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WO2015192927A1 - Dispositif d'hémofiltration, ensemble de tuyaux souples et son utilisation et procédé pour faire fonctionner un dispositif d'hémofiltration - Google Patents

Dispositif d'hémofiltration, ensemble de tuyaux souples et son utilisation et procédé pour faire fonctionner un dispositif d'hémofiltration Download PDF

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Publication number
WO2015192927A1
WO2015192927A1 PCT/EP2015/000678 EP2015000678W WO2015192927A1 WO 2015192927 A1 WO2015192927 A1 WO 2015192927A1 EP 2015000678 W EP2015000678 W EP 2015000678W WO 2015192927 A1 WO2015192927 A1 WO 2015192927A1
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WO
WIPO (PCT)
Prior art keywords
line
hose
addition
substituate
valve
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2015/000678
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German (de)
English (en)
Inventor
Günter Heeke
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Individual
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Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
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Publication of WO2015192927A1 publication Critical patent/WO2015192927A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3424—Substitution fluid path
    • A61M1/3431—Substitution fluid path upstream of the filter
    • A61M1/3434—Substitution fluid path upstream of the filter with pre-dilution and post-dilution
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3424—Substitution fluid path
    • A61M1/3437—Substitution fluid path downstream of the filter, e.g. post-dilution with filtrate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/36—General characteristics of the apparatus related to heating or cooling

