said peritoneal fluid and said adding of concentrated glucose intermittently, whereby the glucose is diluted and replenished intermittently;   wherein the removed portion of said peritoneal fluid and the returned portion of said peritoneal fluid pass through a flow path, which is free from adsorbent materials.   
     
     
         14 . The method according to  claim 13 , further comprising:
 repeating said removing and returning of said portion of said peritoneal fluid and said adding of concentrated glucose intermittently with a period of not greater than 60 minutes, whereby the glucose is diluted and replenished intermittently.   
     
     
         15 . The method according to  claim 13 , further comprising:
 removal of said portion of said peritoneal fluid during a removal period;   returning of said portion of said peritoneal fluid with added concentrated glucose during a returning period   stopping the flow pump during a stop period;   whereby said removal period and said returning period and said stop period forms a replenishment period;   repeating said removing step, returning step and stopping step;   whereby said stop period is between 0 and 50 minutes.   
     
     
         16 . A method for ultrafiltration of a patient, which patient has a peritoneal fluid in a peritoneal cavity, comprising:
 removing a portion of said peritoneal fluid from the peritoneal cavity to an intermittent bag by a flow pump;   subsequent to said removing, returning said portion of said peritoneal fluid to said peritoneal cavity from said intermittent bag;   before or during returning of said portion of said peritoneal fluid, adding concentrated glucose to said portion of said peritoneal fluid for dilution of said concentrated glucose in said portion of said peritoneal fluid;   wherein the removed portion of said peritoneal fluid and the returned portion of said peritoneal fluid pass through flow paths, which are free from dialyzers.   
     
     
         17 . The method according to  claim 16 , further comprising:
 repeating said removing and returning of said portion of said peritoneal fluid and said adding of concentrated glucose intermittently with a period of not greater than 60 minutes, whereby the glucose is diluted and replenished intermittently.   
     
     
         18 . The method according to  claim 16 , further comprising:
 removal of said portion of said peritoneal fluid during a removal period;   returning of said portion of said peritoneal fluid with added concentrated glucose during a returning period   stopping the flow pump during a stop period;   whereby said removal period and said returning period and said stop period forms a replenishment period;   repeating said removing step, returning step and stopping step;   whereby said stop period is between 0 and 50 minutes.