Hemodialysis Machine

Hemodialysis Machine. Bvdt 304 –Unit 3 Bvdt 303-Unit-1 (Common subject).

MODEL: Fresenius/4008S.

INTRODUCTION Hemodialysis removes wastes and water by circulating blood outside the body through an external filter, called a dialyzer, that contains a semi permeable membrane. The blood flows in one direction and the dialysate flows in the opposite, The counter-cunent flow of the blood and dialysate maximizes the concentration gradient of solutes between the blood and dialysate, which helps to remove more urea and creatinine from the blood. The concentrations of solutes (for example potassium, phosphorus, and urea) are undesirably high in the blood, but low or absent in the dialysis solution, Dialysis is an increasingly common type of twalment. The dialysis solution has levels of minerals like potassium and calcium that are similar to their natural concentration in healthy blood..

PURPOSE: When the nephrons in the kidneys are failure or not working properly, the ions like potassium, creatinine etc we go through dialysis. Diseases of renal failure are l. 2. 3. 4. 5. 6. Nephrotoxins Diabetic Nephropathy Hypertension Glomerulonephritis Cystic kidney Disease.

DEFINITION: The Hemodialysis name it self contains hemo means blood and dialysis means the diffusion of solute molecules through a semi permeable membrane, normally passing from the side of higher concentration to that of lower. Semi membrane is one that allows the passage of certain smaller molecules of such crystalloids as GLUCOSE and URFA, but prevents passage of larger molecules such as the colloidal plasma PROIEINS and PROTOPLASM. Hemodialysis, also spelled haemodialysis, commonly called kidney dialysis or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. It is a method that is used to achieve the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of renal failure. Hemodialysis is one of three renal replacement therapies (the other two being renal transplant and peritoneal dialysis). An alternative method for extracorporeal separation of blood components such as plasma.

PRINCIPLE: The principle of Hemodialysis is the same as other nethods of dialysis; it involves diffusion of solutes across a semi permeable membrane. Hemodialysis utilizes counter current flow, where the dialysate is flowing in the opposite direction to blood flow in the extracorporeal circuit. Counter-cument flow maintains the concentration gradient across the membrane at a maximum and increases the efficiency of the dialysis. It involves diffusion,cxsmomis and ultra filtration..

DESCRIPTION: • Hemodialysis is diffusion across a semi permeable membrane (one that allows only certain molecules to pass through it). The semi permeable membrane is used to remove the wastes from the blood and at the same time correct the level of electrolytes in the blood. Before Hemodialysis can be performed, a surgeon must make a way for the blcmm-l to be pumped out of the body and then be returned after it has been cleansed. To do this, the surgeon uses an attery and a vein in the forearm. Arteries (which have muscles in their walls) bring oxygenated blood to the body from the heart, and veins return blood 10 the heart, which needs to have oxygen. The surgeon connects the radial artery in the forearm to a large vein called the cephalic vein. This connection is called an arterio venous shunt. A shunt carries something from one place to another. In this case it carries blood from an artery to a vein. After this shunt is made, the veins in the forearm get big and eventually form muscles in their walls like arteries. They are now strong and can be punctured many times for dialysis..

Description cond't • DIALYSIS: There are two different kinds of dialysis used in medicine: Hemodialysis and peritoneal dialysis, The methods for performing dialysis may be different, but the goal of the treatment is the same, that is, to remove waste products. These wastes are composed mainly of nitrogen in the form of urea, uric acid, and creatinine. • TYPES OF DIALYSIS: There are five of dialysis. 2. 3. 4. 5. Hemodialysis. Peritoneal Dialysis. Hemofiltration. Hemodiafiltration. Intestinal dialysis..

FRONT VIEW: ilii I. Monitor 2. Blood Pressure Cuff 3. Extracorporeal blood circuit module 4. Concentrate connectors S. Brake 6. Shunt interlock for the dialyzer connecting lines 7. IV pole 8. Status indicator.

BACK VIEW: 1. Monitor 2. Sampling value 3.Bracket for the dialyzer connection lines 4. Dialysate outlet tube 5. Dialysate inlet tube 6. Disinfection connector 7. Filter 8. CDS (red) option 9. Drain 10. Water connector (Ik•rmeate) 11. DIASAFE plus 12. Vent tubing 13. Power supply unit.

Air trap and pressure monitor O Filtered blood returns to your body O Blood thinner O Dialyzer o Blood goes into the machine o Pressure monitor and pump Fresh dialysate solution goes in Used dialysate solution pumped out.

PARTS AND FUNCTIONS: .s.N0 2 3 4 PARTS Dialysis Machine Blood Pump and Tubing Syringe Dialyzer Alarms WW.NCTION A blood pump simply pumps the blood from the body into the machine through srwcially made tuhes. The syringe contains a drug called Heparin which prevents the blcx.kl from clotting in the tul*S. The dialyzer is a large canister containing thousands of small fibers through which patient blood is passed. The dialyzer is the key part of a dialysis tnachine where the cleaning ot' the blood takes place. in order to protect the patient flOrn any errors in functioning. The things that arc monitored with alarms include: •Blocxl pressure within the machine •Blood pressure of the patient •Blood flow •Tentperature •Dialysate mixture.

