Fluid diverting device of an apparatus for extracorporeal treatment of blood and blood set provided with the fluid diverting device

Abstract

A fluid diverting device of an apparatus for extracorporeal treatment of blood, configured to be placed in series between a main portion (22) of the apparatus (1) and a vascular access of a patient (P) and comprising a substantially H-shaped conduit assembly comprising an extraction conduit (23), a return conduit (24) and at least one bridging conduit (25, 125) connecting the extraction conduit (23) to the return conduit (24). The extraction conduit (23) is connectable upstream and downstream to an extraction line (6) of the apparatus (1), and the return conduit (24) is connectable upstream and downstream to a return line (7) of the apparatus (1). A plurality of valves (26, 27, 28, 29, 30, 32) or distributors (201, 202) operate on the extraction conduit (23), the return conduit (24) and the at least one bridging conduit (25) and are configured to divert the flow of liquid and / or blood without disconnecting the patient (P).

Description

Technical Field

[0001] The present invention relates to a fluid diverting device of an apparatus for extracorporeal treatment of blood, and to a blood set of an apparatus for extracorporeal treatment of blood provided with the fluid diverting device.

[0002] Extracorporeal blood therapy involves removing blood from a patient, treating the blood outside the patient's body, and returning the treated blood to the patient. Extracorporeal blood therapy is often used to extract undesirable substances or molecules from a patient's blood and add desired substances or molecules to the blood. Extracorporeal blood therapy is used for patients who cannot effectively remove substances from their blood, such as when the patient has temporary or permanent kidney failure. For example, these and other patients may undergo extracorporeal blood therapy to add or remove substances from their blood, to maintain acid / base balance or to remove excess body fluids, or to perform an extracorporeal gas exchange process.

[0003] For example, in hemodialysis treatment, the patient's blood and a treatment liquid that is roughly isotonic with the blood flow circulate in the corresponding compartments of the hemodialyzer so that impurities and undesirable substances (urea, creatinine, etc.) present in the blood can migrate from the blood to the treatment liquid by diffusion transfer. The ion concentration of the treatment liquid is selected so as to correct the ion concentration of the patient's blood. In treatment by hemodiafiltration, the convective transfer by ultrafiltration caused by the positive pressure difference generated between the blood side and the treatment liquid side of the membrane of the hemodiafiltration filter is added to the diffusion transfer obtained by dialysis. Hemoperfusion, oxygenation or decarboxylation treatment are also known.

[0004] The vascular access is used to remove the patient's blood, pass it through a blood treatment unit (dialyser, filter) and then return it to the patient. In the case of long-term treatment, the vascular access may be arteriovenous. Two needles can be inserted into the vein, one for withdrawing the blood and one for returning the blood. The orientation of the needles takes into account the normal flow of blood. The "arterial" needle withdraws blood from an "upstream" position, while the "venous" needle returns the blood "downstream". In the case of acute treatment, the vascular access may be veno-venous, i.e. using a double-lumen catheter inserted into a central vein. The blood treatment unit comprises a pressure monitoring device in order to check, for example, for blockages in the circuit. Background Art

[0005] In the field of extracorporeal blood treatment and therapy, some of the problems reported by users are problems at the vascular access site.

[0006] Access Extremely Negative (AEN) is one of the most common alarms in this field and is primarily related to a catheter tip stuck in the vessel wall or, more rarely, a clot blocking the catheter access. When this alarm is associated with catheter positioning within the vein, the nurse must restore the access pressure to closer to atmospheric levels, for example, by using a Y-connector connected to the access line, remove the catheter tip from the vein wall, and then attempt to move the catheter within the vein and resume treatment.

[0007] Another disadvantage is that at the end of treatment, when the blood is to be returned to the patient, one operator must disconnect the patient's access and connect the saline bag to the inlet line of the kit under sterile conditions, while another operator must operate the machine's monitor under non-sterile conditions. Thus, two operators are required for each patient.

[0008] Another disadvantage is that, according to the blood return described above, both saline and blood recirculation procedures currently require sterile and non-sterile intervention and manual connection of auxiliary devices (Y-connectors, saline bags).

[0009] In all of the scenarios detailed above, the operator must manipulate the vascular access to disconnect and ultimately reconnect it to the patient. All of this means increased operator workload and the potential for non-sterile handling.

[0010] Furthermore, the use of a Y-connector connected to the access line involves additional risks. On the access side, the user may forget to clamp the Y-shaped saline line before resuming treatment. In the event of a blood pump stoppage and a slightly negative patient access pressure, the contents of the saline bag will be drawn into the catheter, leading to air ingress and thus coagulation (or potential air embolism).

[0011] Additional modules are also known that are configured to be placed in-line between a blood treatment device and a patient's vascular access and that are configured to divert blood flow without having to disconnect the patient.

[0012] For example, US Pat. No. 3,626,938 discloses a diverter valve device designed to be permanently mounted on a human body part and permanently connected to a human artery and vein. The device is provided with valve means for selectively connecting the artery and vein to an artificial kidney, etc. The device also has a rotating diverter for redirecting blood flow back to the body part when the device is not operatively connected to the artificial kidney.

[0013] Document US 5,894,011 discloses a device for selectively controlling the direction of blood flow in and out of a patient during hemodialysis. The device includes two interlocking discs that rotate relative to each other without separation. The two discs have fluid fittings that allow the blood line attached to the patient to be connected to one of the discs, and allow the blood inlet and outlet of the hemodialysis machine to be connected to the other disc. The center of each fluid fitting is a channel aligned with the corresponding channel in the other disc. The disc rotates between two fixed relative positions, referred to herein as preferred alignment. This preferred alignment causes the line that extracts blood from the patient in a first preferred alignment to become the line that returns blood to the patient in a second preferred alignment, and the line that returns blood to the patient in the first preferred alignment to become the line that extracts blood from the patient in a second preferred alignment. When the device is not in any one of its two preferred alignments, the bypass channel allows blood to flow from the outlet of the hemodialysis machine to the inlet.

[0014] These devices allow for a limited number of flow path configurations and, due to their construction and piping geometry, may result in pressure drops and / or condensation.

[0015] Therefore, one object of the present invention is to provide a fluid diverting device of an apparatus for extracorporeal treatment of blood, wherein the fluid diverting device is configured to divert the flow of blood or other fluid so that multiple processes (e.g., all steps of treatment, pre-treatment and post-treatment as well as possible troubleshooting processes) can be performed without having to disconnect the patient.

[0016] An object of the present invention is to provide a fluid diverting device that can be easily inserted between an apparatus for extracorporeal treatment of blood and a patient, has various functional components, and can be set in various configurations to perform a variety of procedures.

[0017] In particular, it is an object of the present invention to provide a fluid diverting device that can provide easy and safe AEN troubleshooting, blood return at the treatment end, blood recirculation, saline recirculation.

[0018] Another object is to provide a fluid diverting device that allows its configuration to be controlled in an automated manner.

[0019] Another object of the present invention is to provide a fluid diverting device that can provide device features as a supplementary option on equipment.

[0020] Another object is to provide a fluid diverting device that allows a single person to manage a patient's vascular access in a safe manner under sterile conditions.

[0021] Another object is to provide a fluid diverting device which offers the possibility to conveniently position some commands near the patient access.

[0022] Another object is to provide a fluid diverting device which provides the possibility to operate the sterilization process under aseptic conditions.

[0023] Another object is to provide a fluid diverting device that is structurally simple, cost-effective, and reliable.

[0024] Another object is to provide a fluid diverting device that prevents condensation and / or avoids loss of high pressure and / or requires a minimum amount of fluid to flush the fluid diverting device. Summary of the Invention

[0025] At least one of the above objects is substantially achieved by a fluid diverting device of an apparatus for extracorporeal treatment of blood and an apparatus for extracorporeal treatment of blood according to one or more of the appended claims.

[0026] The following describes a fluid diverting device of an apparatus for extracorporeal treatment of blood, an apparatus for extracorporeal treatment of blood, and a method for diverting liquid and / or blood flow in an apparatus for extracorporeal treatment of blood according to various aspects of the present invention and capable of achieving one or more of the above-mentioned purposes.

[0027] A first aspect relates to a fluid diverting device for an apparatus for extracorporeal treatment of blood. The fluid diverting device is configured to be placed in series between a blood collection set of the apparatus for extracorporeal treatment of blood and a patient's vascular access. The fluid diverting device comprises: a substantially H-shaped catheter assembly comprising an extraction catheter, a return catheter, and at least one bridging catheter, the at least one bridging catheter connecting the extraction catheter to the return catheter or being configured to connect the extraction catheter to the return catheter, wherein the extraction catheter is connected or connectable to the extraction line of the blood collection set upstream and downstream, and wherein the return catheter is connected or connectable to the return line of the blood collection set upstream and downstream; and a plurality of valves or distributors operating on the extraction catheter and / or the return catheter and / or the at least one bridging catheter and configured to divert the flow of liquid and / or blood without disconnecting the patient.

[0028] A second aspect relates to a blood kit for an apparatus for extracorporeal treatment of blood, comprising: a blood treatment unit; an extracorporeal blood circuit coupled to the blood treatment unit and including a blood extraction line and a blood return line connectable to a patient's vascular access; and a fluid diverting device according to the first aspect or one or more of the following aspects, wherein the fluid diverting device is placed or configured to be placed in series between the main portion of the blood kit of the apparatus for extracorporeal treatment of blood and the patient's vascular access. The apparatus includes a blood pump configured to be coupled to a pump section of the extracorporeal blood circuit.

[0029] In another independent aspect, there is provided an apparatus for extracorporeal treatment of blood comprising the blood kit of the preceding aspect.

[0030] A third aspect relates to a method for diverting liquid and / or blood flow in an apparatus for extracorporeal treatment of blood without disconnecting the patient, comprising: placing a fluid diverting device in series between the apparatus for extracorporeal treatment of blood and the patient's vascular access, wherein the fluid diverting device is a fluid diverting device according to the aforementioned first aspect or one or more of the following aspects.

[0031] In a 4th aspect according to any one of the preceding aspects, the extraction conduit is substantially parallel to the return conduit.

[0032] In a 5th aspect according to any of the preceding aspects, the bridging conduit is at least partially transverse, optionally perpendicular, to the extraction conduit and the return conduit.

[0033] In a 6th aspect according to the previous aspect, the extraction conduit and / or the return conduit and / or the bridging conduit is a tube, optionally made of plastic, optionally at least partially straight.

[0034] In a 7th aspect according to any of the preceding aspects, the plurality of valves includes at least one extraction valve operating on the extraction conduit, at least one return valve operating on the return conduit, and at least one bridge valve operating on the bridge conduit.

[0035] In an 8th aspect according to any one of the preceding aspects, the valves of the plurality of valves are clamps or clips, optionally at least one of the plurality of valves is a rotating clamp or clip.

[0036] In aspect 8 bis according to the previous aspect, the rotating jig or clamp includes a rotating body and an abutment element.

[0037] In aspect 8 / 3 according to the previous aspect, the rotating body can rotate between a clamping position (valve closed) and a release position, in which the rotating element approaches the abutment element to close the portion of the pipe between the rotating element and the abutment element, and in the release position, the rotating element is spaced apart from the abutment element (valve open) to open the portion of the pipe.

[0038] In aspect 8 out 4 according to the previous aspect, at least two valves of the plurality of valves include a common rotating body and corresponding abutment elements.The one rotating body and the two abutment elements define two valves.

[0039] In the 8th fifth aspect according to the previous aspect, the rotating body is rotatable between the following positions:

[0040] a first clamping position (one of the two valves closed and the other open) in which the rotating element approaches one of the two abutment elements so as to close the portion of the pipe between said rotating element and said abutment element;

[0041] a second clamping position (one of the two valves closed and the other open), in which the rotary element approaches the other of the two abutment elements to close the portion of the other pipe between said rotary element and said abutment element;

[0042] A released position in which the rotating element is spaced apart from the abutment element (both valves are open) to open the two parts of the tube.

[0043] In a 9th aspect according to the aforementioned aspect 7 or 8, the at least one extraction valve comprises a first extraction valve and a second extraction valve operating on the extraction conduit.

[0044] In a 10th aspect according to the aforementioned aspect 9, the first extraction valve and the second extraction valve are placed on opposite sides with respect to a junction of the bridging conduit and the extraction conduit.

[0045] In an 11th aspect according to the aforementioned aspect 9 or 10, the first extraction valve is placed upstream of the junction of the bridging conduit and the extraction conduit with respect to the blood flow during treatment.

[0046] In a 12th aspect according to the aforementioned aspect 9, 10 or 11, the second extraction valve is placed downstream of the junction of the bridging conduit and the extraction conduit with respect to the blood flow during treatment.

[0047] In a 13th aspect according to aspect 7 or any one of the foregoing aspects 8 to 12 when according to aspect 7, the return valve is placed downstream of the junction of the bridging conduit and the return conduit relative to blood flow during treatment.

[0048] In a 14th aspect according to aspect 7 or any one of the aforementioned aspects 8 to 12 when according to aspect 7, the return valve comprises a first return valve and a second return valve operating on the return conduit.

[0049] In a 15th aspect according to the aforementioned aspect 14, the first return valve and the second return valve are placed on opposite sides with respect to a junction of the bridging conduit and the return pipe.

[0050] In a 16th aspect according to the aforementioned aspect 14 or 15, the first return valve is placed downstream of the junction of the bridging conduit and the return conduit with respect to the blood flow during treatment.

[0051] In a 17th aspect according to the aforementioned aspect 14, 15 or 16, the second return valve is placed upstream of the junction of the bridging conduit and the return conduit with respect to the blood flow during treatment.

[0052] In an 18th aspect according to aspect 7 or any one of the aforementioned aspects 8 to 17 when according to aspect 7, the at least one bridge valve comprises a first bridge valve and a second bridge valve operating on the bridge conduit.

[0053] In a 19th aspect according to the aforementioned aspect 18, the first bridge valve is placed closer to the return conduit than the second bridge valve, and the second bridge valve is placed closer to the extraction conduit than the first bridge valve.

[0054] In a 20th aspect according to aspect 18 or 19, the bridging conduit has an entry point located between the first bridging valve and the second bridging valve and adapted to be connected to a liquid source; optionally, the entry point comprises an entry valve.

[0055] In aspect 20 bis according to any one of aspects 18 to 20 and aspect 20 bis according to any one of aspects 8 to 8 quinquies, the first bridge valve and the return valve comprise a common rotating body and respective abutment elements.

[0056] In aspect 20 ter according to any one of aspects 18 to 20 and aspect 20 ter according to any one of aspects 8 to 11, the second bridge valve and the first extraction valve comprise a common rotating body and respective abutment elements.

[0057] In a 21st aspect according to the aforementioned aspect 20, the liquid source is a saline source.

[0058] In a 22nd aspect according to the aforementioned aspect 20 or 21, the liquid source is a syringe of, for example, 50 mL, or a bag of, for example, 500 mL.

[0059] In a 23rd aspect according to the previous aspect 20 or 21 or 22, the fluid diverting device comprises a liquid source connected or connectable to the access point, optionally a syringe or a bag.

[0060] In aspect 24 according to any one of aspects 1 to 23 above, the fluid diverting device includes a holder configured to hold a substantially H-shaped catheter assembly and multiple valves, optionally having a seat to accommodate the substantially H-shaped catheter assembly and multiple valves.

[0061] In aspect 25 according to aspect 24 above, when aspect 24 is according to aspect 22 or 23, the holder is configured to hold a liquid source, optionally a syringe or a bag, optionally the holder has a seat to accommodate the liquid source, optionally a syringe or a bag; optionally, the holder includes a device for pressurizing the liquid source, optionally a syringe, such as a spring or an actuator, or a bag.

[0062] In a 26th aspect according to any one of the preceding aspects 1 to 25, the fluid diverting device is at least partially disposable.

[0063] In aspect 26 bis according to any one of the preceding aspects 1 to 25, the fluid diverting device is an add-on module.

[0064] In aspect 26 ter according to any one of the preceding aspects 1 to 26, the fluid diverting device is placed on a main part of the apparatus for extracorporeal treatment of blood.

[0065] In aspect 26-quater according to the previous aspect, the fluid diverting device is placed on one side of the main part.

[0066] In aspect 26 of 5 according to the previous aspect, the main part includes at least a housing for a control unit, a control unit, a user interface, a blood pump, an outflow pump, a dialysis fluid pump, an infusion pump and a device for mounting a disposable kit (including a blood treatment unit, an extracorporeal blood circuit, an infusion circuit and a fluid circuit) to the main part.

[0067] In aspect 27 according to any one of aspects 8 to 26 of the previous aspect 7 or aspects 8 to 26 of the previous aspect 7, the plurality of valves are configured to be arranged in at least a therapeutic configuration, in which the at least one extraction valve and the at least one return valve are opened, and the at least one bridging valve is closed, to perform treatment of the patient.

[0068] In aspect 28 according to aspect 9 or any one of aspects 10 to 27 when according to aspect 9, the multiple valves are configured to be arranged in at least a recirculation configuration, in which the return valve is closed, the first extraction valve is closed, the second extraction valve is open, and the at least one bridging valve is open, so that blood or liquid is recirculated in the blood treatment unit of the device without disconnecting the patient.

[0069] In aspect 29 according to aspect 18 or any one of aspects 19 to 28 when according to aspect 18, the multiple valves are configured to be arranged in a return branch flush configuration, in which the first bridging valve is open, the second bridging valve is closed, and a liquid source is connected to the access point to inject liquid and flush the branch of the return catheter placed downstream of the junction of the bridging catheter and the return catheter, and optionally flush the catheter at the patient's vascular access.

[0070] In aspect 30 according to aspect 29 above, in the return branch flush configuration, the monitoring valve on the blood return line (located between the device and the fluid diverting device) is closed, or when aspect 18 is according to aspect 14, the second return valve is closed; wherein the first extraction valve, the second extraction valve, the return valve (or the first return valve) and the inlet valve are opened.

[0071] In aspect 31 according to aspect 18 or any one of aspects 19 to 30 when according to aspect 18, the plurality of valves are configured to be arranged in an extraction branch flush configuration, in which the first bridging valve is closed, the second bridging valve is opened, and a liquid source is connected to the access point to inject liquid and flush the branch of the extraction catheter placed upstream of the junction of the bridging catheter and the extraction catheter, and optionally flush the catheter at the patient's vascular access.

[0072] In a 32nd aspect according to the aforementioned aspect 31, in the extraction branch flush configuration, the second extraction valve is closed.

[0073] In aspect 33 according to any one of aspects 1 to 32 above, a valve or a dispenser among the plurality of valves is operably connected or connectable to a control unit, which control unit is optionally a control unit of an apparatus for extracorporeal treatment of blood, and / or the fluid diverting device comprises a control unit operably connected to the plurality of valves or dispensers; the control unit is configured to command, optionally automatically command, the configuration of the plurality of valves or dispensers.

[0074] In a 34th aspect according to the aforementioned aspect 33, the fluid diverting device is connected or configured to be connected to a control unit of the apparatus for extracorporeal treatment of blood, optionally by wired or wireless communication.