Definitions

  • the invention further relates to a hose set for a Haemofiltrations réelle, consisting of a Y-shaped branched hose of flexible material, and its use.
  • the invention further relates to a method for operating a haemofiltration device.
  • Extracorporeal therapies based on the principle of haemofiltration filter out some of the blood, eliminating dissolved urine-containing substances or toxins in the broadest sense, while leaving the cellular blood components in the bloodstream. In order not to cause unwanted volume losses
  • CONFIRMATION COPY a sterile substituate with a suitable electrolyte composition and with the desired volume, the extracorporeal blood circulation fed back in the course of treatment.
  • the medically required balancing accuracy in this addition of substituent is mostly achieved by electronic control devices using control and control systems such as gravimetric or volumetric measuring devices and processor controlled pumps. If such a therapy method is used in patients with kidney failure, in addition to the elimination of urinary substances and the required volume reduction can be achieved by more liquid withdrawn from the circuit than substituted.
  • Such devices for renal replacement therapy are known as artificial kidney, for example from DE 25 52 304 A1.
  • the delivery of the substituate to the extracorporeal bloodstream may be accomplished downstream of the hemofilter using a standard drip chamber.
  • the filtered blood and the substituate then pass back to the patient via the return line. Since the blood concentrated in the passage through the haemofilter is diluted again behind the filter during this process, this admixing process is referred to as postdilution.
  • the simplest form of switching between post and predilution is to manually shut off the typically used tubing of the substituate using temporary shutoff valves, release it from the postdilution port, and connect it to a port intended for predilution.
  • This manual intervention interferes with the operation and poses an additional risk of contamination.
  • only 100% Postdilution or 100% Predilution can be used with this method. A short-term change between the operating modes is therefore not possible.
  • hose line for the transport of the substituate is divided into two branches in a Y-shape, each leading to the point of addition for mail or for predilution.
  • haemofiltration devices offer such a solution, wherein two peristaltic pumps for the independent, defined liquid transport are connected in the two branch lines after the Y-shaped division. These two peristaltic pumps arranged in the branch lines cause a selectively controllable ratio of post- and predilution, as well as a desired closure of a single one of the line branches or both line branches at standstill.
  • Another technical possibility uses only one peristaltic pump in front of the Y-shaped hose manifold and two separate hose clamp valves downstream of the manifold for the selective closure of one of the two pipe branches after the branching.
  • By opening or closing the typically electrically controllable shut-off valves post or predilution is made possible. Since, in principle, there is the possibility in this embodiment variant of blood flowing through the hose line when the hose clamping valves are open at the same time, check valves must be provided in both line branches.
  • a defined Relation from pre- to post-dilution with simultaneous opening of both shut-off valves is not possible because the delivery rates in the two transport branches are counter-pressure-dependent and this back pressure is influenced by the changing filter state and the blood flow rate.
  • the object of the invention is to provide a hemofiltration apparatus and a corresponding hose set, which allow a simple and safe switching of the addition of a substituate between pre- and post-dilution. Furthermore, the object of the invention is to provide an improved method for operating a Haemofiltrations réelles.
  • a Haemofiltrations réelle with a Haemofilter, a supply line for supplying a blood stream from a patient to the Haemofilter, as well as with a return line for returning the blood stream to the patient, upstream of the Haemofilters a first addition site for the substituate the blood stream is arranged, and wherein downstream of the Haemofilters a second addition point for the Substituat is arranged to the bloodstream, and with a supply means for supplying the substituate from a supply to the first and / or the second addition point, wherein the supply means is a Y-shaped branched hose having a line extending to a branch point line section and extending from the branch point first and second line branch, wherein on the first line section a hose pump for conveying the substituate is arranged, and wherein the first leg extends from the branch to the first point of addition, and wherein the second leg extends from the branch to the second point of addition,
  • a Y-branched hose line is understood to mean any hose line whose lumen splits from a lumen leading to the branching into two lumens leading away from the branching.
  • the branch may also be T-shaped or asymmetric, without departing from the invention.
  • an infusion heating is arranged along the first line section of the hose line. This allows the substituate to preheat to body temperature or slightly higher so as to avoid hypothermia of the patient.
  • the hose line in the region of the hose pump and / or the shut-off valve has a higher load capacity, for example a higher elasticity, than in the remaining hose area.
  • the hose can be designed to be optimally optimized for the stress in its particularly stressed area, without the entire hose being made of such a material, which is adapted to the stresses required only in regions.
  • the increased elasticity can be achieved, for example, by the use of a silicone material, a modified PVC material and / or by changing wall thicknesses of the hose line.
  • a particularly stressed area is, for example, the area of action of the peristaltic pump.
  • the check valve is designed to be spring-loaded according to a particularly advantageous embodiment of the invention, that is, the closed position is left only after concerns a spring force exceeding the opening force, and the valve automatically returns to the closed position, when the spring force is higher than the applied opening force again. This ensures that the check valve is not unintentionally opened by the back pressure of the substituent flowing through the opened shut-off valve.
  • the spring load is preferably set so that the peristaltic pump can open the check valve with closed shut-off valve against the pressure in the filtration circuit problem-free.
  • Typical opening pressures at which the check valve should open are, for example, in the range of 200-500 mbar.
  • the term "spring-loaded” is to be interpreted broadly here, for example, plastic or rubber diaphragms with spring action or even lip valves with suitable shaping and sufficient prestressing in a suitable installation structure can be used.
  • the first leg of the tubing which is connected to the first addition point, is provided in a preferred embodiment of the invention with the shut-off valve.
  • the predominant in typical treatment course postdilution is carried out by the preferably in the de-energized state opening shut-off valve, while the rarer predilution takes place through the check valve, which is arranged in the second leg, leading to the second addition point.
  • the first point of addition and / or the second point of addition are designed as drip chambers. This allows a bubble-free and visually verifiable addition of the substituate.
  • a hose set for a Haemofiltrations réelle consisting of a Y-shaped branched hose of flexible material, wherein in only one of the line branches behind the Verze Trent the hose, in particular a spring-loaded check valve is arranged.
  • the first line section of the hose line and / or the line branch, in which the check valve is not arranged an area with increased strength, eg with increased elasticity.
  • the stated object is achieved by the use of a hose set according to the invention in a Haemofiltrations réelle.
  • Fig. 2 another Haemofiltrations réelle according to the prior art
  • Fig. 3 a Haemofiltrations réelle according to the invention.
  • FIG. 1 shows a hemofiltration apparatus 100 according to the prior art.
