Medical treatment system and methods using a plurality of fluid lines

A system for performing automated peritoneal dialysis comprising;

• a cycler comprising a fluid pump and controller, the controller configured to measure and control an amount of fluid pumped to a peritoneal cavity and to track a remaining volume of the fluid in a solution bag;
• the controller configured to:
• control a dialysis therapy by administering a pre-determined number of therapy cycles, each therapy cycle comprising a fill phase, dwell phase and drain phase;
• and
• maintain a pre-determined minimum volume of intra-peritoneal fluid during the dwell phase;
• cancel a final therapy cycle if a calculated final volume of fluid remaining in the solution bag for the final therapy cycle is less than a volume required to maintain the minimum intra-peritoneal fluid volume for the final therapy cycle dwell phase;
• divide the remaining final volume of fluid in the solution bag among a remaining number of therapy cycle fill volumes;
• and
• divide a duration of the final therapy cycle dwell phase among a remaining number of therapy cycle dwell phases;
• wherein the controller is configured to further adjust the fill volumes of the remaining number of therapy cycles, or the duration of the dwell phases of the remaining number of therapy cycles to prevent an accumulation of intra-peritoneal fluid during the remaining therapy cycles from exceeding a pre-determined maximum intra-peritoneal volume of fluid.

A system in an automated peritoneal dialysis apparatus for replenishing a heater bag with fluid during a dialysis therapy comprising a fluid fill phase, a fluid dwell phase, and a fluid drain phase, the system comprising a controller configured to:

• track a remaining volume of fluid remaining in the heater bag;
• compute a replenish volume of fluid to be infused into the heater bag comprising subtracting the remaining volume from a fill volume of fluid to be infused into a patient in a subsequent fill phase of the dialysis therapy;
• compute a replenish volume transfer time required to transfer the replenish volume from a fluid source to the heater bag;
• compute a replenish volume heating time required to heat the replenish volume to within a pre-determined range of a pre-determined temperature set point;
• and
• compute a remaining dwell time required to complete the fluid dwell phase;
• wherein the controller is configured to control a fluid heater of the peritoneal dialysis apparatus to heat the replenish fluid as it enters the heater bag, and to control a fluid pump of the peritoneal dialysis apparatus to initiate pumping of the replenish volume to the heater bag when the remaining dwell time is equal to or greater than the greater of the replenish volume transfer time or the replenish volume heating time.

A system for replenishing a fluid heater bag of a medical fluid delivery apparatus, the system comprising:

• a processor configured to receive temperature data associated with a fluid in the heater bag, to control a heater to heat the fluid in the heater bag, to control a fluid pump to pump the fluid in a replenish operation into the heater bag from a fluid source, to pump the fluid in a fill phase out of the heater bag to a patient, to control a dwell phase during which the fluid remains in the patient, and to pump the fluid in a drain phase out of the patient to a destination, wherein the controller is further configured to:
• determine a replenish volume to be transferred to the heater bag during the replenish operation, the replenish volume determination made by subtracting the volume of fluid in the bag at the beginning of the replenish operation from a volume of fluid to be pumped to the patient in the next fill phase;
• compute a replenish volume transfer time required to transfer the replenish volume from the fluid source to the heater bag;
• compute a replenish volume heating time required to heat the fluid to within a pre-determined range of a pre-determined temperature set point;
• compute a drain time required to complete the drain phase;
• and
• control the fluid pump to initiate pumping of the fluid in the replenish operation at a remaining dwell time during the dwell phase that is approximately equal to the greater of (1) the drain time plus the replenish volume heating time or (2) the drain time plus the replenish volume transfer time.

A solution expiration timing system for an automated dialysis apparatus connected to a first fluid reservoir and a fluid heating reservoir, the system comprising:

• a controller configured to:
• begin a first solution expiration timer when a fluid is pumped from the first fluid reservoir to the fluid heating reservoir;
• begin a second solution expiration timer when the fluid in the fluid heating reservoir achieves a pre-determined temperature;
• wherein the controller is configured to declare a first expiration time when a first pre-determined time interval has elapsed, and to declare a second expiration time when a second pre-determined time interval has elapsed;
• and wherein the controller stops fluid transfer from the first fluid reservoir to the fluid heating reservoir at the first expiration time, and stops fluid transfer from the fluid heating reservoir to a user at the second expiration time.

A solution expiration timing system for an automated dialysis apparatus connected to a first fluid reservoir containing a first fluid and a second fluid reservoir containing a second fluid, the system comprising a controller configured to:

• begin a first solution expiration timer when the first fluid is pumped from the first fluid reservoir to a fluid heating reservoir;
• begin a second solution expiration timer when the second fluid is pumped from the second fluid reservoir to the fluid heating reservoir;
• wherein the controller is configured to declare a first expiration time when a first pre-determined time interval has elapsed, and to declare a second expiration time when a second pre-determined time interval has elapsed;
• and
• wherein the controller stops fluid transfer from the first fluid reservoir to the fluid heating reservoir at the first expiration time, and stops fluid transfer from the second fluid reservoir to the fluid heating reservoir at the second expiration time.

A system for performing automated peritoneal dialysis (APD) therapy comprising;

• a cycler comprising a fluid pump and controller, the controller configured to measure and control an amount of fluid pumped to a peritoneal cavity and to track a remaining volume of the fluid in a solution bag;
• the controller configured to:
• control a dialysis therapy by administering a pre-determined number of therapy cycles, each therapy cycle comprising a fill phase, dwell phase and drain phase;
• and
• calculate an ultrafiltration volume;
• and
• change the fill volumes, drain volumes, number of cycles or dwell time cycles during the APD therapy;
• wherein the controller maintains a volume of intra-peritoneal fluid including the ultrafiltration volume during the dwell phase between a minimum threshold and a maximum threshold.