The document summarizes the key components and functioning of a hemodialysis machine. It describes how the machine works by circulating blood outside the body through a dialyzer to remove waste and excess water. The blood flows through the dialyzer in one direction while dialysate flows counter-currently to maximize concentration gradients and removal of toxins like urea and creatinine from the blood. The machine monitors various parameters like blood pressure and temperature during the dialysis process to ensure patient safety.

1. HEMODIALYSIS MACHINE

2. MODEL: Fresenius/4008S

3. INTRODUCTION
• Hemodialysis removes wastes and water by circulating blood outside the
body through an external filter, called a dialyzer, that contains a semi
permeable membrane.
• The blood flows in one direction and the dialysate flows in the opposite.
The counter-current flow of the blood and dialysate maximizes the
concentration gradient of solutes between the blood and dialysate, which
helps to remove more urea and creatinine from the blood.
• The concentrations of solutes (for example potassium, phosphorus, and
urea) are undesirably high in the blood, but low or absent in the dialysis
solution, Dialysis is an increasingly common type of treatment.
• The dialysis solution has levels of minerals like potassium and calcium that
are similar to their natural concentration in healthy blood.

4. PURPOSE:
• When the nephrons in the kidneys are failure or not working properly, the
ions like potassium, creatinine etc we go through dialysis.
• Diseases of renal failure are
1. Nephrotoxins
2. Diabetic
3. Nephropathy
4. Hypertension
5. Glomerulonephritis
6. Cystic kidney Disease

5. DEFINITION:
• The Hemodialysis name it self contains hemo means blood and dialysis
means the diffusion of solute molecules through a semi permeable
membrane, normally passing from the side of higher concentration to that
of lower.
• Semi membrane is one that allows the passage of certain smaller molecules
of such crystalloids as GLUCOSE and UREA, but
prevents passage of larger molecules such as the colloidal plasma PROTEINS
and PROTOPLASM.
• Hemodialysis, also spelled haemodialysis, commonly called kidney
dialysis or simply dialysis, is a process of purifying the blood of a person
whose kidneys are not working normally. It is a method that is used to
achieve the extracorporeal removal of waste products such as creatinine
and urea and free water from the blood when the kidneys are in a state
of renal failure. Hemodialysis is one of three renal replacement therapies (the
other two being renal transplant and peritoneal dialysis). An alternative
method for extracorporeal separation of blood components such as plasma

6. PRINCIPLE:
• The principle of Hemodialysis is the same as other methods of dialysis; it
involves diffusion of solutes across a semi permeable membrane.
• Hemodialysis utilizes counter current flow, where the dialysate is flowing
in the opposite direction to blood flow in the extracorporeal circuit.
• Counter-current flow maintains the concentration gradient across the
membrane at a maximum and increases the efficiency of the dialysis.
• It involves diffusion,osmomis and ultra filtration.

7. DESCRIPTION:
• Hemodialysis is diffusion across a semi permeable membrane (one that
allows only certain molecules to pass through it). The semi permeable
membrane is used to remove the wastes from the blood and at the same
time correct the level of electrolytes in the blood. Before Hemodialysis can
be performed, a surgeon must make a way for the blood to be pumped out
of the body and then be returned after it has been cleansed.
• To do this, the surgeon uses an artery and a vein in the forearm.
• Arteries (which have muscles in their walls) bring oxygenated blood to the
body from the heart, and veins return blood to the heart, which needs to
have oxygen.
• The surgeon connects the radial artery in the forearm to a large vein called
the cephalic vein. This connection is called an arterio venous shunt.
• A shunt carries something from one place to another. In this case it carries
blood from an artery to a vein. After this shunt is made, the veins in the
forearm get big and eventually form muscles in their walls like arteries.
They are now strong and can be punctured many times for dialysis.

8. Description cond’t
• DIALYSIS:
There are two different kinds of dialysis used in medicine:
Hemodialysis and peritoneal dialysis. The methods for performing dialysis
may be different, but the goal of the treatment is the same, that is, to
remove waste products. These wastes are composed mainly of nitrogen in
the form of urea, uric acid, and creatinine.
• TYPES OF DIALYSIS:
There are five types of dialysis.
1. Hemodialysis.
2. Peritoneal Dialysis.
3. Hemofiltration.
4. Hemodiafiltration.
5. Intestinal dialysis.

