Automatic priming and flushing of extracorporeal blood processing equipment

Abstract

The present invention relates to an extracorporeal blood treatment apparatus comprising an extracorporeal circuit, a dialyzer, and a dialysate circuit, wherein the extracorporeal blood treatment apparatus is prepared or designed for priming and flushing thereof, and for this purpose, the arterial section and the venous section of the extracorporeal circuit are connected via a connector device, and wherein a control unit of the extracorporeal blood treatment apparatus is designed to control priming in such a way that liquid from the dialysate circuit is supplied to the extracorporeal circuit via the dialyzer, and to control flushing in such a way that it is achieved by generating a pressure difference between the extracorporeal circuit and the dialysate circuit, in order to achieve a liquid transfer via the dialyzer, in particular from the extracorporeal circuit to the dialysate circuit. The present disclosure also relates to a method for priming and flushing an extracorporeal blood treatment apparatus.

Description

Technical Field

[0001] The present disclosure relates to an extracorporeal blood treatment apparatus, in particular a dialysis machine, which is prepared or designed for automatic priming and flushing of the extracorporeal blood treatment apparatus. In addition, the present disclosure relates to a method for automatically priming and flushing an extracorporeal blood treatment apparatus. Background Art

[0002] An extracorporeal (blood) circuit for guiding blood outside the patient's body during a blood purification method is known from practice. This extracorporeal circuit is filled with a priming solution or a priming liquid before the start of the treatment. This filling of the extracorporeal circuit and the dialyzer with the priming solution or priming liquid (priming) serves to prepare the extracorporeal circuit and the dialyzer for subsequent treatment. In particular, this priming serves to replace the air still present in the extracorporeal circuit and in the dialyzer by a physiologically compatible liquid or solution before the treatment, in order to prevent this air from being introduced into the patient's vascular system during the blood treatment and in particular at the start of the blood treatment.

[0003] In addition to the prefilling or prefilling process, a flushing or flushing process is usually performed to prepare the extracorporeal circuit and the dialyzer for subsequent treatment. The flushing or flushing process is usually performed simultaneously with or (directly) after the prefilling or prefilling process. The flushing or flushing process is particularly used to flush out residues / pyrogens from the extracorporeal circuit and the dialyzer, in particular from the membranes thereof (pyrogens are membrane permeates). Such residues / pyrogens may originate from the production, packaging or activation process and are potentially harmful to the patient.

[0004] When the dialyzer and the hose system forming the extracorporeal (blood) circuit are prepared, ie when priming and flushing have been performed, the patient can in principle be placed and the priming or flushing fluid drained from the completely filled system and replaced on one side with the patient's blood.

[0005] The present disclosure relates in particular to the preparation of the extracorporeal blood treatment apparatus, ie priming and flushing. In other words, the placement / treatment of the patient is preferably not the subject of the present disclosure, so that according to the present disclosure preferably no contact of the extracorporeal blood treatment apparatus with the patient is provided.

[0006] Priming with an external saline bag is known from the prior art. The bag is connected to the hose of the extracorporeal circuit (on the side facing the blood hose system), and the priming liquid is filled into the hose system and the dialyzer. To ensure that the dialyzer is properly filled with liquid, it must be rotated simultaneously to remove any remaining air bubbles from the system. The consumed liquid is collected in the empty bag.

[0007] Furthermore, so-called online priming is known from the prior art. During online priming, the dialysate is provided by the blood treatment apparatus and fed via a substituate fluid connection to the blood hose system and the dialyzer by means of an arterial blood pump. During this priming method, the dialyzer must also be rotated to remove any air bubbles still present in the system.

[0008] Both of these priming methods have the disadvantage that, for example, manual steps by the user are generally required when rotating the dialyzer. Due to high cost pressures and some strict regulations (e.g., those of the U.S. Centers for Disease Control and Prevention), automated preparation of extracorporeal blood treatment systems (priming and flushing) is generally required. Preferably, saline solution bags and disposable items that must be removed and disposed of before treatment should not be used.

[0009] It is also known in principle from the prior art to use dialysate / permeate (instead of saline solution) for priming. Here, the dialysate is conveyed through the dialyzer membrane into the blood hose system. If the arterial and venous blood hose lines are short-circuited, dialysate can be pumped from the dialysate side into the dialyzer and blood hose system by means of suitable pump control and valve positions, thereby filling them. In this regard, reference is made, for example, to EP 3 127 564 B1 or EP 1 457 218 A1.

[0010] Other automatic priming methods are known, for example, from US Pat. No. 9,579,440 B2 or EP 2 361 643 B1.

[0011] This prior art has the disadvantage, in particular, that there is no suitable automatic flushing process which would allow the extracorporeal circuit and the dialyzer to be flushed in a satisfactory manner (for the purpose of removing residual substances / pyrogens). Summary of the Invention

[0012] The task of the present disclosure is to provide an improved automatic preparation (including both priming and flushing) of an extracorporeal blood treatment apparatus. In particular, the number of required disposables should be reduced when priming and flushing the dialyzer and extracorporeal hose system, and preferably no additional disposables and replacement connectors should be required.

[0013] This object is achieved by an extracorporeal blood treatment apparatus according to the invention and a method according to the invention for automatically priming and flushing an extracorporeal blood treatment apparatus. Advantageous embodiments and further developments are explained below.

[0014] The present disclosure first relates to an extracorporeal blood treatment device, which comprises: an extracorporeal circuit including an arterial section and a venous section, a dialyzer and a dialysate circuit, wherein the extracorporeal circuit and the dialysate circuit are separated from each other by a membrane arranged in the dialyzer; the extracorporeal blood treatment device is prepared or designed for priming and flushing the extracorporeal circuit and the dialyzer before the first use of the extracorporeal circuit and the dialyzer, and for this purpose the arterial section and the venous section are short-circuited or connected via a connector device; the dialysate circuit has a dialyzer inlet valve, a dialyzer outlet valve and at least one flow pump; the extracorporeal circuit has at least one exhaust valve; and the extracorporeal blood treatment device further comprises a control unit, which is designed to control the priming in such a way that liquid, in particular priming liquid / flushing liquid / dialysis fluid, is supplied from the dialysate circuit to the extracorporeal circuit via the membrane of the dialyzer. The control unit is also designed to control the flushing of the extracorporeal blood treatment apparatus, which is performed simultaneously with or immediately after the priming, in such a way that a pressure difference is generated between the extracorporeal circuit and the dialysate circuit for flushing and a liquid transfer is achieved via the membrane of the dialyzer, in particular from the extracorporeal circuit to the dialysate circuit.

[0015] In other words, the present disclosure provides an extracorporeal blood treatment device that allows both priming and flushing by providing fluid (priming liquid / flushing liquid / dialysis fluid) from the dialysate side via the membrane of the dialyzer. Therefore, according to the present disclosure, there is no need for a separate bag with saline solution / priming / flushing liquid or a replacement fluid connector on the machine for priming and flushing. Therefore, the automatic priming and flushing of the present disclosure can also be applied to extracorporeal blood treatment machines / dialysis machines without replacement fluid connectors. In addition, since no external saline bag is used, time savings are also achieved for the caregiver by the automatic priming and flushing according to the present disclosure. The automatic priming and flushing according to the present disclosure also enables the dialyzer to be filled and flushed without having to rotate it, so that this work step for the caregiver is also eliminated. Because according to the present disclosure, the dialyzer is preferably filled / loaded from below, and air bubbles that may remain in the dialyzer are preferably removed by the flushing process according to the present disclosure.

[0016] In order to enable automatic priming and flushing according to the present disclosure, the arterial section and the venous section of the extracorporeal circuit are short-circuited or connected by a connector device.

[0017] Preferably, the connector device is an adapter into which both the end of the arterial segment and the end of the venous segment can be inserted and thus fluidically connected. Since preferably a Luer connector is provided at both the end of the arterial segment and the end of the venous segment, the adapter is advantageously designed for connecting two Luer connectors. For example, the applicant of the present patent application An adapter is a suitable connector device. However, the connector device according to the present disclosure is not limited thereto. In principle, any connector / connection device can be envisaged as long as it can connect / short-circuit the arterial segment of the extracorporeal circuit with the venous segment of the extracorporeal circuit in a suitable manner.

[0018] The automatic priming and / or flushing of the present disclosure is preferably achieved by (suitable) control of the opening positions of valves present / provided in the extracorporeal blood treatment apparatus.

[0019] It is further preferred that the automatic priming and / or flushing of the present disclosure is (additionally also) achieved by (suitably) controlling a flow pump present / provided in the dialysate circuit.

[0020] According to the present disclosure, a dialyzer inlet valve and a dialyzer outlet valve are provided in the dialysate circuit. The dialyzer inlet valve is preferably provided / arranged upstream of the dialyzer at the dialysate flow inlet. The dialyzer outlet valve is preferably provided / arranged downstream of the dialyzer at the dialysate flow outlet.

[0021] Advantageously, a flow pump inlet is provided / arranged in the dialysate inlet upstream of the dialyzer inlet valve. Further preferably, a flow pump outlet is provided / arranged in the dialysate outflow downstream of the dialyzer outlet valve. However, according to the present disclosure, only one flow pump may be provided, i.e., a flow pump inlet or a flow pump outlet. The flow pump inlet and / or flow pump outlet are preferably configured as a gear pump. The at least one flow pump is preferably designed to provide priming fluid / flushing fluid / dialysis fluid from the dialysate circuit to the extracorporeal circuit via the membrane of the dialyzer.

[0022] The extracorporeal circuit preferably has at least one pressure sensor, which measures / monitors the pressure in the extracorporeal circuit and provides information about the pressure changes in the extracorporeal circuit to the control unit. The control unit of the present disclosure is preferably configured as a processor, in particular a central computing / processing unit (CPU). For example, the at least one pressure sensor is an arterial pressure sensor (preferably configured as a roller pump to convey fluid / liquid by squeezing a hose) in the arterial section of the extracorporeal circuit upstream of a blood pump, or a dialyzer inlet pressure sensor in the arterial section upstream of a dialyzer, or a venous pressure sensor in the venous section of an extracorporeal circuit. Preferably, in the extracorporeal circuit, not only an arterial pressure sensor is provided, but also a dialyzer inlet pressure sensor and a venous pressure sensor are provided.

[0023] At least one expansion chamber is preferably provided in the extracorporeal circuit, which is in particular designed as an air trap. For example, a venous expansion chamber or a venous air trap is provided in the venous section of the extracorporeal circuit. Additionally or alternatively, an arterial expansion chamber or an arterial air trap can be provided in the arterial section of the extracorporeal circuit.

[0024] At least one pressure sensor, which may be provided in the extracorporeal circuit, can measure / remove / monitor the pressure within the extracorporeal circuit at the at least one expansion chamber / air trap. For example, if a venous expansion chamber or air trap is provided, the venous pressure can be measured / received at the venous expansion chamber or air trap using a venous pressure sensor. Alternatively or additionally, if an arterial expansion chamber or air trap is provided, the arterial pressure or dialyzer inlet pressure can be measured / received at the arterial expansion chamber or air trap using an arterial pressure sensor or a dialyzer inlet pressure sensor.

[0025] According to the present disclosure, a liquid level or level control pump is preferably provided / arranged downstream of the at least one pressure sensor (e.g., an arterial pressure sensor, a venous pressure sensor, a dialyzer inlet pressure sensor), the liquid level or level control pump being in particular designed as an air compressor. In particular, the liquid level or level control pump serves to adjust the liquid level or level of the expansion chamber / air trap and can remove air from or squeeze air into the hose system / extracorporeal circuit. For example, a venous expansion chamber / air trap can be provided, at which the venous pressure is taken / measured by a venous pressure sensor, and the liquid level or level control pump can be provided downstream of the venous pressure sensor.

[0026] According to the disclosure, the extracorporeal circuit has at least one exhaust valve. In other words, according to the present disclosure, at least one exhaust valve is provided anywhere (at any position / location) in the extracorporeal circuit, via which air can escape / release from the extracorporeal circuit (via an opened valve).

[0027] Preferably, the at least one exhaust valve is arranged on a section (hose section) of the extracorporeal circuit through which air can escape from the provided expansion chamber / air trap. For example, the exhaust valve can particularly preferably be arranged / arranged behind a pressure sensor which measures / determines the pressure at the expansion chamber / air trap.

[0028] According to a preferred embodiment of the present disclosure, a venous expansion chamber / air trap is preferably provided, where venous pressure is measured / obtained via a venous pressure sensor, and air can escape from the venous expansion chamber / air trap via a section of the extracorporeal circuit (hose section), and a liquid level or level control pump and an exhaust valve are provided / arranged in this section of the extracorporeal circuit. Alternatively or additionally, an arterial expansion chamber / air trap may also be provided, where pressure is measured / obtained via a pressure sensor, and air can escape from the arterial expansion chamber / air trap via a section of the extracorporeal circuit (hose section), and a liquid level or level control pump and an exhaust valve are provided / arranged in this section of the extracorporeal circuit.

[0029] According to the disclosure, the control unit of the extracorporeal blood treatment apparatus is designed to control the priming in such a way that liquid, in particular priming liquid / flushing liquid / dialysis liquid, is supplied from the dialysate circuit via the membrane of the dialyzer to the extracorporeal blood circuit.

[0030] Advantageously, the control unit is designed to open the dialyzer inlet valve and the at least one vent valve for controlling the priming, and to close the dialyzer outlet valve, and to actuate the at least one flow pump, in particular the flow pump inlet (in the dialysate circuit upstream of the dialyzer), so that the flow pump pumps the fluid, in particular the priming fluid / rinsing fluid / dialysis fluid, into the dialyzer at the required pressure. It is obvious that, if more than one vent valve is provided in the extracorporeal circuit, each vent valve is preferably open so that air can escape via one or more vent valves when priming / filling the extracorporeal circuit with priming or flushing fluid.

[0031] The required pressure provided by the flow pump can be determined depending on the dialyzer used, in particular the ultrafiltration coefficient and the volume of the dialyzer, and the extracorporeal circuit / hose system used, in particular the volume of the extracorporeal circuit. In particular, the required pressure to be applied by the flow pump can be calculated as follows depending on the dialyzer used and the extracorporeal circuit / A / V hose system used (see equation 1 below):

[0032]

[0033] In other words, according to Equation 1, to determine the required pressure Δp to be applied by the flow pump, first the extracorporeal circuit / hose system V AV and dialyzer V Dialysator The volumes are added together and the sum is divided by the ultrafiltration coefficient, which specifies the ultrafiltration rate in ml per minute per mmHg transmembrane pressure (TMP). Thus, the pressure required on the dialysate side, provided by the flow pump, to fill the extracorporeal circuit / hose system and the dialyzer within one minute can be calculated using equation 1 above. In other words, the priming lasts one minute.

[0034] In order to ensure that the entire volume flows through the (hollow fiber) membranes of the dialyzer, it is advantageous not only for the priming or flushing fluid to be pressed through the dialyzer membranes from the dialysate side, but also for it to be pumped out in a suitable manner on one side of the extracorporeal circuit, in particular by generating a negative pressure or underpressure in the extracorporeal circuit (e.g. by means of a blood pump or by means of a liquid level or level control pump). In this context, it has proven advantageous to use negative values ​​for the pressure by which the priming or flushing fluid is pressed through the dialyzer membranes on the dialysate side.

[0035] In order to be able to carry out priming according to the disclosure, the pressure in the extracorporeal circuit / hose system can advantageously be reduced when the priming or flushing liquid is pressed or drawn through the membrane of the dialyzer into the extracorporeal circuit / hose system. According to the invention, this can be achieved by means of the at least one vent valve, through which air can escape / flow out of the extracorporeal circuit.

[0036] According to a preferred embodiment, the priming is carried out in a time-controlled manner. In particular, a time-dependent priming is conceivable, which is carried out according to the dialyzer used (volume and KUF), the extracorporeal circuit used (volume), and the applied pressure. Alternatively, the priming can also be carried out in a volume-controlled manner. In particular, it is also conceivable to use a liquid level or level control pump and use it to measure the air volume during the evacuation. Preferably, the priming can be controlled in such a way that it is completed when the system volume is reached.

[0037] Preferably, the control unit is designed to close the dialyzer inlet valve after priming is complete and before flushing begins, stop the at least one flow pump, in particular the flow pump inlet, keep the at least one exhaust valve open, and keep the dialyzer outlet valve closed.

[0038] According to the present disclosure, the flushing of the extracorporeal blood treatment apparatus, in particular the dialyzer and the extracorporeal circuit, is controlled such that for flushing a pressure difference is generated between the extracorporeal circuit and the dialysate circuit in order to cause a transfer of liquid from the extracorporeal circuit to the dialysate circuit via the membrane of the dialyzer.

[0039] Advantageously, a pressure differential is generated between the extracorporeal circuit and the dialysate circuit by first building up / increasing the pressure in the extracorporeal circuit via a fluid / liquid flow of priming / flushing fluid / dialysate from the dialysate circuit via the dialyzer membrane into the extracorporeal circuit (with one or more (vent) valves in the extracorporeal circuit closed), and then draining / removing the pressure in the dialysate circuit (e.g., by opening a valve, in particular a dialyzer outlet valve). The pressure differential thus generated is then first stored in the extracorporeal circuit, for example, in an expansion chamber / equilibrium chamber / air trap. According to the present disclosure, the pressure differential (overpressure) stored in the extracorporeal circuit is preferably reduced via a fluid flow from the extracorporeal circuit via the dialyzer membrane toward / back into the dialysate circuit. To this end, a valve, in particular a dialyzer outlet valve, is advantageously opened. Thus, the flushing process according to the present disclosure is achieved, in particular, by first allowing priming or flushing fluid to flow from the dialysate circuit into the extracorporeal circuit and then returning from the extracorporeal circuit to the dialysate circuit.

[0040] In general, according to the present disclosure, the extracorporeal circuit / AV hose system is preferably filled to maximum pressure in a first step. Decompression is then preferably performed by opening the dialyzer outlet valve. This allows the pressure in the extracorporeal circuit to also be relaxed by allowing accumulated liquid to preferably flow back into the dialysate circuit and be discharged via the dialyzer outlet valve. In other words, the volume stored in the expansion chamber / equilibrium chamber / air trap is reduced by squeezing / pressing the fluid volume through the (hollow fiber) membrane of the dialyzer.

[0041] Advantageously, the described flushing process / flushing is performed multiple times or repeated cyclically to remove as much residue / pyrogen as possible from the extracorporeal circuit and / or dialyzer. The duration of the entire flushing process is preferably individually adjustable. The number of repetitions of the flushing process / flushing depends in particular on the desired, adjusted, or required flushing volume. For example, a minimum flushing volume can be predefined for the extracorporeal circuit / A / V hose system. For typical / commercially available extracorporeal circuits, it has been found that preferably 5 to 30 repetitions, particularly preferably 10 to 25 repetitions, are necessary to properly implement the flushing. It has also been shown that each flushing process achieves a flushing volume of approximately 20 ml to 40 ml, preferably 25 ml to 35 ml, and particularly preferably approximately 30 ml. However, it is of course true that the flushing volume and number of repetitions of each flushing process depend in particular on how much liquid can be additionally introduced into the extracorporeal circuit during pressure buildup. In other words, the flushing volume and number of repetitions of each flushing process depend largely on the extracorporeal circuit / A / V hose system used, the dialyzer used, and the like.

[0042] Preferably, the control unit is designed to control flushing by generating a pressure difference between the extracorporeal circuit and the dialysate circuit such that a predetermined maximum pressure of the liquid, in particular the priming liquid / flushing liquid / dialysis liquid, is first generated in the dialysate circuit and the extracorporeal circuit by a pressure generating device, in particular the at least one flow pump, provided in the dialysate circuit, and then the predetermined maximum pressure is reduced in the dialysate circuit. In other words, pressure is preferably reduced in the dialysate circuit, for example by opening a valve provided in the dialysate circuit (preferably a dialyzer outlet valve). Advantageously, the predetermined maximum pressure in the extracorporeal circuit is reduced by transferring liquid from the extracorporeal circuit to the dialysate circuit through the membrane of the dialyzer.

