Citrate Anticoagulation System for Hemofiltration
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Solution Overview
Problem
Extracorporeal blood treatment systems face challenges in preventing coagulation and maintaining electrolyte balance during hemofiltration, leading to complications such as bleeding and electrolyte imbalances due to systemic anticoagulation and net removal of essential ions and nutrients.
Innovation Solution
A citrate anticoagulation system is integrated into the extracorporeal blood treatment system, using a citrate anticoagulant solution and matching substitution infusion fluids to control blood flow and ion concentrations, preventing coagulation within the extracorporeal circuit and maintaining physiological ion balances.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If heparin or fractionated heparin is used as anticoagulant, then coagulation prevention is achieved, but systemic anticoagulation occurs leading to bleeding complications
Solution Approach 1:
The patent applies local quality by using citrate anticoagulant specifically in the extracorporeal circuit rather than systemic heparin. The citrate is introduced only into the extracorporeal blood treatment system where it binds calcium locally to prevent coagulation in the circuit, while avoiding systemic anticoagulation and its associated bleeding complications.
Solution Approach 2:
The patent uses citrate as an intermediary substance that mediates between the need for coagulation prevention and the avoidance of systemic anticoagulation. Citrate binds calcium ions in the extracorporeal circuit to prevent coagulation, serving as a localized anticoagulant that does not systemically affect the patient's blood.
2Object-affected harmful factors
If citrate anticoagulant is used, then systemic anticoagulation is avoided, but net removal of calcium and magnesium ions occurs
Solution Approach 1:
The patent applies parameter changes by carefully controlling the concentration and flow rate of citrate anticoagulant solution to optimize anticoagulation effectiveness while minimizing ion removal. The system adjusts citrate infusion parameters to maintain adequate anticoagulation in the extracorporeal circuit while limiting the net removal of calcium and magnesium ions from the patient's body.
Solution Approach 2:
The patent implements feedback control by monitoring ion concentrations and adjusting citrate infusion rates accordingly. The system uses feedback from ion monitoring to regulate the citrate anticoagulant flow, ensuring that calcium and magnesium ion removal is minimized while maintaining effective anticoagulation in the extracorporeal circuit.
3Quantity of substance
If substitution infusion fluid is added to maintain blood volume, then blood volume is maintained, but electrolyte imbalances occur
Solution Approach 1:
The patent applies parameter changes by carefully adjusting the composition and flow rate of substitution infusion fluid to maintain blood volume while preserving electrolyte balance. The system modifies infusion fluid parameters (electrolyte composition, osmolarity) to match patient requirements and prevent electrolyte imbalances during hemofiltration.
Solution Approach 2:
The patent implements feedback control by monitoring electrolyte concentrations and adjusting substitution infusion fluid composition and flow rates accordingly. The system uses feedback from electrolyte monitoring to regulate infusion fluid parameters, ensuring that blood volume is maintained while electrolyte balances are preserved.
4Reliability
If hemodialysis is combined with hemofiltration, then treatment effectiveness is improved, but system complexity increases
Solution Approach 1:
The patent applies merging by integrating hemodialysis and hemofiltration into a single extracorporeal circuit system. The combined therapy allows simultaneous performance of both filtration and dialysis functions through coordinated operation of the citrate anticoagulation system and substitution infusion fluid, reducing the need for separate systems while maintaining treatment effectiveness.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The citrate anticoagulation system effectively prevents coagulation and maintains stable ion concentrations, reducing the risk of complications like bleeding and electrolyte imbalances, ensuring safer and more effective hemofiltration procedures.
Implementation Method 1
using a citrate anticoagulant solution and matching substitution infusion fluids to control blood flow and ion concentrations, preventing coagulation within the extracorporeal circuit
Implementation Method 2
the patient's blood is passed through the artificial kidney over a semi-permeable membrane. The semipermeable membrane selectively allows plasma water and matter in the blood to cross the membrane from the blood compartment into the filtrate compartment
Implementation Method 3
Citrate ions, usually added in the form of trisodium citrate, are believed to bind free calcium ions in the blood, which have a pivotal role in the coagulation cascade
Data Source
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AI summary
A machine-readable medium embodying instructions that may be performed by one or more processors, the instructions comprising instructions for pumping blood from a patient's blood stream into an access line, instructions for introducing an anticoagulant solution into the pumped blood, instructions for filtering the pumped blood, instructions for delivering the pumped blood from the filtering step to a return line, instructions for introducing at least one substitution fluid into the pumped blood, instructions for introducing a calcium solution into the blood traveling through the return line, and instructions for returning the blood back to the patient's blood stream.