9. FRONT VIEW:
1. Monitor
2. Blood Pressure Cuff
3. Extracorporeal blood circuit
module
4. Concentrate connectors
5. Brake
6. Shunt interlock for the dialyzer
connecting lines
7. IV pole
8. Status indicator

10. BACK VIEW:
1. Monitor
2. Sampling value
3.Bracket for the dialyzer connection
lines
4. Dialysate outlet tube
5. Dialysate inlet tube
6. Disinfection connector
7. Filter
8. CDS (red) option
9. Drain
10. Water connector (permeate)
11. DIASAFE plus
12. Vent tubing
13. Power supply unit

11. PARTS AND FUNCTIONS:
S.NO PARTS FUNCTION
1 Dialysis Machine Blood
Pump and Tubing
A blood pump simply pumps the blood from the body
into the machine through specially made tubes.
2 Syringe The syringe contains a drug called Heparin
which prevents the blood from clotting in the tubes.
3 Dialyzer The dialyzer is a large canister containing thousands
of small fibers through which patient blood is passed.
The dialyzer is the key part of a dialysis
machine where the cleaning of the blood takes
place.
4 Alarms in order to protect the patient from any errors in
functioning. The things that are monitored with
alarms include:
•Blood pressure within the machine
•Blood pressure of the patient
•Blood flow
•Temperature
•Dialysate mixture

12. 1
S.NO PARTS FUNCTION
5 Pressure monitor •Arterial pressure monitor: Detects the pressure between the blood
access and the blood pump.
•Venous pressure monitor: It normally detects positive pressures. If the
venous pressure goes low, it probably due to disconnection/low blood
flows in the circuit.
6 Air Leakage Detector The detector is settled in the venous blood line and detects as well as in
the purpose of avoiding air embolus
7 Data Interfaces Dialysis machines can include USB, Ethernet, and a variety of serial
interfaces to legacy hospital information systems. Wireless interfaces
(such as Wi-Fi) may also be included for direct connection to the hospital
wireless networks. Data card slots are also available on some designs.
8 Valves Several valves with electronic actuation are needed in the machine to
allow variable mixing ratios. Various implementations are possible from
simple opened/closed valves driven by solenoids to precision variable-
position valves driven by stepper motors.
9 Sensors Dialysis machines require many different types of sensors
to monitor various parameters. Blood pressure at various points
in the extracorporeal circuit, dialysate pressure, temperature,
O2 saturation, motor speed, dialyzer membrane pressure
gradient, and air are all monitored for proper values during
dialysis.

13. PROCEDURE:

14. Step by step procedure:
1. After the dialysis procedure has been done to a patient, the machine
should get ready for another new patient, we should clean the disposable
tubing's and filter with sterilizing fluid and should checked with a type of
litmus test.
2. When the patient arrives, the parameters like weight, blood pressure and
temperature are measured.
3. For fistula procedure we have to connect to veins of arms or legs. For
catheter procedure we have to connect to large veins at chest.
4. Then the patient is connected to the machine with complete loop, then the
timer and pump are started.
5. Hemodialysis is under process.
6. Periodically for every half hour, the blood pressure is taken. If, low blood
pressure can cause cramping, nausea, shakes, dizziness, lightheadedness,
and unconsciousness .
7. The amount of fluid to be removed is set by the dialysis nurse according
to the patient's "estimated dry weight."

15. Procedure cond’t
8. At the end of the procedure time, the patient is disconnected from the
plumbing. Needle wounds are bandaged with gauze, held for up to 1 hour
with direct pressure to stop bleeding, and then taped in place.
9. Temperature, standing and sitting blood pressure, and weight are all
measured again. Temperature changes may indicate infection. BP discussed
above. Weighing is to confirm the removal of the desired amount of fluid.
10.Care staff verifies that the patient is in condition suitable for leaving. The
patient must be able to stand, to maintain a reasonable blood pressure, and
be coherent.

16. RISKS:
1. Anemia: due to the procedure associated blood losses and mild effect on
oxygen transporting function.
2. Hematocrit (Hct): It levels, a measure of red blood cells, are typically
low in ESRD patients. This deficiency is caused by a lack of the hormone
erythropoietin.
3. