Coordinated Dialysis and Infusion Control for Accurate Drug Dosing
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Solution Overview
Problem
Existing renal replacement therapies like CRRT and IHD disrupt the pharmacokinetics of administered drugs, leading to underdelivery or overdelivery, necessitating manual adjustments by physicians, which is inefficient and risky.
Innovation Solution
A combined extracorporeal and drug delivery system with a coordinating logic implementor that synchronizes CRRT or IHD machines with infusion pumps, electronically connects treatment settings, calculates drug dosages, and adjusts flowrates or concentrations to maintain desired dosing, considering patient characteristics and disease state.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If CRRT or IHD therapy is performed to treat acute kidney injury, then fluid removal and solute clearance are improved, but drug pharmacokinetics are disrupted leading to underdelivery or overdelivery
Solution Approach 1:
The system continuously monitors fluid removal rates during CRRT/IHD therapy and uses this feedback to automatically adjust drug dosing calculations. The coordinating logic implementor receives real-time data from the extracorporeal therapy machine and infusion pump, compares it with target dosing parameters, and makes dynamic adjustments to maintain accurate drug delivery despite changing pharmacokinetics during therapy.
Solution Approach 2:
The system dynamically changes dosing parameters (flow rates, concentrations, administration timing) based on the ongoing extracorporeal therapy parameters. The coordinating logic adjust the infusion pump settings in real-time to compensate for fluid removal rates, blood flow changes, and other therapy-induced pharmacokinetic variations, ensuring target drug concentrations are maintained.
2Measurement precision
If manual calculation adjustments are made by physicians to compensate for therapy effects, then drug dosing accuracy is improved, but provider workload and risk increase
Solution Approach 1:
The coordinating logic implementor performs self-service by automatically performing the dosing calculations and adjustments without requiring continuous physician intervention. The system monitors therapy parameters, calculates required dosing adjustments, and executes them through the infusion pump autonomously, freeing providers from repetitive manual calculations while maintaining dosing accuracy.
Solution Approach 2:
The system replaces the mechanical process of manual calculation and physical adjustment with an automated electronic control system. The coordinating logic implementor uses software algorithms to perform dosing calculations and control signals to adjust infusion pump parameters, eliminating the need for providers to manually compute and adjust dosing while reducing human error and workload.
3Adaptability or versatility
If multiple drugs are administered simultaneously during CRRT/IHD, then comprehensive treatment is improved, but coordination complexity and dosing errors increase
Solution Approach 1:
The coordinating logic implementor serves multiple functions simultaneously: it coordinates the extracorporeal therapy machine, controls multiple infusion pumps, calculates dosing adjustments for different drugs, and communicates with hospital IT systems. This multi-functional approach allows comprehensive treatment of multiple drugs during CRRT/IHD while managing coordination complexity through a single integrated control platform.
Solution Approach 2:
The system segments the coordination task into separate functional modules: therapy parameter monitoring, drug dosing calculation, infusion pump control, and data communication. Each module handles specific aspects of coordination independently, reducing overall system complexity while enabling comprehensive multi-drug treatment management through modular integration.
Data Source
AI summary
An extracorporeal and drug delivery system includes a renal failure therapy machine operable with a blood filter in fluid communication with an arterial line and a venous line, the machine including an effluent pump for pumping effluent from the blood filter, and at least one of a dialysis fluid pump for pumping dialysis fluid to the blood filter at a dialysis fluid flowrate, a predilution pump for pumping replacement fluid into the arterial line at a predilution flowrate, or a postdilution pump for pumping replacement fluid into the venous line at a postdilution flowrate; an infusion pump operable to deliver an intravenous (“IV”) drug to the patient; and a coordinating logic implementor configured to determine if a formulation adjustment should be made to the IV drug when a constituent of the IV drug exists in the dialysis fluid, the predilution replacement fluid, and/or the postdilution replacement fluid.