[0043] Therefore, according to the present disclosure, the flushing is preferably achieved by controlling / operating the pressure difference stored in the extracorporeal circuit and the valves (dialyzer inlet valve, dialyzer outlet valve, exhaust valve, etc.), pumps, etc. present in the extracorporeal blood treatment apparatus. In this case, it has been found to be particularly advantageous if:

[0044] Advantageously, the control unit is designed to control flushing: opening or keeping open the dialyzer inlet valve, closing or keeping closed the at least one exhaust valve, closing or keeping closed the dialyzer outlet valve; and controlling the at least one flow pump so that it pumps liquid, in particular priming fluid / flushing fluid / dialysis fluid, into the dialyzer at a (predetermined) required pressure, more precisely until a predetermined maximum pressure is reached in the extracorporeal circuit.

[0045] This preferably prevents the priming liquid / rinsing liquid / dialysis fluid from escaping on the dialysate side during pressure buildup in the extracorporeal circuit. Furthermore, it preferably prevents the priming liquid / rinsing liquid / dialysis fluid or air from escaping outside the body. Furthermore, it is advantageous if the flow pump generates the same pressure on the dialysate side as during priming (calculated according to Equation 1).

[0046] The pressure buildup is preferably performed / conducted until a predetermined maximum pressure is reached or measured in the extracorporeal circuit. To measure the pressure in the extracorporeal circuit, one (or at least one) pressure sensor, such as a venous pressure sensor, an arterial pressure sensor, or a dialyzer inlet pressure sensor, can be used. The predetermined maximum pressure is particularly dependent on the dialyzer or components present in the extracorporeal circuit. For example, the specifications of the dialyzer used should be followed, particularly the maximum transmembrane pressure depending on the dialyzer type / used, and is generally provided in the dialyzer's data sheet. Furthermore, the maximum pressure can be determined based on the components present in the extracorporeal circuit, for example, such that the maximum volume of the provided / existing balancing chamber / air trap is taken into account in determining the maximum pressure. However, it is particularly preferred that the maximum pressure in the extracorporeal circuit is less than or equal to the maximum transmembrane pressure. In principle, the extracorporeal circuit can be flushed faster, i.e., a higher maximum transmembrane pressure requires fewer repetitions of the flushing process. Preferably, the maximum pressure / overpressure is less than 500 mmHg, particularly preferably less than 390 mmHg. However, higher pressures are generally possible or conceivable according to the present disclosure.

[0047] Furthermore, it is advantageous if the control unit is designed to close the dialyzer inlet valve, stop the at least one flow pump, keep the exhaust valve closed and open the dialyzer outlet valve to control flushing when a predetermined maximum pressure is present in the extracorporeal circuit. Thus, the pressure in the dialysate circuit is reduced or removed, and a pressure differential is generated between the extracorporeal circuit and the dialysate circuit. In other words, the pressure differential is therefore preferably stored as an overpressure in the extracorporeal circuit, and the predetermined maximum pressure / pressure differential or overpressure is then ultimately reduced in the extracorporeal circuit by liquid transfer / fluid flow via the membrane of the dialyzer towards the dialysate circuit and towards the (opened) dialyzer outlet valve.

[0048] Advantageously, at least two flow pumps are provided, wherein the second flow pump, in particular the flow pump outlet, assists in the fluid transfer from the extracorporeal circuit to the dialysate circuit through the dialyzer membrane. In particular, when the second flow pump / flow pump outlet, which is arranged downstream of the dialyzer, is operated in a closed / closed manner, it is mandatory that the flow pump outlet assists in the fluid transfer. Otherwise, the relaxation process may be assisted by the second flow pump, but this is not mandatory.

[0049] Advantageously, the control unit is designed to control flushing: when a predetermined maximum pressure in the extracorporeal circuit drops, the dialyzer outlet valve is closed, the second flow pump / flow pump outlet is optionally stopped, and the entire flushing process is repeated.

[0050] In summary, the control unit is therefore preferably designed to control flushing:

[0051] a) opening or keeping open the dialyzer inlet valve, closing or keeping closed the at least one vent valve, closing or keeping closed the dialyzer outlet valve, and actuating the at least one flow pump so that it pumps liquid, in particular priming fluid / flushing fluid / dialysis fluid, into the dialyzer at the required pressure, specifically until a predetermined maximum pressure is reached in the extracorporeal circuit;

[0052] b) when the predetermined maximum pressure is present in the extracorporeal circuit, closing the dialyzer inlet valve, stopping the at least one flow pump, keeping the exhaust valve closed, and opening the dialyzer outlet valve, whereby the predetermined maximum pressure in the extracorporeal circuit is reduced via liquid transfer through the membrane of the dialyzer towards the opened dialyzer outlet valve; and

[0053] c) When the predetermined maximum pressure in the extracorporeal circuit has dropped, the dialyzer outlet valve is closed and the flushing process is repeated starting from step a).

[0054] Preferably, steps a) to c) are carried out in chronological order by the control unit. Further preferably, steps a) to c) are repeated cyclically, so that the flushing process according to steps a) to c) is carried out multiple times for adequate flushing of the dialyzer and the extracorporeal circuit.

[0055] Advantageously, the blood pump adapter / pump section of the blood hose of the extracorporeal circuit is not inserted into the blood pump of the extracorporeal blood treatment apparatus during priming and flushing. Therefore, according to the present disclosure, a peristaltic pump is preferably not required during priming and flushing, and pyrogens / residues are advantageously not dissolved when the peristaltic pump is used to pump liquid during priming and flushing.

[0056] In summary, an extracorporeal blood treatment apparatus is provided, comprising an extracorporeal circuit, a dialyzer and a dialysate circuit, wherein the extracorporeal blood treatment apparatus is prepared or designed for priming and flushing thereof, and for this purpose the arterial section and the venous section of the extracorporeal circuit are connected via a connector device, and wherein a control unit of the extracorporeal blood treatment apparatus is designed to control priming in such a way that liquid from the dialysate circuit is supplied to the extracorporeal circuit via the dialyzer, and to control flushing in such a way that it is achieved by a pressure difference generated between the extracorporeal circuit and the dialysate circuit, so as to achieve a liquid transfer via the dialyzer, in particular from the extracorporeal circuit to the dialysate circuit.

[0057] In addition, the present disclosure relates to a method for prefilling and flushing an extracorporeal circuit and a dialyzer of an extracorporeal blood treatment device, in particular before the first use of the extracorporeal circuit and the dialyzer as described above, the method comprising the following steps: connecting or short-circuiting the arterial section of the extracorporeal circuit of the extracorporeal blood treatment device with the venous section; prefilling the extracorporeal circuit and the dialyzer by supplying liquid from the dialysate circuit of the extracorporeal blood treatment device to the extracorporeal circuit via the membrane of the dialyzer; and flushing the extracorporeal circuit and the dialyzer, which is performed simultaneously with or immediately after the prefilling, comprising the following steps: generating a pressure difference between the extracorporeal circuit and the dialysate circuit; and flushing the extracorporeal circuit and the dialyzer by fluid transfer via the membrane of the dialyzer, in particular from the extracorporeal circuit to the dialysate circuit.