S.NO 5 6 8 9 PARTS Pressure monitor Air Leakage Detector Data Interfaces Valves Sensors FUNCTION •Arterial pressure monitor: Detects the pressure between dte blood access and the blood pump. pressure monitor: It normally detects positive pressures. If the venous pressure goes low, it probably due to disconnection/low• blood flows in the circuit. The detector is settled in the venous blood linc and detects as v,ell as in the purpose of avoiding alr embolus Dialysis machines Can include U.SB. Ethernet, and a variety Of serial interfaces to legacy h09ital information systems. Wireless interfaces (such as WI-Fij may also be Included for direct connection to the hospited wireless networks Data card slots are also available some designs. Several valves with electronic actuation are needed in the machine to allow variable mixing ratios. Various implementations are possible from simple opened/clow'd valves dnven by solenoids to precision variable- tx»sition valves driven by stepper motors, Dialysis machines require many different types of sensors to monitor various parameters. Blood pressure at various points in the extracorporeal circuit, dialysate pressure, temperature, O, saturation, motor speed, dialyzer membrane pressure gradient, and air are all monitored for proper values during dialysis..

PROCEDURE: Saline *Dlution didysate used dialysate Infbw pressure - monior pump (to prcvcnt ck*ting) Bloal pu syesstge Venws pressure monitor Air rap and air detector Clean blood Pitient Removed blcx-»d cleaning.

What does a dialyzer do?. A dialyzer is the part in the hemodialysis machine where your blood gets filtered. The core of the dialyzer is made up of thousands of tiny mesh tubes. Your blood flows inside each tube, and the dialysate stays on the outside of the tubes. Tiny pores in the tubes let waste and excess fluids pass from your blood into the dialysate. Your cleaned blood then leaves the dialyzer and is returned to your body.

Step by step procedure: 2. 3. 4. 5. 6. 7. After the dialysis procedure has been done to a patient, the machine should get ready for another new patient, we should clean the tubing's and filter with sterilizing fluid and should checked with a type of litmus tesL When the patient anives, the parameters like weight, blood pressme and temperature are measured. For fistula procedure we have to connect to veins of arms or legs. For catheter procedure we have to connect to large veins at chest. Then the patient is connected to the machine with complete ICR)P, then the timer and pump are startcü Hemodialysis is under Pericm•lically for every half hour, the blood pressure is taken. If, low blood pressure can cause cramping, nausea, shakes, dizziness, lightheadedness, and unconsciousness . The amount of fluid to be removed is set by the dialysis nurse according to the patient's "estimated dry weight.".

Procedure cond't 8. At the end of the procedure time, the patient is disconnected from the plumbing. Needle wounds are bandaged with gauze, held for up to I hour with direct pressure to stop bleeding, and then taped in place. 9. Temperature, standing and sitting blCKXl pressure, and weight are all measured again. Temperature changes may indicate infection. BP discussed above. Weighing is to confirm the removal of the desired amount of fluid. 10.Care staff verifies that the patient is in condition suitable for leaving. The patient must be able to stand, to maintain a reasonable blood pressure, and be coherent..

RISKS: 1. 2. 3. 4. 5. 6. Anemia: due to the procedure associated blood losses and mild effect on oxygen transporting function. Hematocrit (Hct): It levels, a measure of red blood cells, are typically low in ESRD patients. 'Ihis deficiency is caused by a lack of the hormone erythropoietin. Cramps, nausea, vomiting, and headaches: Some patients experience cramps and flu-like symptoms during treatment. These can be caused by a number of factors, including the type of dialysate used, composition of the dialyzer membrane, water quality in the dialysis unit, and the ultra filtration rate of the treatment. Hypotension: Because of the stress placed on the cardiovascular system with regular Hemodialysis treatments. patients are at risk for hypotension, a sudden drop in blood pressure. This can often be contmlled by medication and adjustment of the patient's dialysis prescription. Infection: Patients can also get infections through surroundings. Ille room and area used for patients must be kept clean. Infectious diseases: There is a great deal of blood exposure involved in dialysis treatment, a slight risk of contracting hepatitis B and hepatitis C exists, The hepatitis B vaccination is recommended for most patients,.

ADVANTAGES: • Low mortality rate Better control of blood pressure and abdominal cramps Less diet restriction Better solute clearance effect for the daily hemo dialysis: better tolerance and fewer complications with more frequent dialysis.

DISADVANTAGES: • Restricts independence, as people undergoing this procedure cannot travel around of supplies' availability Requires more supplies such as high water quality and electricity Requires reliable technology like dialysis machines The procedure is complicated and requires that care givers have more knowledge Requires time to set up and clean dialysis machines, and expense with machines and associated staff.

Recommendations for maintenance of HD machines:. We suggest that machines should be replaced after between five and ten years’ service or after completing between 15,000 and 40,000 hours of use for HD, depending upon an assessment of machine condition and specifications provided by the manufacturer. Routine servicing of the machines should be done at regular intervals by the qualified engineers or technicians. These designated technicians may be located in-house or may be stationed outside. Maintenance of records of routine servicing of machines should be maintained..

There must be a provision for emergency electric power supply for life-saving equipment in case of power failure. An uninterrupted power supply (UPS) backup of up to 15 minutes is desirable for each machine in case of power failure . Fire precautions must be taken and fire escapes should be clearly visible (mandatory for large HD units, optional for small HD units)..

Recommendations for disinfection of the HD machine:.