  • a supply line 1 passes a blood stream from the patient, not shown, through a first drip chamber 2 to a hemofilter 3, in which unwanted blood constituents are filtered out and removed via a filtrate line 4.
  • the purified blood stream is passed through a second drip chamber 5 and returned to the patient via a return line 6.
  • the transport of the blood stream through the haemofiltration device 100 is typically done using a blood pump, not shown here, with the blood taken from a vein and also returned to a vein.
  • a substituate is added to the bloodstream. This is supplied from a supply 9 via a Y-shaped branched hose 13 by means of two peristaltic pumps 14, 15 of the first drip chamber 2 or the second drip chamber 5 and there added to the blood stream.
  • the Drip chambers 2, 5 serve the bubble-free mixing and the visual inspection by the treatment staff.
  • an infusion heater 12 is arranged for preheating the substituate.
  • the infusion heater 12 may be e.g. be designed as a biocompatible heat exchanger, infrared radiator or as Schuplatten-Heizungsberg combination.
  • a first line branch 7 of the hose line 13 leads from the branching point to the first drip chamber 2.
  • a first peristaltic pump 15 is arranged to supply the substituate via the first drip chamber 2 to the blood stream.
  • the first peristaltic pump 15 is activated when predilution is desired and taken out of service when post-dilution is required.
  • first line branch 7 of the hose 13 is closed.
  • a second line branch 8 of the hose line 13 leads from the branching point to the second drip chamber 5.
  • a second hose pump 14 is arranged to supply the substituate via the second drip chamber 5 to the blood stream.
  • the second peristaltic pump 14 is activated when post-dilution is desired and taken out of service when predilution is required.
  • the second leg 8 of the hose 13 is closed.
  • Figure 2 shows another Haemofiltrations réelle 200 according to another prior art, which is similar to the Haemofiltrations réelle 100 gem.
  • Figure 1 is constructed. A repeated description of the same components is therefore omitted here.
  • a peristaltic pump 1 1 is arranged in the first line section 10 of the hose 13, which causes the delivery of the substituate from the supply 9 both in postdilution and in predilution.
  • shut-off valves 16, 17 are arranged, which in order to avoid an unwanted bypass flow of the blood past the filter 3 each with associated return impact valves are executed.
  • the shut-off valves 16, 17 thus allow the substituate to flow only in the direction of the drip chambers 2, 5 in the opened state, but not in the opposite direction.
  • the shut-off valve 17 is first closed to work with post-dilution and the shut-off valve 16 is opened.
  • the substituate is conveyed by the hose pump 11 from the supply 9 through the pipe sections 10 and 8 of the hose 13 to the second drip chamber 5, where it is mixed with the blood stream.
  • shut-off valve 6 is closed and the shut-off valve 17 is opened.
  • the substituate is then conveyed through the conduit sections 10 and 7 of the tubing to the first drip chamber 2 where it is mixed with the blood stream.
  • shut-off valves 16 and 17 must be synchronized. If e.g. the shut-off valve 17 is opened too late, after the shut-off valve 16 is already closed, a pressure peak builds up in the hose line between the hose pump 11 and the shut-off valves 16, 17, which after opening the shut-off valve 7 on the supply line 1 and the Haemofilter acts and can lead to damage of Haemofilters 3. If, however, the shut-off valve 17 is opened before the shut-off valve 16 is closed, both shut-off valves 16, 17 are opened at short notice and a bypass flow can briefly emerge past the line branches 7 and 8 on the haemofilter 3, which are only interrupted by the shut-off valves 16, 16. 17 provided check valves is interrupted.
  • FIG. 3 shows a hemofiltration apparatus 300 according to the invention.
  • the haemofiltration device 300 in turn comprises a supply line 1, which directs a blood flow from the patient, not shown, through a first drip chamber 2 to a hemofilter 3, in which unwanted blood constituents are filtered out and removed via a filtrate line 4.
  • the purified blood stream is returned to the patient through a second drip chamber 5 via a return line 6.
  • the blood flow through the Haemofiltrations réelle 300 again typically takes place by a separate, not shown, blood pump, wherein the blood is removed from a vein and returned to a vein.
  • the substituate is supplied from the supply 9 via a Y-shaped branched hose 13 by means of a peristaltic pump 11 of the first drip chamber 2 or the second drip chamber 5 and admixed there to the blood stream.
  • an infusion heater 12 for preheating the substituate is arranged on the first line section 10 of the hose line 13 which runs from the supply 9 to the branching point.
  • a first line branch 7 of the hose line 13 leads from the branch point to the first drip chamber 2.
  • a check valve 18 is arranged in this first line branch 7.
  • a second line branch 8 of the hose line 13 leads from the branch point to the second drip chamber 5.
  • a shut-off valve 316 is arranged, which in this illustrated embodiment of the invention must have no check function and is therefore designed as a simple hose clamp valve.
  • this hemofiltration apparatus 300 is as follows:
  • the shut-off valve 316 is opened. Since this is the predominantly present operating state, the shut-off valve 316 is designed as a passively opening valve, which closes when energized.
  • the peristaltic pump 1 1 conveys the substituate at low pressure and with a delivery rate, not shown, through the second line branch 8 and the second drip chamber 5 into the blood returning to the patient. Because of the low delivery pressure and because of the pressure gradient prevailing at the same time over the Haemofilter 3, the check valve 18 remains securely closed. By using a spring-loaded check valve 18, the security against unwanted opening is further increased.
  • shut-off valve 316 is closed by energizing.
  • shut-off valve 316 By electrical actuation of the shut-off valve 316 in sufficiently short time intervals, a quasi-simultaneous predilution and postdilution can be achieved with a variable duty cycle to one another. Interchanging the positions of the check valve 18 and the check valve 316 is possible and may be useful for technical reasons. However, since in practice the postdilution mostly outweighs the predilution in terms of time and volume, the illustrated arrangement is preferable for energetic reasons, because the typically solenoid-operated shut-off valve 316 consumes no energy in the normally open state and thus generates no loss-related heat.
  • the advantage of the invention described lies in particular in the special technical simplicity.
  • only one peristaltic pump 11 and only one shut-off valve 316 are required as machine components for dilution control.
  • the thus-equipped hemofiltration apparatus 300 can be produced less costly than conventionally equipped equipment due to a reduced number of components.
  • the elimination of a pump segment in the hose 13 also results in a simpler handling of the device, since only one pump segment is to be inserted into the associated peristaltic pump 11, while in the prior art were two pump segments.
  • One Another advantage is that existing devices that allow, for example, only post-dilution can be easily retrofitted.
  • the hose line which is typically designed as a disposable article, is also technically simpler and thus less expensive. Instead of a second pump segment only one miniaturized check valve 18 is integrated in one of the two line branches. Such components are available in the field of medical technology industrial mass products and as inexpensive, sterilizable disposable items.
  • the dilution control according to the invention has in addition to the previously known arrangements in addition the advantage that they can work independently and thus can be implemented as a separate retrofit unit for such Haemofiltrations Ltd, which were originally designed only for post-dilution. Since, in particular, the safety-related fluid balance of the devices is not affected, no change in the device software and no control-technical electrical intervention is required. Only the hose line, which is usually designed as a disposable article anyway, must be modified by integration of the check valve 18.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