[0058] Preferably, the flushing includes the following steps: generating a pressure difference between the extracorporeal circuit and the dialysate circuit such that first a predetermined maximum pressure of the liquid, in particular the priming liquid / flushing liquid / dialysis liquid, is generated in the dialysate circuit and the extracorporeal circuit by a pressure generating means, in particular at least one flow pump, arranged in the dialysate circuit, and then reducing the predetermined maximum pressure in the dialysate circuit.

[0059] Advantageously, the priming comprises the following steps: opening the dialyzer inlet valve of the dialysate circuit and the exhaust valve of the extracorporeal circuit; closing the dialyzer outlet valve of the dialysate circuit; and pumping the liquid, in particular the priming liquid / flushing liquid / dialysis liquid, into the dialyzer at the required pressure by means of a flow pump arranged in the dialysate circuit.

[0060] Preferably, flushing comprises the following steps: opening or keeping open the dialyzer inlet valve, closing or keeping closed the exhaust valve, closing or keeping closed the dialyzer outlet valve, and pumping liquid, in particular priming fluid / flushing fluid / dialysis fluid, into the dialyzer at the required pressure, more precisely until a predetermined maximum pressure is reached in the extracorporeal circuit.

[0061] Advantageously, the flushing further comprises the steps of closing the dialyzer inlet valve, stopping the at least one flow pump, keeping the exhaust valve closed, and opening the dialyzer outlet valve when a predetermined maximum pressure exists in the extracorporeal circuit, and whereupon the predetermined maximum pressure in the extracorporeal circuit is reduced by liquid transfer via the membrane of the dialyzer towards the open dialyzer outlet valve.

[0062] Further preferably, the flushing further comprises the step of assisting the fluid transfer from the extracorporeal circuit to the dialysate circuit via the membrane of the dialyzer by means of a flow pump.

[0063] In summary, the flushing preferably comprises the following steps: a) opening or keeping open the dialyzer inlet valve, closing or keeping closed the at least one exhaust valve, closing or keeping closed the dialyzer outlet valve, and pumping liquid, in particular priming liquid / flushing liquid / dialysis liquid, into the dialyzer at the required pressure, more precisely until a predetermined maximum pressure is reached in the extracorporeal circuit; b) when a predetermined maximum pressure exists in the extracorporeal circuit, closing the dialyzer inlet valve, stopping the at least one flow pump, keeping the exhaust valve closed, and opening the dialyzer outlet valve, and the predetermined maximum pressure in the extracorporeal circuit is subsequently reduced by liquid transfer via the membrane of the dialyzer towards the open dialyzer outlet valve; and c) when the predetermined maximum pressure in the extracorporeal circuit is reduced, closing the dialyzer outlet valve and re-implementing the flushing process starting from step a).

[0064] Therefore, the flushing / the flushing process is preferably carried out multiple times, in particular repeatedly in a cycle.

[0065] In summary, the present disclosure provides a fully automated priming and flushing wherein no replacement fluid port, no waste port, and no additional disposables are required for the fully automated priming and flushing. BRIEF DESCRIPTION OF THE DRAWINGS

[0066] The present disclosure will be further described below with reference to the accompanying drawings.

[0067] Figure 1 An extracorporeal blood treatment apparatus according to the present disclosure is shown, with which automatic priming and flushing according to the present disclosure is explained;

[0068] Figure 2 A flow chart illustrating automatic priming according to the present disclosure; and

[0069] Figure 3 A flow chart illustrating automatic flushing according to the present disclosure is shown.

[0070] Among them: 2-extracorporeal blood treatment equipment; 4-extracorporeal circuit; 6-dialyzer; 8-dialysate circuit; 10-membrane; 12-arterial section; 14-venous section; 16-adapter; 18-venous expansion chamber / air trap; 20-venous safety air detector; 22-venous hose clamp; 24-arterial hose clamp; 26-arterial safety air detector; 28-blood pump; 30-arterial pressure sensor; 32-dialyzer inlet pressure sensor; 34-venous pressure sensor; 36, 37-liquid level or level regulating pump; 38-(venous) exhaust valve; 40-machine front; 42-(arterial) exhaust valve; 44-blood pump adapter / pump section of the blood hose; 46-dialyzer inlet valve; 48-dialyzer outlet valve; 50-flow pump inlet; 52-flow pump outlet; 54-dialysate flow inlet; 56-dialysate flow outlet; 57-pressure sensor; 58-control unit. DETAILED DESCRIPTION

[0071] The drawings are merely schematic and are only useful for understanding the invention.

[0072] Figure 1 The diagram shows an extracorporeal blood treatment apparatus (dialysis machine) 2. The extracorporeal blood treatment apparatus 2 essentially comprises an extracorporeal circuit (A / V hose system) 4, a dialyzer 6, and a dialysate circuit 8. The extracorporeal circuit 4 and the dialysate circuit 8 are separated from each other by a membrane 10 arranged in the dialyzer 6.

[0073] The extracorporeal circuit 4 comprises an arterial section 12 situated upstream of the dialyzer 6 and a venous section 14 situated downstream of the dialyzer 6 .

[0074] As Figure 1 As can be seen, arterial segment 12 and venous segment 14 are connected or short-circuited via adapter 16, which is an example of a connector device. In other words, both the end of arterial segment 12 and the end of venous segment 14 are inserted into adapter 16, thereby fluidically connecting arterial segment 12 and venous segment 14 to one another. Preferably, two Luer connectors can be inserted into adapter 16, which are preferably provided at the ends of arterial segment 12 and venous segment 14.

[0075] In the venous section 14 of the extracorporeal circuit 4 , a venous expansion chamber or air trap 18 , a venous safety air detector 20 and a venous hose clamp 22 are arranged or provided downstream of the dialyzer 6 (ie in the direction from the dialyzer 6 towards the adapter 16 ).

[0076] Arranged in the arterial section 12 , starting from the adapter 16 in the direction of the dialyzer 6 , are an arterial hose clamp 24 , an arterial safety air detector 26 and a blood pump 28 .

[0077] In the arterial section 12, the arterial pressure upstream or in front of the blood pump 28 can be measured by means of an arterial pressure sensor 30. Furthermore, the dialyzer inlet pressure can be measured downstream or after the blood pump 28 and upstream or in front of the dialyzer 6 (between the dialyzer 6 and the blood pump 28) by means of a dialyzer inlet pressure sensor 32. In the venous section 14, the venous pressure at / after the venous expansion chamber or air trap 18 can be measured by means of a venous pressure sensor 34. The pressure sensors 30, 32, 34 provided in the extracorporeal circuit 4 can measure / receive / monitor the pressure at the corresponding locations in the extracorporeal circuit 4 at which they are arranged / provided.