[0075] In a 35th aspect according to any one of the previous aspects 1 to 34, the fluid diverting device comprises a power source or a power source connected to an apparatus for extracorporeal treatment of blood.

[0076] In aspect 36 according to any one of the preceding aspects 1 to 35, the fluid diverting device comprises an attachment device configured to optionally removably mount the fluid diverting device to, for example, the patient's clothing or the patient's bed or a main part of an apparatus for extracorporeal treatment of blood.

[0077] In a 37th aspect according to any one of the previous aspects 1 to 36, the fluid diverting device comprises a quick connector (optionally a Luer connector) placed at the ends of the extraction conduit and the return conduit.

[0078] In a 38th aspect according to any one of the previous aspects 1 to 36, the fluid diverting device comprises a further access point on the return catheter, eg for calcium infusion.

[0079] In aspect 39 according to any one of aspects 1 to 37 above, the fluid diverting device comprises at least one sensor, at least one sensor acting on the H-shaped catheter assembly, optionally acting on the return catheter and / or the extraction catheter and / or the bridging catheter; at least one sensor is connected to or configured to be connected to an apparatus for extracorporeal treatment of blood or a control unit of the fluid diverting device; the at least one sensor may be a pressure sensor, a flow meter, an air detector.

[0080] In a 40th aspect according to one or more of the preceding aspects 7 to 23, the control unit of the apparatus for extracorporeal treatment of blood or the fluid diverting device is configured to command the execution of a task for diverting a liquid and / or blood flow, the task or the method for diverting a liquid and / or blood flow comprising the following steps:

[0081] - keeping the at least one extraction valve (optionally the first extraction valve and the second extraction valve) and the at least one return valve open, and keeping the at least one bridge valve (optionally the first bridge valve and the second bridge valve) closed, to perform treatment of the patient;

[0082] - Optionally, periodically opening the first and second bridge valves and the inlet valve to flush with fluid and prevent condensation, or periodically opening the first and second bridge valves while the inlet valve is closed to create a short recirculation and prevent condensation.

[0083] In a 41st aspect according to the preceding aspects, said task or method for diverting a fluid and / or blood flow in case of an access extreme negative (AEN) alarm comprises the following steps:

[0084] - Stop the blood pump;

[0085] - optionally, opening the second bridge valve and the inlet valve to enable suction of liquid from the liquid source until the line pressure reaches approximately atmospheric level, or opening the first bridge valve and the second bridge valve to form a connection between the extraction conduit and the return conduit and normalize the pressure; and then

[0086] - keeping the first bridging valve closed, closing the second extraction valve and keeping the access valve, second bridging valve and first extraction valve open to allow fluid from the fluid source to flush back through the patient's vascular access, thereby dislodging the catheter tip from the vessel wall.

[0087] In a 42nd aspect according to the aforementioned aspect 40, said task or method for diverting a liquid flow and / or a blood flow comprises the following steps:

[0088] - optionally, while the return valve is open and the second bridge valve is closed, opening the first bridge valve and the inlet valve and closing the first and second extraction valves and the monitoring valve on the blood return line (located between the device and the fluid diverting device) to flush at least a portion of the return conduit with liquid;

[0089] - optionally, closing the first bridge valve and the second extraction valve and opening the second bridge valve while the return valve, the inlet valve and the first extraction valve are open, in order to flush at least a portion of the extraction conduit with liquid;

[0090] - Closing the return valve, the first extraction valve and the inlet valve and opening the second extraction valve simultaneously with the opening of the first and second bridge valves, in order to recirculate the blood in the blood treatment unit of the device.

[0091] In a 43rd aspect according to the aforementioned aspect 40, said task or method for diverting a liquid flow and / or a blood flow comprises the following steps:

[0092] - closing the first extraction valve and opening the second bridge valve and the inlet valve simultaneously with the opening of the return valve and the second extraction valve;

[0093] -Pump fluid until all blood is returned to the patient;

[0094] - Closing the return valve and opening the first bridging valve to recirculate the liquid in the blood treatment unit of the device while the second bridging valve is open, the second extraction valve is open and the first extraction valve is closed.

[0095] In a 44th aspect according to any one of the aforementioned aspects 1 to 43, the blood treatment unit includes a main chamber and a secondary chamber separated by a semipermeable membrane, wherein the blood extraction line is connected to the inlet of the main chamber and the blood return line is connected to the outlet of the main chamber. In particular, the blood treatment unit is part of a blood kit of the device.

[0096] In a 45th aspect according to the aforementioned aspect 44, the outflow fluid line is connected to the outlet of the secondary chamber, and the dialysis fluid line is connected to the inlet of the secondary chamber and to the dialysis fluid source.

[0097] In aspect 45 bis, an infusion circuit comprising one or more infusion lines of a replacement fluid is connected to the extracorporeal blood circuit. In particular, the outflow fluid line and the infusion circuit are part of a blood set of the device.

[0098] In aspect 45 ter according to aspect 45 bis and aspect 20, at least one infusion line is connected to the access point and, optionally, an infusion fluid container is connected to the infusion line.The liquid source may be an infusion fluid container.

[0099] In aspect 45a-4 according to aspect 45a-3, the infusion pump operates on the infusion line.

[0100] In aspect 45 quinquies according to aspect 45 ter, the at least one infusion line comprises an infusion line connected to a blood extraction line between the blood pump and the treatment unit.

[0101] In aspect 45-6 according to aspect 45-3, at least one infusion line includes a pre-blood pump infusion line connected to an entry point of the fluid diverting device and / or to a blood extraction line between the vascular access and the fluid diverting device.

[0102] In aspect 45-7 according to aspect 45-5 and / or 45-60, the infusion pump is operated on the infusion line and / or the infusion pump is operated on the infusion line before the blood pump.

[0103] In aspect 45 / 8 according to aspect 45 / 6 and / or aspect 45 / 7, at least one infusion valve operates on the blood pump pre-infusion line; optionally, a first infusion valve or an inlet valve and a second infusion valve; optionally, the inlet valve is placed upstream of the branch of the blood pump pre-infusion line connected to the entry point of the fluid diverting device; optionally, the second infusion valve is placed downstream of the branch of the blood pump pre-infusion line connected to the entry point of the fluid diverting device.

[0104] In aspect 45 ninth according to the preceding aspect, aspects 9 to 12 and aspects 8 to 8 quinquies, the second extraction valve and the first infusion valve or inlet valve comprise a common rotating body and respective abutment elements.

[0105] In aspect 45 deces according to aspect 45 nines and aspects 8 to 8 fenes, the second infusion valve is a rotating clamp or clip, optionally comprising a common rotating body and an abutment element.

[0106] In aspect 45 of eleven according to any one of aspects 9 to 12, the auxiliary extraction valve operates on the extraction conduit, wherein the auxiliary extraction valve is positioned downstream of the first extraction valve with respect to blood flow during treatment.

[0107] In aspect 45-12 according to aspects 45-eight and 45-eleven, the auxiliary extraction valve and the second infusion valve include a common rotating body and corresponding abutment elements.

[0108] In a 46th aspect according to any one of the preceding aspects 1 to 45, each of the blood withdrawal line and the blood return line has a respective end connector configured to be connected to a patient's vascular access.

[0109] In a 47th aspect according to any one of the aforementioned aspects 1 to 46, each of the extraction conduit and the return conduit has a corresponding end mating connector, which is configured to connect to the corresponding end connectors of the blood extraction line and the blood return line, or to connect with the corresponding end connectors of the blood extraction line and the blood return line.

[0110] In a 48th aspect according to any one of the preceding aspects 1 to 47, each of the extraction catheter and the return catheter has a corresponding end connector, which is configured to be connected to a corresponding end mating connector of the patient's vascular access, or to be connected with a corresponding end mating connector of the patient's vascular access.

[0111] In a 49th aspect according to any one of the previous aspects 1 to 48, the auxiliary bridging conduit connects the extraction conduit to the return conduit or is configured to connect the extraction conduit to the return conduit.

[0112] In a 50th aspect according to the aforementioned aspect 49, the auxiliary bridging conduit is arranged in parallel with the bridging conduit.

[0113] In aspect 50 bis according to aspect 49 or 50, the auxiliary bridging conduit is connected to the extraction conduit upstream of the bridging conduit and to the return conduit downstream of the bridging conduit with respect to blood flow during treatment.

[0114] In a 51st aspect according to the aforementioned aspect 49 or 50, an auxiliary pump is operated on the auxiliary bridging catheter, wherein the auxiliary pump is configured at least to recirculate blood on the patient side.

[0115] In a 52nd aspect according to the previous aspect 49, 50 or 51, the auxiliary extraction valve operates on the extraction conduit and the auxiliary return valve operates on the return conduit.

[0116] In aspect 52-2 according to aspect 52 above, the auxiliary extraction valve is placed upstream of the connection point of the auxiliary bridging catheter to the extraction catheter, and the auxiliary return valve is placed downstream of the connection point of the auxiliary bridging catheter to the return catheter, relative to the blood flow during treatment.

[0117] In a 53rd aspect according to the aforementioned aspect 52, the auxiliary extraction valve is placed upstream of the first extraction valve with respect to blood flow during treatment; and the auxiliary return valve is placed downstream of the return valve with respect to blood flow during treatment.

[0118] In a 54th aspect according to any one of the previous aspects 49 to 53, the first auxiliary bridge valve and the second auxiliary bridge valve operate on the auxiliary bridge conduit.

[0119] In a 55th aspect according to aspect 54, when aspect 54 is according to aspect 51, the first auxiliary bridge valve and the second auxiliary bridge valve are placed on opposite sides with respect to the auxiliary pump.

