US3707967A - Steady flow regenerative peritoneal dialysis system and method - Google Patents
Steady flow regenerative peritoneal dialysis system and method Download PDFInfo
- Publication number
- US3707967A US3707967A US00077240A US3707967DA US3707967A US 3707967 A US3707967 A US 3707967A US 00077240 A US00077240 A US 00077240A US 3707967D A US3707967D A US 3707967DA US 3707967 A US3707967 A US 3707967A
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- United States
- Prior art keywords
- fluid
- flow
- dialysate
- conduits
- means includes
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- Expired - Lifetime
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Classifications
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- 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
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
-
- 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
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1654—Dialysates therefor
- A61M1/1656—Apparatus for preparing dialysates
- A61M1/1674—Apparatus for preparing dialysates using UV radiation sources for sterilising the dialysate
-
- 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
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1694—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid
- A61M1/1696—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid with dialysate regeneration
-
- 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
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
- A61M1/281—Instillation other than by gravity
-
- 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
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
- A61M1/282—Operational modes
- A61M1/284—Continuous flow peritoneal dialysis [CFPD]
-
- 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
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
- A61M1/285—Catheters therefor
Definitions
- ATTORNEYS quantity of dialysing STEADY FLOW REGENERATIVE PERITONEAL DIALYSIS SYSTEM AND METHOD BACKGROUND OF THE INVENTION for treatment of chronic kidney disease.
- Two types of lo dialysis are currently in use; hemodialysis and peritoneal dialysis.
- hemodialysis the blood is removed from an artery or vein, dialyzed in an artifical kidney machine external of the body and returned to a vein usually through cannulas in the arm or leg.
- This type if dialysis involves permanent connectors to major blood vessels for attachment of the device and also requires the handling of blood in an external prothesis.
- the second type of dialysis which does not involve handling of blood directly in a prosthesis is peritoneal dialysis.
- dialysing fluid is introduced in the abdominal cavity either through a puncture in the abdominal wall or through a permanently installed percutaneous tube.
- the dialysate resides in the cavity for a period of time minutes to 1 hour) and is then removed. While the fluid is in the cavity, it picks up urea and other metabolic wastes from the blood stream by diffusion through the walls of the blood vessels within the abdominal cavity.
- This scheme of dialysis avoids the requirement of handling the blood and invasion of the vascular system but requires the penetration of the abdominal wall. Both types of dialysis require that the blood stream be brought directly or indirectly in chemical equilibrium with a very large quantity of dialysate.
- a dialysis system including in-flow and outflow conduits extending through the abdominal wall and provided with a surface which permits the growing and attachment of tissue to the surface of the conduits.
- the conduits provide means for introducing and removing fluid from the peritoneal cavity which communicates with means for circulating the dialysate fluid through the cavity and regenerative means for regenerating the fluid.
- the cavity, associated conduits, and circulating and regenerating means are connected in a closed fluid system whereby the fluid is continuously reconstituted and circulated through the peritoneal cavity.
- FIG. 1 is a schematic diagram of the regenerative peritoneal dialysis system in accordance with the present invention shown connected to supply fluid to the cavity.
- FIG 2 is an enlarged view of the abdominal wall showing the skin, subcutaneous tissue and peritoneum together with a conduit anchored in the wall by tissue growth.
- FIG. 3 is an enlarged view of the portion of the conduit of FIG. 2 showing the surface microcavities into which the tissue grows.
- FIG. 4 is a detailed drawing of the fluid circulating flow control and regeneration means.
- microcavities which have a depth in the range of 0.002 to 0.020 inches. These microcavities permit the subcutaneous tissue to grow around the outside walls and become permanently affixed or anchored to the walls. Thus, the track along the peritoneal penetrations is completely sealed by the tissue which grows into the microcavities and is nourished from adjacent cells.