[0078] In addition, if Figure 1 The venous expansion chamber or air trap 18 is connected to a level control pump 36. The level control pump 36 serves to control the fluid level in the venous expansion chamber or air trap 18 and is designed, for example, as an air compressor. In particular, the level control pump 36 can remove air from the extracorporeal circuit 4 (in particular from the venous expansion chamber or air trap 18) or press air into the extracorporeal circuit 4 (in particular into the venous expansion chamber or air trap 18) in order to thereby control the fluid level or fluid level in the venous expansion chamber or air trap 18.

[0079] A vent valve, in particular a venous vent valve 38, is arranged downstream of the liquid level or level regulating pump 36, through which air can escape from the extracorporeal circuit / hose system 4. Figure 1 In the embodiment, the venous expansion chamber / air trap 18 is therefore also connected to the degassing valve 38 , so that when the degassing valve 38 is open, air can in principle escape from the venous expansion chamber / air trap 18 or from the extracorporeal circuit 4 .

[0080] In addition, if Figure 1 It follows that another or second level or level regulating pump 37 can be arranged on the machine front 40 of the extracorporeal blood treatment apparatus 2. For example, the another or second level or level regulating pump 37 can be connected to (at Figure 1 The arterial expansion chamber or air trap is connected so that the fluid level or fluid level of the arterial expansion chamber or air trap can be adjusted in principle by a second liquid level or level regulating pump 37. Figure 1 In the embodiment, a further or second exhaust valve, in particular an arterial exhaust valve 42 , is arranged downstream of the second liquid level or level regulating pump 37 , through which air can escape from the arterial expansion chamber / air trap and thus from the extracorporeal circuit 4 .

[0081] However, it is also conceivable in principle that, even if a venous expansion chamber / air trap 18 and an arterial expansion chamber / air trap are provided, only a single level control pump is provided, and this level control pump can regulate the fluid level or fluid level of both air traps (for example, via an interposed valve). In this case, only one exhaust valve can also be provided downstream of one of the level control pumps.

[0082] As in Figure 1 As can be seen in the figure, the extracorporeal circuit 4 (particularly its blood pump adapter 44) has already been inserted into the blood pump 28, which is preferably designed as a roller pump or peristaltic pump and is configured to convey fluids / liquids by squeezing a hose. However, according to the present disclosure, it is preferred that the blood pump adapter 44 of the extracorporeal circuit 4 is not yet inserted into the blood pump 28 during priming and flushing, because according to the present disclosure, the blood pump 28 is not absolutely required for automatic priming and flushing. If the blood pump adapter 44 is not yet inserted into the blood pump 28 during priming and flushing, priming and flushing are greatly simplified. In particular, in this case, the blood pump adapter (hose) 44 is not sealed or squeezed by the (mostly closed) blood pump 28, and actuation of the blood pump 28 is not required either during priming or flushing.

[0083] The dialysate circuit 8 comprises a dialyzer inlet valve 46, a dialyzer outlet valve 48, a flow pump inlet 50 and a flow pump outlet 52. However, in principle, it is sufficient to provide only one flow pump, for example, the flow pump inlet 50, in the dialysate circuit 8. The dialyzer inlet valve 46 and the flow pump inlet 50 are arranged / disposed upstream of the dialyzer 6 at the dialysate inlet 54. The dialyzer outlet valve 48 and the flow pump outlet 52 are arranged / disposed downstream of the dialyzer 6 at the dialysate outflow outlet 56. Preferably, the flow pump inlet 50 and the flow pump outlet 52 are gear pumps. Figure 1 In the embodiment of the present invention, the pressure sensor 57 is arranged in the dialysate outflow port 56. However, according to the present disclosure, the pressure sensor 57 can also be arranged in the dialysate inflow port 54. It is also conceivable to arrange multiple pressure sensors, for example two or three pressure sensors, in the dialysate circuit 8. However, at least one pressure sensor 57 should be arranged in the dialysate circuit 8 so that the transmembrane pressure can be determined (together with one or more pressure sensors arranged in the extracorporeal circuit 4 / the pressure sensors arranged are, for example, the arterial pressure sensor 30, the dialyzer inlet pressure sensor 32, and the venous pressure sensor 34).

[0084] Furthermore, the extracorporeal blood treatment apparatus 2 has a control unit 58, which is preferably designed as a processor, in particular as a central computing / processing unit (CPU). The control unit 58 receives information from sensors arranged in the extracorporeal blood treatment apparatus 2. Figure 1 The sensors shown in FIG. 5 , namely the arterial pressure sensor 30, the dialyzer inlet pressure sensor 32, the venous pressure sensor 34 or the pressure sensor 57 in the dialysate circuit 8. On the other side, the control unit 58 controls or operates the actuators provided in the extracorporeal blood treatment apparatus 2. Here, only the actuators shown in FIG. 5 are listed as examples. Figure 1 The valves or pumps shown in the figure, namely in particular the exhaust valves 38 and 42, the dialyzer inlet valve 46, the dialyzer outlet valve 48, the flow pump inlet 50, the flow pump outlet 52, the blood pump 28, the liquid level or level control pumps 36, 37, etc.

[0085] The control unit 58 controls the automatic priming. In particular, it controls the priming in such a way that liquid (priming / flushing / or dialysate) is supplied from the dialysate circuit 8 via the membrane 10 of the dialyzer 6 to the extracorporeal circuit 4. To this end, the control unit 58 first opens the dialyzer inlet valve 46 and the (venous) vent valve (VVV) 38. If the (arterial) vent valve (VVA) 42 is connected to the extracorporeal circuit 4, in particular to the arterial section 12 of the extracorporeal circuit 4, the control unit 58 also opens the (arterial) vent valve 42. Furthermore, the control unit 58 closes the dialyzer outlet valve 48. In this state, the control unit 58 controls the flow pump inlet 50 so that it pumps the liquid (priming / flushing / or dialysate) into the dialyzer 6 at the required pressure.

[0086] Control unit 58 is preferably designed to calculate the required pressure itself, and accordingly adjusts the parameters of the flow pump inlet, such as flow velocity / volume flow. For the information required for calculation (see above-mentioned equation 1), in particular the volume of dialyzer 6 and extracorporeal circuit 4 and ultrafiltration coefficient KUF are obtained by control unit 58, for example, via the manual input (for example, via an unillustrated user interface) of the tube system / extracorporeal circuit 4 and the dialyzer 6 used. Alternatively, the tube system 4 used and the dialyzer 6 used can also be read, for example, via an unillustrated reading device, and the information read is passed to control unit 58.

[0087] Preferably, the liquid (priming / rinsing / or dialysate) is not only "pressed" through the membrane 10 of the dialyzer 6 via the flow pump inlet 50, but also "pulled" through the membrane 10 of the dialyzer 6 on one side of the extracorporeal circuit 4 by generating a negative pressure (negative pressure). This negative pressure can be generated, for example, by means of a liquid level or level control pump 36.