[0120] In a 56th aspect according to aspects 52 and 54 and aspects 8bis to 8fen, the auxiliary extraction valve and the second auxiliary bridge valve comprise a common rotating body and respective abutment elements.

[0121] In the 57th aspect according to aspects 52 and 54 and aspects 8 bis to 8 pentez, the auxiliary return valve and the first auxiliary bridge valve comprise a common rotating body and corresponding abutment elements.

[0122] In a 58th aspect according to aspects 52 and 54, when aspects 52 and 54 are according to aspects 29, 30 or 31, 32, in the extraction branch flushing configuration and / or the return branch flushing configuration, the auxiliary extraction valve and the auxiliary return valve are opened, and the first auxiliary bridge valve and the second auxiliary bridge valve are closed.

[0123] In a 59th aspect according to aspects 52 and 54, when aspects 52 and 54 are according to aspect 28 or 29, in the recirculation configuration, the auxiliary extraction valve and the auxiliary return valve are open, and the first auxiliary bridge valve and the second auxiliary bridge valve are open.

[0124] In a 60th aspect according to the aforementioned aspect 59, when aspects 52 and 54 are according to aspect 51, in the recirculation configuration, the auxiliary pump operates to recirculate blood on the patient side.

[0125] In a 61st aspect according to any one of the preceding aspects 49, 50 or 51, when aspect 49, 50 or 51 is according to any one of aspects 1 to 6, the first distributor is operably coupled to the extraction conduit, the bridging conduit and the auxiliary bridging conduit.

[0126] In a 62nd aspect according to the aforementioned aspect 61, the second distributor is operatively coupled to the return conduit, the bridge conduit and the auxiliary bridge conduit.

[0127] In a 63rd aspect according to aspects 61 and 62, the first distributor and the second distributor are movable between a first configuration corresponding to a treatment configuration and a second configuration corresponding to a recirculation configuration.

[0128] In a 64th aspect according to aspect 63, in a first configuration, the extraction conduit defines a continuous channel connected to the extraction line, the return conduit defines a continuous channel connected to the return line, and the bridging conduit together with the auxiliary bridging conduit defines a closed loop disconnected from the extraction line and the return line.

[0129] In aspect 65 according to aspect 63 or 64, in the second configuration, the bridging conduit defines a closed loop with the blood treatment unit for recirculating blood in the blood treatment unit, and the auxiliary bridging conduit defines a closed loop connected to the access device for recirculating blood on the patient side.

[0130] In a 66th aspect according to the aforementioned aspect 65, each of the first distributor and the second distributor includes a rotating element provided with a through-channel configured to communicate with a branch of the extraction duct or the return duct and with the bridging duct and the auxiliary bridging duct.

[0131] In a 67th aspect according to the aforementioned aspect 66, the through-channel includes a first through-channel and a second through-channel.

[0132] In a 68th aspect according to the aforementioned aspect 67, in the first configuration, the first through channel of the first distributor connects the first and second branches of the extraction conduit, and the second through channel of the first distributor connects the bridging conduit to the auxiliary bridging conduit.

[0133] In a 69th aspect according to any one of the previous aspects 67 and 68, in the first configuration, the first through channel of the second distributor connects the first branch and the second branch of the return duct, and the second through channel of the second distributor connects the bridging duct to the auxiliary bridging duct.

[0134] In a 70th aspect according to any one of the aforementioned aspects 67 to 69, in the second configuration, the first through-channel of the first distributor connects the first branch of the extraction conduit to the auxiliary bridging conduit, and the second through-channel of the first distributor connects the second branch of the extraction conduit to the bridging conduit.

[0135] In aspect 71 according to any one of aspects 67 to 70, in the second configuration, the first through-channel of the second distributor connects the first branch of the return conduit to the bridging conduit, and the second through-channel of the second distributor connects the second branch of the return conduit to the auxiliary bridging conduit. BRIEF DESCRIPTION OF THE DRAWINGS

[0136] Various aspects of the invention are illustrated in the accompanying drawings, which are provided by way of non-limiting example, in which:

[0137] Figure 1 shows a schematic diagram of an apparatus for extracorporeal treatment of blood comprising a fluid diverting device according to the present invention;

[0138] Figure 2 Shown Figure 1 An enlarged view of a fluid diverting device;

[0139] Figure 3 Another embodiment of the fluid diverting device of the present invention is shown;

[0140] Figure 4 Shown Figure 2 A variation of a fluid steering device;

[0141] Figures 5 to 11 Shown Figure 1 The corresponding working configuration of the fluid steering device;

[0142] Figures 12 to 15 a flow chart showing corresponding modes of operation of the fluid steering device of the present invention;

[0143] Figure 16 An apparatus for extracorporeal treatment of blood comprising different embodiments of a fluid diverting device according to the invention is shown;

[0144] Figures 17 to 19 Shown Figure 16 The corresponding working configuration of the fluid steering device;

[0145] Figure 20A and Figure 20B Shown in the corresponding working position Figure 16 an enlarged view of components of a fluid diverting device;

[0146] Figure 21 Shown Figure 16 Variants of devices for extracorporeal treatment;

[0147] Figures 22 to 25 Shown Figure 21 The corresponding working configuration of the fluid steering device;

[0148] Figure 26 yes Figures 21 to 25 Flowchart of the corresponding operating mode of the device;

[0149] Figure 27 An apparatus for extracorporeal treatment of blood comprising different embodiments of a fluid diverting device according to the invention is shown;

[0150] Figure 28A and Figure 28B Shown in the corresponding working position Figure 27 an enlarged view of components of a fluid diverting device;

[0151] Figure 29 and Figure 30 Shown Figure 27 The corresponding working configuration of the fluid steering device;

[0152] Figure 30 yes Figures 27 to 30Flowchart of the corresponding operating mode of the device;

[0153] Figure 31 yes Figures 27 to 30 Flowchart of another operating mode of the device. DETAILED DESCRIPTION

[0154] exist Figure 2 、 Figure 3 、 Figure 4 、 Figure 16 、 Figure 21 and Figure 26 A non-limiting embodiment of a fluid diverting device of an apparatus 1 for extracorporeal treatment of blood is shown in FIG. 1 , which fluid diverting device can implement the innovative aspects of the present invention. In the following description and in Figure 2 、 Figure 3 、 Figure 4 、 Figure 16 、 Figure 21 and Figure 26 In the drawings, the same components are denoted by the same reference numerals.

[0155] exist Figure 1 In FIG, a device 1 for the extracorporeal treatment of blood is shown. Figure 1 The device 1 comprises a blood treatment unit 2 (such as a blood filter, an ultrafilter, a hemodiafiltration filter, a dialyzer, a plasmafilter, etc.) having a primary chamber 3 and a secondary chamber 4 separated by a semipermeable membrane 5. Depending on the treatment, the semipermeable membrane 5 of the blood treatment unit 2 can be selected to have different properties and performances.

[0156] A blood withdrawal line 6 is connected to the inlet of the main chamber 3, and a blood return line 7 is connected to the outlet of the main chamber 3. In use, the blood withdrawal line 6 and the blood return line 7 are connected to a needle or catheter or other access device 8, which is then placed in fluid communication with the vascular system of a patient "P" so that blood can be withdrawn through the blood withdrawal line 6, flow through the main chamber 3, and then returned to the patient's vascular system through the blood return line 7. An air separator, such as a degassing chamber 9, may be present on the blood return line 7. Additionally, a monitoring valve 10 may be present on the blood return line 7, downstream of the degassing chamber 9.

[0157] The blood flow through the blood lines is controlled by a blood pump 11 , for example a peristaltic blood pump, which acts on the blood withdrawal line 6 or on the blood return line 7 . Figure 1 The embodiment of FIG. 4 shows a blood pump 11 coupled to a pump section of an extraction line 6. A control unit 100 is connected to and controls the blood pump 11 to regulate the blood flow rate.

[0158] An effluent fluid line 12, or spent dialysate line, may be connected at one end to the fluid outlet of the secondary chamber 4 and at its other end to waste, which may be a drain conduit or effluent fluid container 13 that collects the effluent fluid extracted from the secondary chamber 4. An effluent pump 14 operates on the effluent fluid line 13 under the control of the control unit 100 to regulate the flow rate of the effluent fluid through the effluent fluid line.

[0159] Figure 1 The apparatus of the treatment unit 2 includes a dialysis fluid line 15 connected to a fresh dialysis fluid source 16 at one end and to a fluid inlet of the secondary chamber 4 of the treatment unit 2 at the other end thereof for supplying fresh dialysis fluid to the secondary chamber 4. A dialysis fluid pump 17 operates on the dialysis fluid line 15 under the control of the control unit 100 to supply fluid from the dialysis fluid source 16 to the secondary chamber 4 and adjust the flow rate of the dialysis fluid.

[0160] Figure 1 The embodiment of the present invention also shows an infusion line 18 connected to the blood extraction line 6 between the blood pump 11 and the treatment unit 2. The infusion line 18 supplies the replacement fluid from an infusion fluid container 19 connected at one end of the infusion line 18. Note that, as an alternative or in addition to the infusion line 18, Figure 1 The apparatus may include a post-dilution fluid line (not shown) connecting an infusion fluid container to the blood return line 7 and / or a pre-blood pump infusion line 18' having its own pre-blood pump infusion fluid container 19'. Furthermore, an infusion pump 20 operates on the infusion line 18, and an infusion pump 20' operates on the pre-blood pump infusion line 18' to regulate the respective flow rates through the infusion lines 18, 18'. The infusion pumps 20, 20' also operate under the control of the control unit 100.