- the tubes are preferably very small in diameter, for example, 1 to 3 mm. in diameter, and are very flexible because of the very low flow rates required in steady flow dialysis in accordance with another feature of the present invention. Both of these characteristics greatly facilitate the permanent fixation of the tubes into the abdominal wall.
- the conduits 11 and 12 each have a portion 16 and 17, respectively, which extend into the abdominal cavity.
- the other end of the conduit 12 is connected to means for removing the fluid from the abdominal cavity comprises a conduit 18 which, in turn, connects the pump 19 which serves to transport fluid from the upper portion of the abdominal cavity and pumps the fluid along the conduit2l to the reconstitution system 22 which reconstitutes the dialysate fluid and forms a means for supplying the fluid to the abdominal cavity.
- the fluid then flows through the conduit 23 through the conduit 11 and into'the lower portionof the abdominal cavity at the tube 16.
- the out-flow from'the peritoneal cavity flows along the line 18 to the fluid pump 19.
- the pump 19 may include a cup-shaped chamber 26 provided with a cap 27 which is suitably secured to the portion 26 as, for example, by screws.
- Piston 28 which includes a pair of spaced ports 29 provided with one-way valves 31 is disposed in the chamber 26.
- the piston is urged in one as by a ring 36 and its other end suitably secured to the cup by being sandwiched between the cap 27 and the side walls 26;
- fluid is drawn into the chamber 33 as the springs urge the piston in one direction.
- the fluid in the upper chamber 39 which is defined by the other side of the piston, the flexible seal membrane 34 and a second sealing membrane 40, is moved through the conduit 21 into the reconstitution system.
- the upper chamber 39 is defined by the upper wall of the pump together with the flexible seal 36 which has one end affixed to the upper wall by means of a ring 41 and to the piston rod by means of a second ring 42.
- the reconstitution system may be one of two general types.
- a first type illustrated in FIGS. 1 and 4
- the fluid travelling along the conduit 21 passes through a urea removal column 46, an activated carbonor charcoal column 47, a transparent conduit portion 48 which is irradiated by an ultra-violet source 49, and a conventional flow regulator 50 which regulates the flow and finally through a filter 51.
- the reconstituted fluid leaving the reconstitution system is thenapplied along the conduit 23 to the in-flow conduit 11.
- the rate of flow through the system is controlledby flow regulator 50.
- the chamber 33 is full and, of course, chamber 39 is basically empty.
- the piston is then depressed and fluid is transferred from the lower chamber 33 to the upper chamber 34, through valve means 31.
- the piston is released and the springs urge thepiston upwardly pumping fluid into the chamber and expelling fluid from the chamber 39.
- the urea removal column includes material which serves to absorb urea or converts the urea to ammonia enzymatically as with the enzyme, urease, and then absorbs the ammonia. Such columns are known.
- An activated carbon column may be used to absorb creatinine, uric acid and other toxic substances.
- the ultraviolet sterilizer is used to sterilize the dialysate and prevent bacterial growth.
- the filter may be of a type which can or cannot pass bacteria depending upon the effectiveness of the ultra-violet sterilizer and sterilizing procedures. It, of course, will trap larger particles and prevent them from entering into the abdominal cavity where they may be a source of tissue irritation and adhesions.
- the filter, flow regulator, sterilizer, transparentwindow and reconstitution columns form a selfcontained package which may or may not include the pump and which can easily be replaced.
- dialysate of the order of one liter or less,'and the fact that this same'amount of dialysate is continuously reconstituted permits use of a steady flow and possibly a continuous dialysis process.
- the system is of relatively small size because of the small volume of dialysate fluid being used which makes it possible to devise a system which can be made portable and worn in the vicinity of the patients waist.
- the patient can be completely rehabilitated by wearing such a system. He can continue to perform his normal tasks while dialysis is taking place. This is very much like a physiologic process performed by the kidneys.
- a second type of reconstitution system which is conventional in the dialysis field, essentially all of the material removed from the abdominal cavity is non-selectively eliminated from the dialysate fluid.