[0088] During pre-filling, the dialyzer 6 and the extracorporeal circuit 4 are filled with liquid (pre-filling / flushing / or dialysate). The control of the pre-filling by the control unit 58 can be carried out in a time-controlled or volume-controlled manner. For example, the control unit 58 can calculate in advance the time required for the pre-filling, and when the calculated required time has passed, the pre-filling process is interrupted. Alternatively, the volume of air leaving the extracorporeal circuit 4 can also be measured by means of a liquid level or a level regulating pump 36, and the corresponding information is passed to the control unit 58, and when the volume of air reaching the dialyzer 6 and the extracorporeal circuit 4 is reached, the control unit 58 ends the pre-filling process.

[0089] Therefore, the automatic pre-charge according to the present disclosure can be based on Figure 2 The flowchart shown in FIG is summarized in its simplest embodiment as follows: the automatic priming starts at "S" for "Start". In A, the dialyzer inlet valve 46 and the at least one exhaust valve 38 are opened or remain open, and the dialyzer outlet valve 48 is closed or remains closed. In B, the flow pump inlet 50 is controlled so that it pumps the priming liquid / flushing liquid / dialysis liquid into the dialyzer 6 at the required pressure. When the interruption criterion (time-controlled or volume-controlled) is met, the automatic priming ends at "E" for "Ende".

[0090] The control unit 58 also controls the automatic flushing of the dialyzer 6 and the extracorporeal circuit 4. Preferably, the flushing is carried out directly after the pre-filling. When the pre-filling is completed / finished, that is, when the dialyzer 6 and the extracorporeal circuit 4 are filled with liquid (pre-filling / flushing / or dialysate), the control unit 58 closes the dialyzer inlet valve 46 and stops the flow pump inlet 50. The exhaust valve 38 (or exhaust valves 38 and 42) initially remains open, and the dialyzer outlet valve 48 remains closed. In order to start flushing, the control unit 58 opens the dialyzer inlet valve 46 and closes the exhaust valve 38 (or exhaust valves 38 and 42). The dialyzer outlet valve 48 remains closed. In this state, the control unit 58 controls the flow pump inlet 50 so that the flow pump inlet pumps liquid into the dialyzer 6 at the required pressure. In other words, the flow pump inlet 50 generates an overpressure. This first causes the pressure in the dialysate circuit 8 to rise, and the pressure rise is transferred to the extracorporeal circuit 4 via the membrane 10 (pressure compensation) by liquid transfer. This process continues until the target pressure (desired overpressure / predetermined maximum pressure) is reached in the extracorporeal circuit 4 .

[0091] For example, a predetermined maximum pressure in the extracorporeal circuit 4 can be reached when the maximum transmembrane pressure of the dialyzer 6 used is reached, or when the maximum liquid level / maximum fluid volume of the venous expansion chamber / air trap 18 is reached.

[0092] When a predetermined maximum pressure is present in the extracorporeal circuit 4, the control unit 58 closes the dialyzer inlet valve 46, stops the flow pump inlet 50, and opens the dialyzer outlet valve 48. This allows the pressure on the dialysate side / in the dialysate circuit 8 to relax. Consequently, a pressure difference is generated between the extracorporeal circuit 4 and the dialysate circuit 8. This results in the excess pressure or pressure difference stored in the extracorporeal circuit 4 being released or reduced via the fluid flow through the membrane 10 of the dialyzer 6 from the extracorporeal circuit 4 to the dialysate circuit 8 to the open dialyzer outlet valve 48. This process can optionally be assisted by the flow pump outlet 52.

[0093] In other words, according to the present disclosure, automatic flushing is achieved by firstly causing a fluid flow from the dialysate circuit 8 via the dialyzer 6 to the extracorporeal circuit 4, and then causing a fluid flow from the extracorporeal circuit 4 via the dialyzer 6 to the dialysate circuit 8, by suitable valve / pump actuation. The fluid flow according to the present disclosure is generated by firstly generating a maximum pressure in the extracorporeal circuit 4 (fluid flow in one direction), then reducing the pressure in the dialysate circuit 8 so that a pressure difference is generated between the extracorporeal circuit 4 and the dialysate circuit 8, and finally reducing the pressure difference / overpressure stored in the extracorporeal circuit 4 by a fluid flow in the other direction (return).

[0094] After the pressure has been relaxed in the extracorporeal circuit 4 , the control unit 58 closes the dialyzer outlet valve 48 and repeats the described flushing process (several times), specifically until the required flushing volume is reached.

[0095] In general, the automatic flushing according to the present disclosure can be performed according to the Figure 3The flowchart shown in FIG. 1 is summarized in its simplest implementation as follows: The automatic flushing begins at "S" for "Start." In step a, the dialyzer inlet valve 46 is opened or remains open, the at least one vent valve 38 is closed or remains closed, the dialyzer outlet valve 48 is closed or remains closed, and the flow pump inlet 50 is actuated so that it pumps priming / flushing / dialysis fluid into the dialyzer 6 at the required pressure, specifically until a predetermined maximum pressure is reached in the extracorporeal circuit 4. In step b, when the predetermined maximum pressure is present in the extracorporeal circuit 4, the dialyzer inlet valve 46 is closed, the flow pump inlet 50 is stopped, the vent valve 38 remains closed, and the dialyzer outlet valve 48 is opened. The predetermined maximum pressure in the extracorporeal circuit 4 is reduced by fluid transfer through the membrane 10 of the dialyzer 6 toward the open dialyzer outlet valve 48. In step c, when the predetermined maximum pressure in the extracorporeal circuit 4 has decreased, the dialyzer outlet valve 48 is closed. A check is then performed to determine whether the required flushing volume has been reached. If this is not the case, the flushing process is repeated, ie steps a, b and c. When the desired removal volume is reached, the automatic flushing is terminated at "E" for "Ende".

Claims

1. An extracorporeal blood treatment apparatus (2), comprising: An extracorporeal circuit (4) comprising an arterial section (12) and a venous section (14), a dialyzer (6) and a dialysate circuit (8), wherein: The extracorporeal circuit (4) and the dialysate circuit (8) are separated from each other via a membrane (10) arranged in the dialyzer (6); The extracorporeal blood treatment apparatus (2) is prepared or designed for priming and flushing the extracorporeal circuit (4) and the dialyzer (6) before the first use of the extracorporeal circuit (4) and the dialyzer (6), and for this purpose the arterial section (12) and the venous section (14) are short-circuited or connected via a connector device (16); The dialysate circuit (8) has a dialyzer inlet valve (46), a dialyzer outlet valve (48) and at least one flow pump (50); The extracorporeal circuit (4) has at least one exhaust valve (38); and The extracorporeal blood treatment apparatus (2) further comprises a control unit (58) which is designed to control the priming in such a way that liquid is supplied from the dialysate circuit (8) via the membrane (10) of the dialyzer (6) to the extracorporeal circuit (4); It is characterized by: The control unit (58) is further designed to control flushing of the extracorporeal blood treatment apparatus (2) performed simultaneously with or immediately after the priming in such a way that a pressure difference is generated between the extracorporeal circuit (4) and the dialysate circuit (8) for flushing and a liquid transfer via the membrane (10) of the dialyzer (6) is achieved. Wherein, the control unit (58) is designed to control flushing, opening or keeping open the dialyzer inlet valve (46) and the at least one exhaust valve (38), and closing or keeping closed the dialyzer outlet valve (48); and The at least one flow pump (50) is actuated so that it pumps liquid into the dialyzer (6) at a desired pressure.

