Hemodialysis machine (hereinafter referred to as hemodialysis machine) is a medical device used for hemodialysis treatment. It can replace part of the function of the patient's kidneys to maintain normal vital signs. It can also help patients get through the dangerous period of reverse uremia, maintain the lives of patients with late-stage uremia, prepare for kidney transplantation, and extend the treatment time. The hemodialysis machine is currently one of the more effective medical equipment for treating acute and chronic renal failure .
hemodialysis machine structure is composed of three parts: extracorporeal circulation channel, dialysate channel, and control and detection circuit. The quality and matching of dialysis consumables such as dialyzer , dialysis tubing, defects in the water treatment system, and the composition of the concentrate are the main factors that cause hemodialysis safety risks.
Hemodialysis machine structural schematic
Microorganisms and endotoxins Risks
The control of microorganisms and endotoxins is crucial in hemodialysis. The bacterial filter installed in the hemodialysis machine is the final barrier to the control of microorganisms and endotoxins, ensuring that every Each hemodialysis machine is equipped with a bacterial filter and operates normally to avoid adverse dialysis reactions. Microbial and endotoxin risks mainly arise from incorrect or incomplete disinfection of water treatment systems, concentrate preparation systems and hemodialysis machines. At present, the water treatment system of most hemodialysis centers in China still adopts the traditional disinfection mode. There is a disinfection dead space in the water treatment system and the water inlet of the hemodialysis machine, which is prone to the breeding of microorganisms and endotoxins. And with the popularity of high-flux dialysis and hemodiafiltration , while improving the clearance rate and dialysis effect, it is also easier for bacteria or endotoxins to enter the blood through the dialyzer, causing harm to patients. Endotoxin control in water treatment systems and concentrates shall be implemented in accordance with YY0572-2015 standards.
Risks of dialysis water
The main risks of dialysis water are unqualified dialysis water and interruption of dialysis water. Hemodialysis centers all have central water treatment systems, that is, one water treatment system supplies dialysis water to multiple hemodialysis machines. Once the water quality of the water treatment system fails or the supply of dialysis water is stopped, it will cause death, injury and even the entire dialysis machine. Center paralysis accident, so ensuring the continuity, stability and quality of dialysis water is a crucial part of hemodialysis.
The design of the water treatment system should comply with the YY0793-2011 standard and be equipped with appropriate components and closed-loop dialysis water supply pipelines without dead space. The monitoring of the water treatment system should be carried out in accordance with the standards YY0572-2015 and YYT1269-2015. It is also recommended that hemodialysis centers should consider independent water storage tanks when designing water treatment systems, and the series and parallel design of various key components such as pressure pumps and multiple water treatment systems to ensure the continuous supply of hemodialysis water.
Risks of concentrated solutions
The supply of concentrated solutions in hemodialysis in my country is generally divided into four types: finished solution, dry powder, manual preparation by the hospital, and centralized supply of concentrated solutions. Among them, the hospital manually prepares or centrally supplies the concentrated liquid by itself, which may cause adverse consequences due to incorrect proportion of concentrated liquid due to human factors or failure of the centralized liquid supply system. At worst, the alarm of the hemodialysis machine is triggered and the dialysis treatment is stopped. At worst, the specific components of the dialysate cannot be monitored due to the too broad alarm limit of the hemodialysis machine, resulting in unqualified dialysate being delivered to the dialyzer.
Risks of dialyzers and dialysis tubing
Dialyzers and dialysis tubing are the main consumables of hemodialysis machines. The main risks are reflected in adverse reactions of dialyzers and dialysis tubing, dialyzer membrane rupture, and damage to dialysis tubing. Adverse reactions to dialyzers can be divided into allergic reactions and non-specific reactions. Patients with adverse reactions will show symptoms such as chest and back pain, nausea, vomiting, skin itching, tearing, spasm, and other symptoms. In severe cases, they may have difficulty breathing, Cardiac arrest , or even death. The main cause of adverse reactions is allergic reactions caused by blood contacting dialysis tubing, dialyzer membranes and other substances. It may be related to the materials used, or it may be related to the residues of disinfectants such as ethylene oxide used.The risk of dialyzer membrane rupture also often occurs in clinical practice. If the dialyzer membrane rupture occurs during dialysis, the blood will directly contact the dialysate and may contaminate the blood, especially when the transmembrane pressure TMP is <0mmhg.>
In order to improve the knowledge level and standardized operation capabilities of practitioners related to hemodialysis treatment, the Hospital Architecture and Culture Branch of the China Architectural Culture Research Association, the Emergency Treatment Equipment Branch of the China Medical Equipment Association, and the Clean Park have joined forces with dozens of large and well-known domestic hospitals and departments. Well-known experts in the industry worked together to compile the "Quality Control Management Guidelines for First Aid and Life Support Medical Equipment." The "Guide" strives to have a complete range of equipment and rich and comprehensive quality control management content, so as to guide hospitals to take effective measures and form a long-term mechanism. Welcome to inquire and purchase.
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