Haemodialysis Machine

The patient's blood is made to pass over the other side of the membrane so that fluids and toxins of low molecular weight can pass from the blood into the dialysate. Other molecules from the dialysate pass into the blood to rectify imbalances before it passes to waste. Blood is drawn from, and returned to the patient at a shunt or fistula between blood vessels of an arm, leg, or other access point.

HAEMODIALYSIS MACHINE
- This is commonly called an 'artificial kidney'. - It is a system of pumps, clamps, timers, tubing circuitry, and heaters, which passes blood from the patient, and a dialysate solution, through a dialyser. - Usually the dialysate is formed in the system by mixing a concentrated solution with filtered, de- ionized water. - The dialysate is heated to blood temperature, de-aerated and checked for conductivity before passing through the dialyser where it flows over a semipermeable membrane.

 Haemodialysis machines are used in hospitals in cases of acute renal failure and also in some cases of poisoning (e.g. drug overdoses). Patients with chronic renal failure are usually treated using machines at their homes or at special dialysis centres. Since the patient's life depends upon the correct functioning of the machine it contains a number of measuring and alarm circuits including

 A conductivity meter which identifies the correct concentration of the dialysing fluid, a temperature monitor to ensure that the dialysate neither cools nor heats the blood, and A dialysate pressure monitor since the quantity of water withdrawn from the patient will depend upon the pressure differential between the blood and dialysate. Because of the pressure differential, or incorrect assembly of the dialyser, the membrane may rupture leading to a blood leak into the dialysate. A blood leak detector, which is essentially an optical densitometer, is always included in the dialysate circuit after the artificial kidney.

 In the circuit containing the patient's blood, the pressure of the blood returning to the patient (venous pressure) is measured, to give protection against leaks in the blood lines, and a special monitor is required to ensure that no air is passed to the patient. This may be a blood level detector on the bubble trap, or another optical densitometer or ultrasonic bubble detector to identify the presence of bubbles in the return circuit to the patient.

BLOOD LEAK DETECTOR

In a hemodialysis machine there is always the possibility of rupture of the dialysing membrane with consequent leaking of blood into the dialysate. To identify this problem an optical blood leak detector is included to detect staining of the dialysate after it leaves the artificial kidney. This is normally an optical device which detects reduction in light transmission through the dialysate in a special cell which causes the machine to indicate that there is a fault, and also causes the machine to fail to a safe condition. Blood leak detectors are normally an integral part of the hemodialysis machine, but may be a separate device on some machines. The chamber may be disposable on some modern machines.

BLOOD LEVEL DETECTOR

During hemodialysis, blood passes from the patient through the artificial kidney (dialyser) and is returned to the body via a bubble trap. This is a broad chamber in which bubbles rise, thus preventing air being pumped back into the patient via the venous return tube which leaves the chamber at the bottom. As the quantity of air at the top of the trap builds up, so the blood level falls. A blood level detector may be a photoelectric detector on the trap to show when blood has fallen below an acceptable level. The technique is not completely foolproof because of frothing, and so a second photoelectric detector on the narrow outlet tube is sometimes used. If air is detected, or the blood level falls too low, an alarm sounds and the dialysis may be interrupted until the condition is corrected. On some modern machines air may be detected in the blood by an ultrasonic detector combined with a clamp for extra safety. The blood level detector may be an integral part of the dialysis machine, or it may be a separate device.

BUBBLE TRAP
When blood must be drawn from the body and then returned to it, bubbles of air may develop due to leaks, pressure changes in the circuit, or arising from the oxygenation process in a heartlung machine. The purpose of a bubble trap is to allow these bubbles to rise in a special chamber from which the blood leaves at the bottom. In haemodialysis special alarm circuitry is linked either to a blood level detector to identify when the air removed from the circuit displaces the blood downwards below an acceptable level, or there may be an optical or ultrasonic detector to show when bubbles are passing back to the patient. The bubble trap is normally part of the disposable tubing set used for the procedure.

PUMP
Blood pump. In haemodialysis and during open heart surgery blood is pumped round an extracorporeal (outside the body) circuit by roller pumps. Blood may also be pumped for blood transfusion, but this is less common. Dialysis pump. This is a proportioning pump to mix a concentrated dialysing fluid with purified tap water to produce a mixture of controlled concentration in a haemodialysis machine.

ROLLER PUMP
To preserve sterility of body fluids (e.g. blood) during pumping they can be pumped inside soft rubber tubes squeezed between rollers. The rollers move forward keeping a part of the tube closed. This produces a pulsatile or peristaltic form of flow which is suitable for many applications such as pumping during haemodialysis and open-heart surgery. The usual form has two or three rollers on a rotating arm which presses the tubing into a shoe so that one of the rollers is always occluding the tube (thus preventing back flow). The tubing must be relatively soft. It may be part of a long silicon-rubber tube or it may be a short section within a stiffer tube. This type of pump produces relatively little damage to blood.

Hello Fiber Dialyzer

Parallel Plate Dialyzer