2. The extracorporeal blood treatment apparatus (2) according to claim 1, characterized in that The control unit (58) is designed to generate a pressure difference between the extracorporeal circuit (4) and the dialysate circuit (8) in order to control flushing, so that a predetermined maximum pressure of the liquid is first generated in the dialysate circuit (8) and the extracorporeal circuit (4) by a pressure generating device arranged in the dialysate circuit (8), and then the predetermined maximum pressure is reduced in the dialysate circuit (8).

3. The extracorporeal blood treatment apparatus (2) according to claim 1, characterized in that The control unit (58) is designed to control flushing: Opening or keeping open the dialyzer inlet valve (46), closing or keeping closed the at least one exhaust valve (38), closing or keeping closed the dialyzer outlet valve (48), and The at least one flow pump (50) is actuated so that it pumps fluid into the dialyzer at a required pressure, specifically until a predetermined maximum pressure is reached in the extracorporeal circuit (4).

4. The extracorporeal blood treatment apparatus (2) according to claim 1, characterized in that The control unit (58) is designed to control flushing: When the predetermined maximum pressure is present in the extracorporeal circuit (4), the dialyzer inlet valve (46) is closed, the at least one flow pump (50) is stopped, the exhaust valve (38) remains closed, and the dialyzer outlet valve (48) is opened, whereby the predetermined maximum pressure in the extracorporeal circuit (4) is reduced via a transfer of liquid through the membrane (10) of the dialyzer (6) towards the opened dialyzer outlet valve (48).

5. The extracorporeal blood treatment apparatus (2) according to claim 4, characterized in that At least two flow pumps (50, 52) are provided, wherein a second flow pump (52) assists in the transfer of fluid from the extracorporeal circuit (4) to the dialysate circuit (8) through the membrane (10) of the dialyzer (6).

6. The extracorporeal blood treatment apparatus (2) according to any one of claims 1 to 3, characterized in that The fluid is priming fluid / flushing fluid / dialysis fluid.

7. The extracorporeal blood treatment apparatus (2) according to claim 1, characterized in that A fluid transfer is achieved from the extracorporeal circuit (4) to the dialysate circuit (8).

8. The extracorporeal blood treatment apparatus (2) according to claim 1, characterized in that The flow pump inlet is controlled.

9. The extracorporeal blood treatment apparatus (2) according to claim 2, characterized in that The pressure generating mechanism is the at least one flow pump (50).

10. The extracorporeal blood treatment apparatus (2) according to claim 5, characterized in that The second flow pump (52) is a flow pump outlet.

11. A method for priming and flushing the extracorporeal circuit (4) and the dialyzer (6) of an extracorporeal blood treatment apparatus (2) according to any of the preceding claims 1 to 10 before first use of the extracorporeal circuit (4) and the dialyzer (6), which therefore does not include the placement and treatment of a patient, comprising the following steps: connecting or short-circuiting the arterial section (12) and the venous section (14) of the extracorporeal circuit (4) of the extracorporeal blood treatment apparatus (2); priming the extracorporeal circuit (4) and the dialyzer (6) by supplying liquid from the dialysate circuit (8) of the extracorporeal blood treatment apparatus (2) via the membrane (10) of the dialyzer (6) to the extracorporeal circuit (4); It is characterized by: Flushing of the extracorporeal circuit (4) and the dialyzer (6), which is performed simultaneously with or immediately after the priming, comprises the following steps: generating a pressure difference between the extracorporeal circuit (4) and the dialysate circuit (8); and flushing the extracorporeal circuit (4) and the dialyzer (6) by fluid transfer via the membrane (10) of the dialyzer (6), Wherein, the pre-charging comprises the following steps: Opening or keeping open the dialyzer inlet valve (46) of the dialysate circuit (8) and the exhaust valve (38) of the extracorporeal circuit (4); closing or keeping closed the dialyzer outlet valve (48) of the dialysate circuit (8); and The fluid is fed into the dialyzer (6) at a required pressure by means of a flow pump (50) arranged in the dialysate circuit (8).

12. Method for priming and flushing an extracorporeal blood treatment apparatus (2) according to claim 11, characterized in that The flushing comprises the following steps: A pressure difference is generated between the extracorporeal circuit (4) and the dialysate circuit (8) such that a predetermined maximum pressure of the fluid is first generated in the dialysate circuit (8) and the extracorporeal circuit (4) by a pressure generating device arranged in the dialysate circuit (8), and then the predetermined maximum pressure is reduced in the dialysate circuit (8).

13. Method for priming and flushing an extracorporeal blood treatment apparatus (2) according to claim 11, characterized in that The flushing further comprises the following steps: Opening or keeping open the dialyzer inlet valve (46), closing or keeping closed the exhaust valve (38), closing or keeping closed the dialyzer outlet valve (48), and The fluid is pumped into the dialyzer at the required pressure, specifically until a predetermined maximum pressure is reached in the extracorporeal circuit (4).

14. Method for priming and flushing an extracorporeal blood treatment apparatus (2) according to claim 13, characterized in that The flushing further comprises the following steps: When a predetermined maximum pressure exists in the extracorporeal circuit (4), the dialyzer inlet valve (46) is closed, the at least one flow pump (50) is stopped, the exhaust valve (38) remains closed, and the dialyzer outlet valve (48) is opened, and the predetermined maximum pressure in the extracorporeal circuit (4) is subsequently reduced by fluid transfer via the membrane (10) of the dialyzer (6) towards the opened dialyzer outlet valve (48).

15. Method for priming and flushing an extracorporeal blood treatment apparatus (2) according to claim 14, characterized in that The flushing further comprises the step of assisting the transfer of fluid from the extracorporeal circuit (4) to the dialysate circuit (8) via the membrane (10) of the dialyzer (6) by means of a flow pump (52).

16. Method for priming and flushing an extracorporeal blood treatment apparatus (2) according to any one of claims 11 to 13, characterized in that The fluid is priming fluid / flushing fluid / dialysis fluid.

17. Method for priming and flushing an extracorporeal blood treatment apparatus (2) according to claim 11, characterized in that A fluid transfer is achieved from the extracorporeal circuit (4) to the dialysate circuit (8).

18. Method for priming and flushing an extracorporeal blood treatment apparatus (2) according to claim 12, characterized in that The pressure generating mechanism is the at least one flow pump (50).

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