DBB-EXA has been developed for the value-oriented dialysis providers who are committed to high quality and safety standards, looking for a monitor to deliver standard HD treatments and advanced therapies as well.
With the D-FAS system DBB-EXA can simplify and automate user operations.
Healthcare professionals in the dialysis facility have many tasks to complete such as lining, priming, entering prescribed treatment data, blood filling and wash back besides the primary role of patient care. Dialysis Fully-Automated System (D-FAS) can simplify and automate user operations. As a result, it may be possible that operator errors and / or the risk of contamination can be significantly reduced.
The operator installs the bloodline set and dialyser, and then starts D-FAS priming. D-FAS automatically primes the extracorporeal circuit without operator intervention.
The operator simply connects the arterial and venous patient access and starts D-FAS blood filling. D-FAS blood filling can remove the priming solution automatically through the dialyser, therefore the patients UF removal can be minimised.
After the completion of the treatment, D-FAS wash back returns the blood in the extracorporeal circuit automatically through the arterial and venous patient access without any operator intervention. All the operator needs to do is simply disconnect the patient.
The operator can start the emergency bolus without handling the bloodline set. D-FAS emergency bolus can deliver automatically a defined volume of substitution fluid to the patient.
To minimise the risk for the patient DBB-EXA triggers an alarm and stops the Blood Pump according to the signal from an external device.
e.g. Venous Needle Dislodgement System
DBB-EXA is the first device which is designed according to the Publicly Available Specification [IEC PAS 63023]
Positive long-term prognosis & higher quality of life for your patients!
Several studies have proven that a positive longterm prognosis and improved quality of life (QOL) of patients depends on the actual delivery of dialysis dose. Adequate dialysis dose may improve QOL [7-9].
Insufficient clearance performance can have various reasons:
A sensor located directly in the spent dialysis fluid measures the absorbance at a wavelength which directly correlates with patient blood urea nitrogen (BUN) concentration.
The continuously measured values are inserted in the formulas for single pool Kt/V (spKt/V) and urea reduction ratio (URR) and the results are immediately displayed.
K, Kt, Kt/V, eKt/V, URR can be displayed.
Reaching the individual treatment goals for your patients can only be achieved by always knowing the actual status. At the same time, necessary adaption of treatment parameters must be considered.
By using the Dialysis Dose Monitor, measured Kt/V is displayed in graphic form with a projection line.
You can see deviations from the treatment goal at an early stage, and react accordingly.
When the dialysate flow rate equals the blood flow rate, almost 90% of the maximum small solute clearance is achieved.
By using Flow adaption, the dialysate flow rate increases automatically with an increasing blood flow rate thereby ensuring an equal treatment efficiency for all conditions.
This could lead to reduced dialysis fluid consumption and costs in terms of energy, water etc without compromising Kt/V.
Dialysate flow rate (Duplex pump speed) is controlled by below formula.
*Setting: multiplying factor (Range 1 to 2)
High volume Haemodiafiltration has been shown to have survival benefits for a patient, therefore physicians prefer to set increased substitution volumes where possible.
However, it is difficult to define because higher volumes may also lead to excessive hemoconcentration and subsequent high transmembrane pressures or other related alarms
With the DBB-EXA, optimised substitution rate is automatically calculated when the nurse enters the Ultrafiltrate removal value (Quf).
When blood Flow, Haematocrit and Total Protein are downloaded from the Patient Card, DBB-EXA calculates an optimised Substitution volume (Qs) by using the Filtration Fraction of plasma water. If the TMP rises during treatment, the substitution rate is automatically reduced by the TMP Substitution Flow control.
TMP Sub control avoids alarms = less alarms leading to more trouble-free treatments, less workload for nurses, no need for further operator intervention during treatment and convenience for patients
This ultimately means an effective High Volume Haemodiafiltration treatment can be performed.
BVM module transmits near-infrared light through the bloodline and measures the reflected light. A wavelength of near-infrared light is adsorbed and reflected by the red blood cells. Patient blood volume and blood cell concentration in the arterial bloodline are correlated. Haemo-Master observes the change of reflected light during the treatment and a change of patient blood volume (dBV) can be monitored continuously. Blood volume measurement is considered as a useful tool to help improve tolerance and the hemodynamic response . Estimated patient PRR is calculated from UF rate and dBV trend. Nephrologists can refer to the PRR to help estimate adequate UF rate to stabilise the dBV. The monitored dBV and PRR are displayed in graphical form and clinicians can observe the patient fluid status visually.
For each patient an individual curve for the ideal blood volume change is established. DBB-EXA continuously measures dBV during the dialysis treatment. This is the basis for automatic regulation of the UF rate (BV-UFC) and dialysis fluid conductivity (BV-COC) so that patient dBV follows the ideal curve. Some studies show that automatic regulation of the UF rate and dialysis fluid conductivity reduces incidents of hypotensive episodes and the frequency of symptoms during the treatment [4-6].
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