[0161] The outflow fluid line 12, the dialysis fluid line 15, and the secondary chamber 4 of the blood treatment unit 2 are part of the fluid circuit of the apparatus 1. The blood withdrawal line 6, the blood return line 7, and the primary chamber 3 of the treatment unit 2 form part of the extracorporeal blood circuit of the apparatus 1. The infusion lines 18, 18' form part of the infusion circuit of the apparatus 1.

[0162] The control unit 100 may comprise a digital processor (CPU) with a memory (or memories), an analog type circuit, or a combination of one or more digital processing units and one or more analog processing circuits. In the present specification and claims, it is indicated that the control unit 100 is "configured" or "programmed" to perform steps: this may be achieved in practice by any means that allow the control unit 100 to be configured or programmed. For example, in the case where the control unit 100 comprises one or more CPUs, one or more programs are stored in an appropriate memory: the one or more programs contain instructions that, when executed by the control unit 100, cause the control unit 100 to perform the steps described and / or claimed in conjunction with the control unit 100. Alternatively, if the control unit 100 is of analog type, the circuitry of the control unit 100 is designed to include circuitry that is configured to process electrical signals in use in order to perform the steps of the control unit 100 disclosed herein.

[0163] The control unit 100 may also be operably connected to sensors (such as flow sensors and / or pressure sensors) on the blood circuit and / or the fluid circuit and / or the infusion circuit. The control unit 100 may also be operably connected to clamps and valves, such as the monitoring valve 10. The control unit 100 may also be connected to a user interface (not shown), such as a graphical user interface, which receives input from an operator and displays device output. For example, the graphical user interface may include a touch screen, a display screen, and hard keys for entering user input, or a combination thereof. During extracorporeal blood treatment, the control unit 100 is configured to control at least the pumps 11, 14, 17, 20, 20' to ensure that a predetermined net fluid removal of the patient is achieved during the treatment time, as required by a prescription provided to the control unit 100, for example, via the user interface.

[0164] The device 1 comprises a main part 22, which includes at least a housing for the control unit 100, the control unit 100, a user interface, a blood pump 11, an outflow pump 14, a dialysis fluid pump 17, an infusion pump 20, 20' and a device for mounting a disposable set (including the blood treatment unit 2, the extracorporeal blood circuit, the infusion circuit and the fluid circuit) to the main part 22.

[0165] Figure 1The apparatus 1 for the extracorporeal treatment of blood shown in FIG also includes a fluid diverting device 21 configured to be placed in-line between a main portion 22 of the apparatus 1 and a vascular access of a patient "P," in particular an access device 8 (e.g., a needle or a catheter) placed in fluid communication with the vascular system of the patient "P." The fluid diverting device 21 can be placed in-line on the withdrawal line 6 and on the return line 7 and closer to the access device 8 than to the main portion 22 of the apparatus 1 for the extracorporeal treatment of blood. The fluid diverting device 21 can be at least partially disposable. Figure 1 The fluid diverting device 21 is an additional module which can be supplied to the apparatus and connected to the extraction line 6 and the return line 7 at a later stage relative to the manufacture of the apparatus 1 .

[0166] The fluid diverting device 21 includes a substantially H-shaped conduit assembly including an extraction conduit 23, a return conduit 24, and a bridge conduit 25 connecting the extraction conduit 23 to the return conduit 24. In the embodiment shown in the drawings, each of the extraction conduit 23, the return conduit 24, and the bridge conduit 25 is a straight plastic tube. The extraction conduit 23 is parallel to the return conduit 24, while the bridge conduit 25 is perpendicular to both the extraction conduit 23 and the return conduit 24.

[0167] The extraction conduit 23 has a first end 23a and an opposing second end 23b, each provided with a quick connector, such as a Luer connector, to allow easy and rapid connection / disconnection to / from the rest of the extraction line 6. The first end 23a is connected to, or is configured to be connected to, the portion of the extraction line 6 that includes the pump section coupled to the blood pump 11. The second end 23b is connected to, or is configured to be connected to, the portion of the extraction line that is connected to the access device 8.

[0168] The return conduit 24 has a first end 24a and an opposing second end 24b, each provided with a quick connector, such as a Luer connector, to allow easy and rapid connection / disconnection to / from the rest of the return line 7. The first end 24a is connected to, or is configured to be connected to, the portion of the return line 7 that includes the degassing chamber 9 and the monitoring valve 10. The second end 24b is connected to, or is configured to be connected to, the portion of the return line 7 that is connected to the inlet device 8.

[0169] Bridging conduit 25 has a first end 25a that forms a junction with extraction conduit 23 and an opposing second end 25b that forms a junction with return conduit 24. For example, bridging conduit 25, extraction conduit 23, and return conduit 24 are connected via a T-shaped connector. Extraction conduit 23 includes two branches connected to the T-shaped connector: a branch including a first end 23a and a branch including a second end 23b. Return conduit 24 includes two branches connected to the T-shaped connector: a branch including a first end 24a and a branch including a second end 24b.

[0170] A plurality of valves (eg, clamps) operate on the extraction conduit 23, the return conduit 24, and the bridging conduit 25 and are configured to divert fluid and / or blood flow without disconnecting the patient "P."

[0171] Figure 1 、 Figure 2 and Figures 4 to 11 The fluid diverting device 21 of the embodiment includes a first extraction valve 26 and a second extraction valve 27 operating on the extraction conduit 23. The first extraction valve 26 is placed upstream of the junction of the bridging conduit 25 and the extraction conduit 23 relative to the blood flow during treatment (flowing from the second end 23b to the first end 23a of the extraction conduit 23), and the second extraction valve 27 is placed downstream of the junction of the bridging conduit 25 and the extraction conduit 23 relative to the blood flow during treatment. Figure 2 As disclosed in , the first extraction valve 26 and the second extraction valve 27 are placed on opposite sides relative to the T-connector connecting the bridging conduit 25 to the extraction conduit 23.

[0172] Figure 1 、 Figure 2 and Figures 4 to 11 The fluid diverting device 21 of the embodiment includes a single return valve 28 operating on the return conduit 24. The return valve 28 is placed downstream of the junction of the bridging conduit 25 and the return conduit 24 relative to the blood flow during treatment (flow from the first end 24a to the second end 24b of the return conduit 24). Figure 2 As disclosed in , the return valve 28 is placed on the side of the T-connector connecting the bridging conduit 25 to the return conduit 24 and on the branch including the second end 24 b of the return conduit 24 .

[0173] In a modified embodiment (not shown), similar to first extraction valve 26 and second extraction valve 27, first return valve and second return valve operate on return conduit 24 and are positioned on opposite sides relative to a T-connector connecting bridging conduit 25 to return conduit 24. The return valves, positioned upstream of the junction of bridging conduit 25 and return conduit 24 relative to blood flow during treatment, can perform the function of monitoring valve 10.

[0174] Figure 1 、 Figure 2 and Figures 4 to 11 The fluid diverting device 21 of the embodiment includes a first bridge valve 29 and a second bridge valve 30 operating on the bridge conduit 25. The first bridge valve 29 is placed closer to the return conduit 24 (closer than the second bridge valve 30), and the second bridge valve 30 is placed closer to the extraction conduit 23 (closer than the first bridge valve 29).

[0175] Bridging conduit 25 includes a first branch having a first end 25a and a second branch having a second end 25b. The first and second branches are connected to each other via a T-shaped connector, which also defines an entry point 31 suitable for connection to a liquid source. A first bridging valve 29 is placed on the second branch of bridging conduit 25, and a second bridging valve 30 is placed on the first branch of bridging conduit 25. Entry point 31 is located between first bridging valve 29 and second bridging valve 30.

[0176] A section of tubing leaves the entry point 31 and is provided with an entry valve 32. This section of tubing can be connected to a liquid source 33, such as a 50 ml syringe or a 500 ml bag. The liquid of the liquid source can be saline.

[0177] exist Figure 3 In a variant embodiment of the invention, the fluid diverting device 21 comprises a single bridging valve 29' operating on the bridging conduit 25 and does not comprise any entry point 31. Figure 4 In a modified embodiment, the fluid steering device 21 further includes (relative to Figure 3 In another embodiment (in addition), another entry point 31 'on the return catheter 24, for example for calcium infusion, is provided. The other entry point 31 'is placed on the branch comprising the second end 24b and can be connected to a bag of the device.

[0178] The substantially H-shaped conduit assembly and the plurality of valves 26, 27, 28, 29, 30, 32 are mounted on a holder 34, which may be shaped as a plate provided with a seat or other retaining means configured to accommodate the substantially H-shaped conduit assembly and the plurality of valves 26, 27, 28, 29, 30, 32. Figure 1 、 Figure 2 and Figures 4 to 11 In the embodiment of FIG. 5 , the retainer 34 includes a seat or other retaining device for retaining the syringe 33 and a spring 35 that pressurizes the syringe 33 and ejects the fluid contained in the syringe 33 through the entry point 31 .

[0179] The fluid diverting device 21 may also include one or more sensors (e.g., pressure sensors, flow meters, air detectors, etc.) (not shown) that act on the H-shaped conduit assembly, i.e., on the return conduit 24 and / or on the extraction conduit 23, and on the bridging conduit 25.

[0180] The plurality of valves 26, 27, 28, 29, 30, 32 and sensors are operatively connected or connectable to the control unit 100 of the apparatus 1 and / or the control unit of the fluid diverting device 21, which may be subordinate to the control unit 100 of the apparatus 1. The control unit is configured to command (optionally automatically command) the configuration of the plurality of valves 26, 27, 28, 29, 30, 32. The control units of the valves 26, 27, 28, 29, 30, 32 and / or the fluid diverting device 21 may be connected to the control unit 100 of the apparatus 1 by wired or wireless communication means.