L'invention concerne un dispositif d'hémofiltration comportant un hémofiltre (3), une conduite d'alimentation (1) destinée à amener un flux de sang d'un patient à l'hémofiltre (3), et une conduite de retour (6) destinée à renvoyer le flux de sang vers le patient, un premier point d'alimentation du flux de sang en un substitut étant disposé en amont de l'hémofiltre (3), et un second point d'alimentation du flux sanguin en un second substitut étant disposé en aval de l'hémofiltre (3), et un moyen d'alimentation destiné à amener le substitut d'un réservoir (9) au premier et/ou au second point d'alimentation, le moyen d'alimentation comportant un conduit en tuyau souple ramifié (13) pourvu d'une première section de conduit (10) qui s'étend du réservoir (9) à un point d'embranchement et de première et seconde branches de conduite (7, 8) partant du point d'embranchement, une pompe à tuyau (11) étant disposée au niveau de la première section de conduite (10) pour transporter le substitut, et la première branche de conduite (7) s'étendant de l'embranchement au premier point d'alimentation situé en amont, et la seconde branche de conduite (8) s'étendant de l'embranchement au second point d'alimentation situé en aval. L'invention est caractérisée en ce qu'une vanne anti-retour (18) n'est disposée que dans l'une des deux branches de conduite (7, 8) de la conduite en tuyau souple (13), et en ce qu'une vanne anti-retour (316), en particulier une vanne à pincement de tuyau, n'est disposée que dans l'autre des deux branches de conduite (7, 8) de la conduite en tuyau souple (13). En outre, l'invention concerne un ensemble de tuyaux souples destiné à un dispositif d'hémofiltration et son utilisation. Enfin, l'invention concerne un procédé pour faire fonctionner un dispositif d'hémofiltration.
PCT/EP2015/000678 2014-06-16 2015-03-30 Dispositif d'hémofiltration, ensemble de tuyaux souples et son utilisation et procédé pour faire fonctionner un dispositif d'hémofiltration Ceased WO2015192927A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102014008546.5A DE102014008546B4 (de) 2014-06-16 2014-06-16 Haemofiltrationsgerät, Schlauchset und dessen Verwendung und Verfahren zum Betrieb eines Haemofiltationsgeräts
DE102014008546.5 2014-06-16