- Those components removed during dialysis which are desirable to replace, such as glucose, the ions of sodium, calcium and potassium are supplied to the in-flow conduit from a source external to the reconstitution system.
- Such systems include the electrolytic type as described in S. B. Tuwiner, Research Design and Development of an Improved Water Reclamation System for Manned Space Vehicles (April 1966), Report No. NASA CR66323, and the ion exchange type as described in R. D. Fall et al., Feasibility of Microcapsule System for Artifical Kidney Applications, Annual Report by Battelle Memorial Institute (Dec. 1968).
- a simplified technique for supplying dialysate fluid to the abdominal cavity and removing the fluid from the same eliminates the need for any reconstitution system.
- the dialysate fluid is supplied from a fresh external source along with the aforementioned desirable components removed during dialysis.
- the fluid removed from the abdominal cavity is directed to a waste sink.
- the features that make this system possible and of considerable advantage over prior art systems are the use of the permanently implanted conduits which allow fluid to be introduced and removed from the peritoneal cavity, the reconstitution system which permits the same fluid to be recycled after the waste that is picked up in the peritoneal cavity has been removed, and the simple system for sterilizing and pumping the fluid through the regeneration system and back to the abdominal cavity.
- flow rate also permits effective ultra-violet sterilization and ultrafiltration to be accomplished.
- a steady flow peritoneal dialysis system including in-flow and out-flow conduits adapted to extend through the abdominal wall into the abdominal cavity whereby dialysate fluid may be introduced into and removed from the cavity, each of said conduits including an external surface portion at the interface between the abdominal wall and the conduits which is compatible with the skin, subcutaneous tissue and other tissue, said surface including a plurality of adjacent substantially discrete pockets having openings which face in the direction of said skin and tissue, the walls of said pocket extending inwardly to a depth in the range of 0.002 to 0.020 inches and being of such shape and size as to provide means to accommodate a number of living cells sufficient to provide anchorin but not solarge as to prevent essentially normal trans er of nutrients o the living cells in said pockets from adjacent skin and tissue, means for supplying the dialysate fluid to said inflow conduit, means for causing the dialysate fluid to flow through the cavity, and means for removing the dialysate fluid from said out-flow conduit.
- a system as in claim I in whichsaid means for causing fluid to flow comprises a sealed pump.
- said supply and removal means includes means for reconstituting the dialysate fluid connected by fluid conduits to said inflow and out-flow conduits.
- a system as in claim 5 including means for irradiating the circulatory fluid with ultra-violet radiation.
- said reconstitution means includes a filter adapted to receive the fluid flowing from the irradiation means.
- a system as in claim 5 in which said system is a closed self-contained fluid system.
