Renal Replacement Blood Viscosity Monitoring for Clot Prevention
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Solution Overview
Problem
Current renal replacement therapy (RRT) systems face challenges in maintaining the patency of the extracorporeal blood circuit due to clot formation, which is not accurately predicted by existing methods, leading to inefficiencies and increased costs.
Innovation Solution
Integration of a flow measuring device, such as a viscometer or rheometer, to directly measure blood viscosity and rheological properties, combined with a controller that adjusts RRT parameters in real-time using artificial intelligence to maintain optimal blood flow conditions and prevent clotting.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If anticoagulation is applied to prevent clotting, then circuit patency is improved, but cost increases and risk of bleeding and citrate toxicity increases
Solution Approach 1:
The patent replaces the chemical anticoagulation system with a physical monitoring and control system. A flow measuring device (viscometer/rheometer) directly measures blood viscosity and flow properties, and the controller adjusts RRT parameters (blood flow rate, ultrafiltration rate, replacement fluid rate) to maintain optimal flow conditions and prevent clotting mechanically rather than chemically.
Solution Approach 2:
The system enables self-regulation of circuit patency by continuously monitoring blood flow properties and automatically adjusting RRT parameters. The flow measuring device provides real-time feedback to the controller, which modifies operational parameters to maintain laminar flow and prevent clot formation without external anticoagulant intervention.
2Reliability
If filtration fraction is adjusted to prevent clotting, then circuit patency is improved, but measurement accuracy deteriorates because filtration fraction is an inaccurate surrogate for end-filter hematocrit
Solution Approach 1:
The patent replaces the indirect calculation method (filtration fraction as surrogate) with direct physical measurement. The flow measuring device directly measures blood viscosity and flow properties, providing accurate real-time data on blood rheological state without relying on inaccurate surrogate measurements.
Solution Approach 2:
The system implements continuous feedback by measuring blood flow properties in real-time and using this information to adjust RRT parameters. The flow measuring device provides ongoing feedback on viscosity and flow conditions, enabling dynamic adjustment of blood flow rate and ultrafiltration rate to maintain optimal conditions and prevent clotting.
3Reliability
If pre-filter fluid replacement is used instead of post-filter replacement, then clotting risk is reduced, but toxin clearance efficiency decreases
Solution Approach 1:
The patent implements dynamic adjustment of replacement fluid timing and rate based on real-time blood flow property measurements. The controller can switch between pre-filter and post-filter replacement modes, or use combined replacement, optimizing both circuit patency and toxin clearance efficiency based on actual blood viscosity and flow conditions rather than using a fixed approach.
4Productivity
If hemofiltration is used instead of hemodialysis, then fluid removal efficiency is improved, but clotting risk increases due to higher ultrafiltration rates
Solution Approach 1:
The system uses real-time feedback from the flow measuring device to monitor blood viscosity and flow properties during hemofiltration. The controller dynamically adjusts blood flow rate and ultrafiltration rate to maintain optimal flow conditions, enabling efficient fluid removal while preventing the high shear stress and stasis conditions that lead to clotting.
Solution Approach 2:
The patent dynamically changes operational parameters (blood flow rate, ultrafiltration rate, replacement fluid rate) based on measured blood flow properties. This allows optimization of fluid removal efficiency while maintaining circuit patency by adjusting parameters in real-time according to actual blood rheological conditions.
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
Enhances the efficiency and safety of RRT by accurately predicting and preventing clot formation, reducing downtime and treatment costs while ensuring treatment adequacy and patient safety.
Implementation Method 1
The flow measuring device includes at least one of a viscometer and a rheometer
Implementation Method 2
The flow measuring device includes at least one of a viscometer and a rheometer
Implementation Method 3
In hemofiltration, blood is passed through the hemofilter where water in the blood is driven across a semipermeable membrane by convection resulting from a pressure difference across the semipermeable membrane
Implementation Method 4
In hemodialysis, blood is passed through a hemofilter (also called dialyzer), in which solutes such as toxins and wastes diffuse through a semipermeable membrane from the blood to a dialysis fluid
Data Source
AI summary
A renal replacement apparatus (100), having a hemofilter (108); an extracorporeal blood circuit (102) configured to communicate blood from a patient (104), through the hemofilter, and back to the patient; and a flow measuring device (150) configured to measure at least one blood flow property as the blood is leaving the hemofilter and before the blood returns to the patient at a flow measuring device location (152), wherein the flow measuring device comprises at least one of a viscometer and a rheometer. Alternately, or in addition, the renal replacement apparatus may include thermomodulator system (222) including at least one thermomodulator configured to selectively heat and cool the blood in the extracorporeal blood circuit. The renal replacement apparatus (100) may have a controller (160). The controller may use artificial intelligence. Other embodiments are described herein.