Publications (1)

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WO2015192927A1 true WO2015192927A1 (fr) 2015-12-23

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PCT/EP2015/000678 Ceased WO2015192927A1 (fr) 2014-06-16 2015-03-30 Dispositif d'hémofiltration, ensemble de tuyaux souples et son utilisation et procédé pour faire fonctionner un dispositif d'hémofiltration

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DE (1) DE102014008546B4 (fr)
WO (1) WO2015192927A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2019508129A (ja) * 2016-02-16 2019-03-28 フレゼニウス メディカル ケア ドイッチェランド ゲゼルシャフト ミット ベシュレンクテル ハフツング 体外血液処理を実行する装置
EP3834859A4 (fr) * 2018-11-08 2022-05-25 Nikkiso Company Limited Dispositif de purification du sang

Citations (6)

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Publication number Priority date Publication date Assignee Title
DE4240681A1 (de) * 1992-12-03 1994-06-09 Fresenius Ag Vorrichtung zur Hämodialyse ohne Antikoagulation
WO2008146144A2 (fr) * 2007-05-29 2008-12-04 Haemotronic Advanced Medical Technologies S.P.A. Coffret de traitement extracorporel d'un fluide biologique d'un patient, et unité dotée dudit coffret
US20090053084A1 (en) * 2007-08-21 2009-02-26 Klein Jeffrey A Roller pump and peristaltic tubing with atrium
US7744553B2 (en) * 2003-12-16 2010-06-29 Baxter International Inc. Medical fluid therapy flow control systems and methods
US20120061320A1 (en) * 2009-05-19 2012-03-15 Thomas Nuernberger Apparatus and method for identifying a tubing system for an extracorporeal blood treatment device
US20120318739A1 (en) * 2009-11-26 2012-12-20 Fresenius Medical Care Deutschland Gmbh Method for regulating the supply of substituting during extracorporeal blood treatment and extracorporeal blood treatment device comprising a unit for regulating the supply of substituate

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Publication number Priority date Publication date Assignee Title
DE2552304C3 (de) 1975-11-21 1980-02-21 Sartorius Gmbh, 3400 Goettingen Künstliche Niere
US8029454B2 (en) * 2003-11-05 2011-10-04 Baxter International Inc. High convection home hemodialysis/hemofiltration and sorbent system
DE102009037917B4 (de) * 2009-08-19 2016-04-07 Fresenius Medical Care Deutschland Gmbh Schlauchset für eine Vorrichtung zur Blutbehandlung und Vorrichtung zur Blutbehandlung mit einem Schlauchset

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4240681A1 (de) * 1992-12-03 1994-06-09 Fresenius Ag Vorrichtung zur Hämodialyse ohne Antikoagulation
US7744553B2 (en) * 2003-12-16 2010-06-29 Baxter International Inc. Medical fluid therapy flow control systems and methods
WO2008146144A2 (fr) * 2007-05-29 2008-12-04 Haemotronic Advanced Medical Technologies S.P.A. Coffret de traitement extracorporel d'un fluide biologique d'un patient, et unité dotée dudit coffret
US20090053084A1 (en) * 2007-08-21 2009-02-26 Klein Jeffrey A Roller pump and peristaltic tubing with atrium
US20120061320A1 (en) * 2009-05-19 2012-03-15 Thomas Nuernberger Apparatus and method for identifying a tubing system for an extracorporeal blood treatment device
US20120318739A1 (en) * 2009-11-26 2012-12-20 Fresenius Medical Care Deutschland Gmbh Method for regulating the supply of substituting during extracorporeal blood treatment and extracorporeal blood treatment device comprising a unit for regulating the supply of substituate

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2019508129A (ja) * 2016-02-16 2019-03-28 フレゼニウス メディカル ケア ドイッチェランド ゲゼルシャフト ミット ベシュレンクテル ハフツング 体外血液処理を実行する装置
EP3834859A4 (fr) * 2018-11-08 2022-05-25 Nikkiso Company Limited Dispositif de purification du sang
US12083257B2 (en) 2018-11-08 2024-09-10 Nikkiso Company Limited Blood purification apparatus

Also Published As

Publication number Publication date
DE102014008546B4 (de) 2021-12-16
DE102014008546A1 (de) 2015-12-17

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