Abstract
Description
Claims (9)
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US7724070A | 1970-10-01 | 1970-10-01 |
Publications (1)
Publication Number | Publication Date |
---|---|
US3707967A true US3707967A (en) | 1973-01-02 |
Family
ID=22136901
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US00077240A Expired - Lifetime US3707967A (en) | 1970-10-01 | 1970-10-01 | Steady flow regenerative peritoneal dialysis system and method |
Country Status (5)
Country | Link |
---|---|
US (1) | US3707967A (en) |
JP (1) | JPS528635B1 (en) |
DE (1) | DE2149040A1 (en) |
GB (1) | GB1307056A (en) |
NL (1) | NL7113434A (en) |
Cited By (71)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4160454A (en) * | 1975-07-09 | 1979-07-10 | University Of Utah | Implantable catheter system |
US4184497A (en) * | 1977-08-26 | 1980-01-22 | University Of Utah | Peritoneal dialysis catheter |
US4265760A (en) * | 1979-02-26 | 1981-05-05 | Becton Dickinson & Company | Device for dilution and delivery of in vivo chemicals |
US4381003A (en) * | 1979-10-26 | 1983-04-26 | Vincenzo Buoncristiani | Method and apparatus for the automatic semicontinuous peritoneal dialysis |
FR2515966A1 (en) * | 1981-11-06 | 1983-05-13 | Sord Orga Sarl | Automatic peritoneal dialysis bag drainage control during treatment - using modules, each having corresponding clamp and hook arrangement, and UV sterilisation system |
US4417888A (en) * | 1982-03-15 | 1983-11-29 | Renal Systems, Inc. | Percutaneous implant |
US4496349A (en) * | 1981-05-08 | 1985-01-29 | Renal Systems, Inc. | Percutaneous implant |
DE4001760A1 (en) * | 1989-02-08 | 1990-08-09 | Avl Medical Instr Ag | DEVICE FOR DETERMINING AT LEAST ONE MEDICAL MEASURING SIZE |
US5037385A (en) * | 1988-10-24 | 1991-08-06 | National Research Development Corporation | Continuous ambulatory peritoneal dialysis method |
US6245039B1 (en) * | 1998-10-05 | 2001-06-12 | Vasca, Inc. | Methods and apparatus for performing flow-through peritoneal dialysis |
US6409699B1 (en) | 1996-10-22 | 2002-06-25 | Renal Solutions, Inc. | Continuous flow-through peritoneal dialysis (CFPD) method with control of intraperitoneal pressure |
WO2003030960A2 (en) * | 2001-10-05 | 2003-04-17 | Medical Components, Inc. | Catheter for peritoneal dialysis |
US6569130B1 (en) * | 2001-04-12 | 2003-05-27 | John M. Levin | Chronic peritoneal dialysis sac |
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US6666842B1 (en) * | 1998-10-07 | 2003-12-23 | Asahi Sakai | Device and method for perfusing peritoneal dialyzing fluid |
WO2004009156A2 (en) | 2002-07-19 | 2004-01-29 | Baxter International Inc. | Systems and methods for peritoneal dialysis |
US20040019320A1 (en) * | 2002-07-19 | 2004-01-29 | Childers Robert W. | Systems and metods for performing peritoneal dialysis |
US20040193098A1 (en) * | 2001-10-05 | 2004-09-30 | Angela Wentling | Continuous flow peritoneal dialysis catheter |
US6976973B1 (en) | 2000-10-12 | 2005-12-20 | Baxter International Inc. | Peritoneal dialysis catheters |
US7241272B2 (en) | 2001-11-13 | 2007-07-10 | Baxter International Inc. | Method and composition for removing uremic toxins in dialysis processes |
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US20080033346A1 (en) * | 2002-12-31 | 2008-02-07 | Baxter International Inc. | Pumping systems for cassette-based dialysis |
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US20090281484A1 (en) * | 2003-10-28 | 2009-11-12 | Baxter International Inc. | Peritoneal dialysis machine |
US20090287178A1 (en) * | 2008-05-13 | 2009-11-19 | Herbert Curtis B | Interosmolar fluid removal |
US20100010429A1 (en) * | 2002-07-19 | 2010-01-14 | Baxter International Inc. | Systems and methods for performing peritoneal dialysis |
US20100051552A1 (en) * | 2008-08-28 | 2010-03-04 | Baxter International Inc. | In-line sensors for dialysis applications |
US20100114012A1 (en) * | 2008-11-03 | 2010-05-06 | Sandford Harold F | Portable Peritoneal Dialysis System |
US20100217179A1 (en) * | 2009-02-20 | 2010-08-26 | Baxter International Inc. | Bulk delivery peritoneal dialysis system and method |