[0181] The fluid steering device 21 includes a power supply for supplying power to the valves 26, 27, 28, 29, 30, 32 and / or sensors and / or control units, or the valves 26, 27, 28, 29, 30, 32 and / or control units of the fluid steering device 21 can be connected to the power supply of the device 1 to be powered by the device 1.

[0182] The fluid diverting device 21 may be a portable module and / or include an attachment device configured to optionally removably mount the fluid diverting device on another element, such as on clothing of the patient "P" or on the bed of the patient "P" or on a main part of the apparatus for extracorporeal treatment of blood. The length of the portion of the return line 7 including the degassing chamber 9 and the monitoring valve 10 and the length of the portion of the extraction line 6 including the pump section connected to the blood pump 11 allow the fluid diverting device to be placed close to the patient "P".

[0183] In use and according to the method for diverting a fluid and / or blood flow in the apparatus 1 of the present invention, before treating the patient "P", the blood circuit is primed and the control unit 100 controls the valves 26, 27, 28, 29, 30, 32 to allow priming of the withdrawal conduit 23, the return conduit 24 and the bridging conduit 25 using a solution bag of the apparatus 1 or saline from a fluid source 33 connected to an access point 31.

[0184] During the patient's treatment ( Figure 5 and Figure 12), when blood flows from the patient "P" into the main chamber 3 of the blood treatment unit 2 through the extraction line 6 and then returns to the patient "P" through the return line 7, the control unit 100 controls the valves 26, 27, 28, 29, 30, 32 to configure the valves 26, 27, 28, 29, 30, 32 to a treatment configuration. In the treatment configuration, the first bridging valve 29, the second bridging valve 30, and the inlet valve 32 are closed, and the first extraction valve 26, the second extraction valve 27, and the return valve 28 are opened.

[0185] During patient treatment, since blood may stagnate at the closed first and second bridge valves 29 and 30, in order to prevent clotting, the first and second bridge valves 29 and 30 and the inlet valve 32 are periodically (intermittently) opened to flush the bridge conduit 25 with fluid and prevent clotting. According to a variation of the method, when the inlet valve 32 is closed, the first and second bridge valves 29 and 30 are periodically (intermittently) opened to flush the bridge conduit 25 with blood, thereby generating a brief recirculation and preventing clotting ( Figure 12 ).

[0186] In the event of an Access Extremely Negative (AEN) alarm, the blood pump 11 is stopped, the second bridging valve 30 and the access valve 32 are opened to enable saline to be drawn from the syringe 33 until the access pressure reaches approximately atmospheric levels, or both the first bridging valve 29 and the second bridging valve 30 are opened to form a connection between the extraction conduit 23 and the return conduit 24 and normalize the pressure.

[0187] After the access pressure approaches atmospheric level, the first bridging valve 29 remains closed and the second extraction valve 27 is closed while the inlet valve 32, the second bridging valve 30, and the first extraction valve 26 remain open. In this way, the fluid from the syringe 33 flushes back into the vascular access of the patient "P" to help remove the catheter tip from the vascular wall ( Figure 6 and Figure 13 ).

[0188] According to another possible action for resolving the AEN alarm, first extraction valve 26 and second extraction valve 27 are closed while the other valves are open. Blood pump 11 is controlled to increase the negative pressure in the access channel to a defined value and then stopped. Then, first extraction valve 26 and second extraction valve 27 are opened to generate a sudden negative pressure peak in the catheter's access channel, thereby dislodging or disrupting the clot.

[0189] If these attempts fail, the control unit 100 controls the plurality of valves 26, 27, 28, 29, 30, 32 to recirculate the blood while notifying the staff that action is required (moving the patient "P", taking care of the vascular access, etc.).

[0190] Before blood recirculation is achieved, it is necessary to flush the return conduit 24 and the extraction conduit 23 to avoid blood clotting and to enable patient reconnection after staff intervention. For this purpose, while the first bridging valve 29, the first extraction valve 26, the second extraction valve 27, the return valve 28 and the inlet valve 32 are opened and the fluid from the syringe 33 is injected, the branch of the return conduit 24 including the second end 24b is flushed with fluid by closing the second bridging valve 30 and the monitoring valve 10. Figure 7 and Figure 14 ).

[0191] The branch with the second end 23b of the extraction conduit 6 is then flushed. The first bridge valve 29 and the second extraction valve 27 are closed, the second bridge valve 30, the first extraction valve 26 and the inlet valve 32 are opened, and saline ( Figure 8 and Figure 14 ).

[0192] Blood recirculation begins with the return valve 28 closed, the first extraction valve 26 closed, the second extraction valve 27 opened, and the first bridge valve 29 and the second bridge valve 30 opened, so that blood recirculates in the blood treatment unit 2 of the apparatus 1, and staff intervention ( Figure 9 and Figure 14 ).

[0193] At the end of treatment, saline recirculation begins as the blood returns to the patient "P." With the first extraction valve 26 and the first bridge valve 29 closed and the second bridge valve 30, return valve 28, second extraction valve 27, and inlet valve 32 open, saline is pumped by the blood pump 11 until all the blood has returned to the patient "P." Then, while the second bridge valve 30 remains open, the second extraction valve 27 is open, and the first extraction valve 26 is closed, the return valve 28 is closed and the first bridge valve 29 is opened to recirculate the liquid in the blood treatment unit 2 of the apparatus 1. Figure 11 and Figure 15 ).

[0194] Figures 16 to 20B There is shown another embodiment of a fluid diverting device 21. The fluid diverting device 21 of this embodiment may be mounted on one side of a main part 22 of the apparatus 1.

[0195] and Figure 1 、 Figure 2 and Figure 4-11 As in the embodiment of FIG. 2 , the fluid diverting device 21 includes a first extraction valve 26 , a second extraction valve 27 , a return valve 28 , a first bridge valve 29 , a second bridge valve 30 and an entry point 31 .

[0196] The valve type is different from Figure 1 、 Figure 2 and Figure 4-11 Each of the plurality of valves is a rotary clamp or clip.

[0197] The first bridge valve 29 and the return valve 28 share a common rotating body 140 and include two corresponding abutment elements 145, one for the first bridge valve 29 and one for the return valve 28. The second bridge valve 30 and the first extraction valve 26 share a common rotating body 140 and two corresponding abutment elements 145, one for the second bridge valve 30 and one for the first extraction valve 26.

[0198] Figure 16 Also shown is a calcium bag 300 connected to another access point 31 ′ on the return conduit 24 for calcium infusion operated by a calcium pump 301 .

[0199] Figure 20A and Figure 20B An enlarged view of the first bridge valve 29 and the return valve 28 is shown. Each valve comprises a rotating body 140 and an abutment element 145. The rotating body 140 comprises a pressing piece 141 spaced apart from the axis of rotation of the rotating body 140. The pressing piece 141 is placed close to the rotating body 140 so that a pipe section can be positioned between the abutment element 145 and the pressing piece 141. Figure 20A and Figure 20B The assembly shown in FIG1 , comprising the first bridge valve 29 and the return valve 28, comprises a rotating body 140 and two abutment elements 145. The two abutment elements 145 are stationary relative to the axis of rotation of the rotating body 140 and are located on opposite sides relative to the rotating body 140. A pipe section of the return duct 24 is placed against one of the abutment elements 145, and a pipe section of the bridge duct 25 is placed against the other of the abutment elements 145.

[0200] The rotating body 140 is rotatable between a first clamping position (one of the two valves is closed and the other is open), a second clamping position (one of the two valves is closed and the other is open), and a release position (both valves are open).

[0201] In the first clamping position ( Figure 20B ), the pressing member 141 of the rotating element 140 approaches one of the two abutting elements 145 to press and close the tube between the rotating element 140 and the abutting element 145 ( Figure 20B A portion of the return conduit 24 in.

[0202] In the second clamping position (not shown), the pressing piece 141 of the rotating element 140 approaches the other of the two abutting elements 145 to press and close the other tube (which should be Figure 20A and Figure 20B A portion of the bridging catheter 25).

[0203] In the release position, the pusher 141 of the rotary element is spaced apart from the two abutment elements 145 to open the two parts of the tube ( Figure 20A ).

[0204] The assembly comprising the first extraction valve 26 and the second bridge valve 30 has the same Figure 20A and Figure 20B The same structure and function as shown in and disclosed above.

[0205] The access point 31 of this embodiment is connected to the pre-pump infusion line 18', which has its own pre-pump infusion fluid container 19' and infusion pump 20'. The pre-pump infusion line 18' has a branch connected to the access point 31 and a branch connected to the blood withdrawal line 6 at a point between the vascular access 8 and the fluid diverting device 21.

[0206] An infusion pump 20' operates on the blood pre-pump infusion line 18' to regulate the corresponding flow rate through the branches.

[0207] A first infusion valve or inlet valve 32 is placed upstream of the branch of the blood pre-pump infusion line 18' connected to the entry point 31. A second infusion valve 110 is placed downstream of the branch connected to the entry point 31, i.e., on the branch connected to the blood withdrawal line 6.

[0208] The inlet valve 32 is also a rotating clamp or clamp. Similar to the assembly including the first extraction valve 26 and the second bridge valve 30, and the assembly including the first bridge valve 29 and the return valve 28, the inlet valve 32 is also coupled to the second extraction valve 27. The second extraction valve 27 and the inlet valve 32 include a common rotating body 140 and two corresponding abutment elements 145.