US20100312172A1 (en) * | 2009-06-06 | 2010-12-09 | Hoffman Josef C A | Method of Peritoneal Dialysis |
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US20150273131A1 (en) * | 2012-11-23 | 2015-10-01 | Triomed Ab | Phosphate and urea adsorption for dialysis |
US20150290384A1 (en) * | 2012-11-23 | 2015-10-15 | Triomed Ab | Adsorbent for dialysis |
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US20160008529A1 (en) * | 2014-07-11 | 2016-01-14 | Josef C. A. Hoffman | Peritoneal Dialysis System and Method |
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US10226263B2 (en) | 2015-12-23 | 2019-03-12 | Incuvate, Llc | Aspiration monitoring system and method |
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US10426919B2 (en) | 2015-07-20 | 2019-10-01 | Strataca Systems Limited | Systems and methods for inducing negative pressure in a portion of a urinary tract of a patient |
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US10702292B2 (en) | 2015-08-28 | 2020-07-07 | Incuvate, Llc | Aspiration monitoring system and method |
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US11040180B2 (en) | 2015-07-20 | 2021-06-22 | Strataca Systems Limited | Systems, kits and methods for inducing negative pressure to increase renal function |
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US11179516B2 (en) | 2017-06-22 | 2021-11-23 | Baxter International Inc. | Systems and methods for incorporating patient pressure into medical fluid delivery |
US11229771B2 (en) | 2015-07-20 | 2022-01-25 | Roivios Limited | Percutaneous ureteral catheter |
US11495334B2 (en) | 2015-06-25 | 2022-11-08 | Gambro Lundia Ab | Medical device system and method having a distributed database |
US11497521B2 (en) | 2008-10-13 | 2022-11-15 | Walk Vascular, Llc | Assisted aspiration catheter system |
US11510689B2 (en) | 2016-04-06 | 2022-11-29 | Walk Vascular, Llc | Systems and methods for thrombolysis and delivery of an agent |
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US11540847B2 (en) | 2015-10-09 | 2023-01-03 | Incuvate, Llc | Systems and methods for management of thrombosis |
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US11678905B2 (en) | 2018-07-19 | 2023-06-20 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
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DE2739350A1 (en) * | 1977-09-01 | 1979-03-15 | Schi Wa Arzneimittel | DEVICE FOR TREATMENT OF URAEMIC PATIENTS |
DE3147722C2 (en) * | 1981-11-27 | 1985-02-28 | Dr. Eduard Fresenius, Chemisch-pharmazeutische Industrie KG, 6380 Bad Homburg | Peritoneal catheter |
DD210385A3 (en) * | 1982-06-28 | 1984-06-06 | Medizin Labortechnik Veb K | DIALYSIS DEVICE WITH REGENERATION SYSTEM FOR THE CONTINUOUS AMBULANT PERITONEAL DIALYSIS |
US4747822A (en) * | 1984-07-09 | 1988-05-31 | Peabody Alan M | Continuous flow peritoneal dialysis system and method |
ATE65416T1 (en) * | 1986-05-01 | 1991-08-15 | Alan M Peabody | DEVICE FOR PERITONEAL DIALYSIS IN CONTINUOUS CURRENT. |
JPH02102934U (en) * | 1989-02-02 | 1990-08-16 |
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- 1970-10-01 US US00077240A patent/US3707967A/en not_active Expired - Lifetime
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- 1971-09-22 GB GB4416871A patent/GB1307056A/en not_active Expired
- 1971-09-30 NL NL7113434A patent/NL7113434A/xx unknown
- 1971-10-01 JP JP46077014A patent/JPS528635B1/ja active Pending
- 1971-10-01 DE DE19712149040 patent/DE2149040A1/en active Pending
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US11516183B2 (en) | 2016-12-21 | 2022-11-29 | Gambro Lundia Ab | Medical device system including information technology infrastructure having secure cluster domain supporting external domain |
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Also Published As
Publication number | Publication date |
---|---|
DE2149040A1 (en) | 1972-04-06 |
JPS528635B1 (en) | 1977-03-10 |
NL7113434A (en) | 1972-04-05 |
GB1307056A (en) | 1973-02-14 |
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