[0209] The auxiliary extraction valve 126 operates on the extraction conduit 6 and is placed downstream of the first extraction valve 26 with respect to the blood flow during treatment. The second infusion valve 110 and the auxiliary extraction valve 126 comprise a common rotating body 140 and two corresponding abutment elements 145.

[0210] like Figures 16 to 20B As shown, the common rotating body 140 of the first bridging valve 29 and the return valve 28 is placed between the return conduit 24 and the bridging conduit 25, the common rotating body 140 of the first extraction valve 26 and the second bridging valve 30 is placed between the extraction conduit 23 and the bridging conduit 25, the common rotating body 140 of the inlet valve 32 and the extraction valve 27 is placed between the extraction conduit 23 and the blood pump pre-infusion line 18', and the common rotating body 140 of the second infusion valve 110 and the auxiliary extraction valve 126 is placed between the extraction conduit 23 and the blood pump pre-infusion line 18'.

[0211] The positions of valves 26, 27, 28, 29, 30, 32, 110, 126 configured to perform patient treatment are Figure 16 The first bridge valve 29, the second bridge valve 30, the inlet valve 32 and the second infusion valve 110 are closed, and the first extraction valve 26, the second extraction valve 27, the auxiliary extraction valve 126 and the return valve 28 are opened.

[0212] Figure 17 1 shows the positions of valves 26, 27, 28, 29, 30, 32, 110, and 126, which are configured to flush the extraction conduit 23 and the vascular access of the patient "P." While the inlet valve 32, the second bridging valve 30, the auxiliary extraction valve 126, and the first extraction valve 26 are open, the first bridging valve 29, the second extraction valve 27, and the second infusion valve 110 are closed. Fluid from the pre-pump infusion fluid container 19' flows through the inlet point 31 into the extraction conduit 23 and toward the patient "P."

[0213] Figure 18 1 shows the positions of valves 26, 27, 28, 29, 30, 32, 110, 126, which are configured to perform a flush of return conduit 24. While second extraction valve 27, second bridge valve 30, and second infusion valve 110 are closed, first bridge valve 29, return valve 28, inlet valve 32, first extraction valve 26, and auxiliary extraction valve 126 are opened. Fluid from pre-blood pump infusion fluid container 19' flows through entry point 31 into return conduit 24 and toward patient "P."

[0214] Figure 19 2 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56

[0215] While the second extraction valve 27 , the first and second bridge valves 29 , 30 , and the auxiliary extraction valve 126 are open, the return valve 28 , the first extraction valve 26 , the second infusion valve 110 , and the inlet valve 32 are closed.

[0216] Figures 21 to 26 Shown Figures 16 to 20B A variation of the embodiment of Figures 16 to 20B , this variation further includes an auxiliary bridging conduit 125 that is arranged parallel to the bridging conduit 25 and that also will or is configured to connect the extraction conduit 23 to the return conduit 24. The auxiliary bridging conduit 125 is positioned between the bridging conduit 25 and the access device 8. With respect to blood flow during treatment, the auxiliary bridging conduit 125 is connected to the extraction conduit 23 at a connection site located upstream of the bridging conduit 25 and to the return conduit 6 at a connection site located downstream of the bridging conduit 25.

[0217] An auxiliary pump 150 (eg, a peristaltic pump) operates on the auxiliary bridging conduit 125 and is configured to recirculate blood on the patient "P" side.

[0218] Similar to Figures 16 to 20B , an auxiliary extraction valve 126 operates on the extraction conduit 23, and an auxiliary return valve 128 operates on the return conduit 24. The auxiliary return valve 128 is placed downstream of the return valve 28 with respect to the blood flow during treatment. The auxiliary extraction valve 126 is placed upstream of the connection point of the auxiliary bridging conduit 125 to the extraction conduit 23, and the auxiliary return valve 128 is placed downstream of the connection point of the auxiliary bridging conduit 125 to the return conduit 24 with respect to the blood flow during treatment.

[0219] A first auxiliary bridge valve 129 and a second auxiliary bridge valve 130 operate on the auxiliary bridge conduit 125 and are positioned on opposite sides relative to the auxiliary pump 150 .

[0220] The first auxiliary bridge valve 129 and the auxiliary return valve 128 comprise a common rotating body 140 and two corresponding abutment elements 145 . Likewise, the auxiliary extraction valve 126 and the second auxiliary bridge valve 130 comprise a common rotating body 140 and two corresponding abutment elements 145 .

[0221] like Figures 21 to 25 As shown, the common rotating body 140 of the first auxiliary bridge valve 129 and the auxiliary return valve 128 is placed between the return conduit 24 and the auxiliary bridge conduit 125. The common rotating body 140 of the auxiliary extraction valve 126 and the second auxiliary bridge valve 130 is placed between the extraction conduit 23 and the auxiliary bridge conduit 125.

[0222] During the patient's treatment ( Figure 21 and Figure 22 ), while the auxiliary extraction valve 126 and the auxiliary return valve 128 are open, the first auxiliary bridge valve 129 and the second auxiliary bridge valve 130 are closed. The positions of the other valves can be the same as Figure 16 The inlet valve 32 can be opened and the blood pre-pump infusion line 18 ′ can be operated to supply the replacement fluid from the blood pre-pump infusion fluid container 19 ′ to the blood withdrawal line 6 .

[0223] When flushing the extraction catheter 23 ( Figure 23 ) or return conduit 24 ( Figure 24 ), while the first auxiliary bridge valve 129 and the second auxiliary bridge valve 130 are closed, the auxiliary extraction valve 126 and the auxiliary return valve 128 are opened. The positions of the other valves can be the same as those in Figure 17 or Figure 18 Same as shown in .

[0224] During blood recirculation ( Figure 25 and Figure 26 ), the auxiliary extraction valve 126, the auxiliary return valve 128, the first auxiliary bridge valve 126 and the second auxiliary bridge valve are all open. The positions of the other valves can be the same as Figure 19 The blood pump 11 is operated to recirculate blood through the treatment unit 2, and the auxiliary pump 150 is activated to recirculate blood on the patient "P" side.

[0225] Figures 27 to 30 Another different embodiment of the fluid diverting device 21 is shown. The fluid diverting device 21 of this embodiment includes dispensers 201, 202 instead of valves. The dispensers 201, 202 can be disposable. The dispensers 201, 202 can be rotary dispensers and can be operated by a rotary actuator (not shown) that is part of the main part 22 and controlled by the control unit 100.

[0226] The fluid diverting device 21 includes (Figures 28 and Figure 29 ) An extraction conduit 23, a return conduit 24, a bridging conduit 25 and an auxiliary bridging conduit 125. The extraction conduit 23 includes a first branch 23' and a second branch 23". Similarly, the return conduit 24 includes a first branch 24' and a second branch 24". The auxiliary bridging conduit 125 is connected to an auxiliary pump 150.

[0227] The first distributor 201 is operably coupled to the extraction conduit 23, the bridge conduit 25, and the auxiliary bridge conduit 125. The first distributor 201 operates between the first branch 23' and the second branch 23" of the extraction conduit 23. The first distributor 201 also operates between the first end of the bridge conduit 25 and the first end of the auxiliary bridge conduit 125.

[0228] The second distributor 202 is operably coupled to the return conduit 24, the bridge conduit 25, and the auxiliary bridge conduit 125. The second distributor 202 operates between the first branch 24' and the second branch 24" of the return conduit 24. The second distributor 202 also operates between the second end of the bridge conduit 25 and the second end of the auxiliary bridge conduit 125.

[0229] like Figure 28A and Figure 28BAs better shown in FIG, the first distributor 201 includes a rotating element 205 having a first through-channel 210 and a second through-channel 211. The first through-channel 210 and the second through-channel 211 are parallel and each has an open end facing an opposite portion of the rotating element 205. The second distributor 202 includes a rotating element 205 having a first through-channel 212 and a second through-channel 213. The structure of the second distributor 202 (not shown in the enlarged view) is the same as that of the first distributor 201.

[0230] Each of the first distributor 201 and the second distributor 202 is rotatable between a first configuration corresponding to a treatment configuration and a second configuration corresponding to a recirculation configuration.

[0231] exist Figure 27 、 Figure 28A 、 Figure 29 and Figure 31 In the first configuration, the extraction duct 23 defines a continuous channel connected to the extraction line 6 .

[0232] The first through channel 210 of the first distributor 201 connects the first branch 23 ′ and the second branch 23 ″ of the extraction conduit 23 , and the second through channel 211 of the first distributor 201 connects the first end of the bridging conduit 25 to the first end of the auxiliary bridging conduit 125 .

[0233] In this first configuration, the return conduit 24 defines a continuous passage ( Figure 29 ).

[0234] The first through channel 212 of the second distributor 202 connects the first branch 24 ′ and the second branch 24 ″ of the return conduit 24 , and the second through channel 213 of the second distributor 202 connects the second end of the bridge conduit 25 to the second end of the auxiliary bridge conduit 125 .

[0235] In this first configuration, the bridge conduit 25 delimits, together with the auxiliary bridge conduit 125 , a closed circuit disconnected from the extraction line 6 , disconnected from the return line 7 and coupled to the auxiliary pump 150 .

[0236] exist Figure 28B 、 Figure 30 and Figure 32 In the second configuration, the bridging conduit 25 defines a closed circuit with the blood treatment unit 2 for recirculating blood in the blood treatment unit 2, and the auxiliary bridging conduit 125 defines a closed circuit connected to the access device 8 for recirculating blood on the patient "P" side. The closed circuit on the blood treatment unit 2 side is disconnected from the closed circuit on the patient "P" side.

[0237] In this second configuration, the first through-channel 210 of the first distributor 201 connects the first branch 23' of the extraction conduit 23 to the auxiliary bridging conduit 125, and the second through-channel 211 of the first distributor 201 connects the second branch 23" of the extraction conduit 23 to the bridging conduit 25 ( Figure 28B and Figure 30 ).

[0238] In this second configuration, the first through-channel 212 of the second distributor 202 connects the first branch 24' of the return conduit 24 to the bridging conduit 25, and the second through-channel 213 of the second distributor 202 connects the second branch 24" of the return conduit 24 to the auxiliary bridging conduit 125 ( Figure 30 ).

[0239] In the event of an access extreme negative (AEN) alarm during blood treatment, the control unit 100 switches the first and second dispensers 201, 202 from the first configuration to the second configuration. The auxiliary pump 150 is controlled to operate in one direction or the other in an attempt to escape the condition that triggered the alarm. The dispensers 201, 202 are then switched back to the first configuration (treatment mode), and the auxiliary pump 150 is operated continuously or intermittently at a low rate to prevent blood stagnation.

[0240] While the invention has been described in connection with what are presently considered to be the most practical and preferred embodiments, it is to be understood that the invention is not limited to the disclosed embodiments, but on the contrary is intended to cover various modifications and equivalent arrangements included within the purview of the appended claims.

Claims

1. A fluid diverting device for an apparatus for extracorporeal treatment of blood, wherein: The apparatus (1) for extracorporeal treatment of blood comprises: Hematology Unit (2); an extracorporeal blood circuit connected to the blood treatment unit (2) and comprising a blood withdrawal line (6) and a blood return line (7) connectable to a vascular access of the patient (P); a blood pump (11) configured to be coupled to a pump section of an extracorporeal blood circuit; The fluid diverting device (21) is configured to be placed in series between the blood set of the device (1) and the vascular access of the patient (P), and comprises: H-shaped conduit assembly, comprising an extraction conduit (23), a return conduit (24) and at least one bridging conduit (25, 125), the at least one bridging conduit (25, 125) connecting the extraction conduit (23) to the return conduit (24) or being configured to connect the extraction conduit (23) to the return conduit (24), wherein the extraction conduit (23) is connected or connectable to the extraction line (6) upstream and downstream, wherein the return conduit (24) is connected or connectable to the return line (7) upstream and downstream; a plurality of valves (26, 27, 28, 29, 30, 32) or distributors (201, 202) operating on the extraction conduit (23), the return conduit (24) and the at least one bridging conduit (25), and configured to divert fluid and / or blood flow without disconnecting a patient (P); wherein the plurality of valves (26, 27, 28, 29, 30, 32) includes at least one extraction valve (26, 27) operating on an extraction conduit (23), at least one return valve (28) operating on a return conduit (24), and at least one bridging valve (29, 30) operating on a bridging conduit (25); wherein the at least one extraction valve (26, 27) comprises a first extraction valve (26) and a second extraction valve (27) operated on the extraction conduit (23), wherein the first extraction valve (26) and the second extraction valve (27) are placed on opposite sides relative to a junction between the bridging conduit (25) and the extraction conduit (23), wherein the first extraction valve (26) is placed upstream of the junction between the bridging conduit (25) and the extraction conduit (23) relative to blood flow during treatment, and wherein the second extraction valve (27) is placed downstream of the junction between the bridging conduit (25) and the extraction conduit (23) relative to blood flow during treatment.

2. The device according to claim 1, wherein The extraction conduit (23) is parallel to the return conduit (24), and wherein the bridging conduit (25) is at least partially transverse to the extraction conduit (23) and the return conduit (24).

3. The device according to claim 1, wherein At least one of the extraction conduit (23), the return conduit (24) and the bridging conduit (25) is at least partially straight.

4. The device according to claim 1, wherein The return valve (28) is placed downstream of the junction of the bridging conduit (25) and the return conduit (24) relative to the blood flow during treatment.

5. The device according to claim 1, wherein The at least one bridge valve (29, 30) includes a first bridge valve (29) and a second bridge valve (30) operating on the bridge conduit (25), wherein the first bridge valve (29) is placed closer to the return conduit (24) and the second bridge valve (30) is placed closer to the extraction conduit (23).

6. The device according to claim 5, wherein The bridge conduit (25) has an entry point (31) located between the first bridge valve (29) and the second bridge valve (30) and adapted to be connected to a liquid source (33, 19').

7. The device according to claim 6, wherein The access point (31) is suitable for connection to a saline source or a citrate source coming from the device (1) for extracorporeal treatment of blood.

8. The apparatus according to claim 5, comprising: A source of liquid is connected or connectable to the entry point (31).

9. The apparatus according to claim 1, comprising: A holder (34) is configured to hold the H-shaped catheter assembly and the plurality of valves (26, 27, 28, 29, 30, 32).

10. The device according to claim 1, wherein The plurality of valves (26, 27, 28, 29, 30, 32) are configured to be arranged in at least a treatment configuration in which the at least one extraction valve (26, 27) and the at least one return valve (28) are opened and the at least one bridging valve (29, 30) is closed to perform treatment of a patient (P).

11. The device according to claim 4, wherein The plurality of valves (26, 27, 28, 29, 30, 32) are configured to be arranged in at least a recirculation configuration, in which the return valve (28) is closed, the first extraction valve (26) is closed, the second extraction valve (27) is open, and the at least one bridging valve (29, 30) is open, so that blood or liquid is recirculated in the blood treatment unit (2) of the device (1) without disconnecting the patient (P).

12. The device according to claim 5, wherein The plurality of valves (26, 27, 28, 29, 30, 32) are configured to be arranged in a return branch flush configuration in which the first bridging valve (29) is open, the second bridging valve (30) is closed, and a liquid source (33, 19') is connected to the entry point (31) to inject liquid and flush a branch of the return conduit (24) positioned downstream of the junction of the bridging conduit (25) and the return conduit (24).

13. The device according to claim 12, wherein The plurality of valves (26, 27, 28, 29, 30, 32) are configured to be arranged in an extraction branch flush configuration, in which the first bridging valve (29) is closed, the second bridging valve (30) is open, the second extraction valve (27) is closed, and a liquid source (33, 19') is connected to the entry point (31) to inject liquid and flush the branch of the extraction conduit (23) placed upstream of the junction of the bridging conduit (25) and the extraction conduit (23).

14. The device according to claim 10, wherein A valve of the plurality of valves (26, 27, 28, 29, 30, 32) is operatively connected or connectable to a control unit (100) of an apparatus (1) for extracorporeal treatment of blood, or wherein, The fluid diverting device (21) comprises a control unit operatively connected to a valve of the plurality of valves (26, 27, 28, 29, 30, 32); wherein the control unit (100) is configured to command the configuration of the plurality of valves (26, 27, 28, 29, 30, 32).

15. The device according to claim 1, wherein At least one of the plurality of valves (26, 27, 28, 29, 30, 32) is a rotating clamp, wherein the rotating clamp includes a rotating body (140) and an abutment element (145).

16. The device according to claim 15, wherein At least two valves of the plurality of valves (26, 27, 28, 29, 30, 32) comprise a common rotating body (140) and corresponding abutment elements (145).

17. The device according to claim 6, wherein At least one infusion line (18') is connected to the access point (31), wherein an infusion fluid container (19') is connected to the infusion line (18') and an infusion pump (20') operates on the infusion line (18').

18. The apparatus according to claim 1, comprising: An auxiliary bridging conduit (125) connects the extraction conduit (23) to the return conduit (24) or is configured to connect the extraction conduit (23) to the return conduit (24) and is arranged in parallel with the bridging conduit (25); an auxiliary pump (150) operates on the auxiliary bridging conduit (125).

19. The apparatus according to claim 18, comprising: An auxiliary extraction valve (126) operates on the extraction conduit (23); an auxiliary return valve (128) operates on the return conduit (24); a first auxiliary bridge valve (129) and a second auxiliary bridge valve (130) operate on the auxiliary bridge conduit (125) and are placed on opposite sides relative to the auxiliary pump (150).

20. The apparatus according to claim 18, comprising: a first distributor (201) operatively coupled to the extraction conduit (23), the bridging conduit (25), and the auxiliary bridging conduit (125); a second distributor (202) operatively coupled to the return conduit (24), the bridge conduit (25), and the auxiliary bridge conduit (125); Wherein, the first distributor (201) and the second distributor (202) are movable between a first configuration and a second configuration, in which, in the first configuration, the extraction conduit (23) defines a continuous channel connected to the extraction line (6), the return conduit (24) defines a continuous channel connected to the return line (7), and the bridging conduit (25) together with the auxiliary bridging conduit (125) define a closed loop disconnected from the extraction line (6) and the return line (7); in the second configuration, the bridging conduit (25) defines a closed loop with the blood treatment unit (2) to recirculate blood in the blood treatment unit (2), and the auxiliary bridging conduit (125) defines a closed loop connected to the access device (8).

21. A blood kit for an apparatus for extracorporeal treatment of blood, the blood kit comprising: Hematology Unit (2); an extracorporeal blood circuit connected to the blood treatment unit (2) and comprising a blood withdrawal line (6) and a blood return line (7) connectable to a vascular access of the patient (P); The fluid diverting device (21) according to any one of claims 1 to 20, wherein: The fluid diverting device (21) is placed in series or configured to be placed in series between a blood kit of an apparatus (1) for extracorporeal treatment of blood and a vascular access of a patient (P), and the extraction conduit (23) and the return conduit (24) have corresponding end-matching connectors, which are configured to connect to the end connectors of the blood extraction line (6) and the blood return line (7), or to connect to the end connectors of the blood extraction line (6) and the blood return line (7).

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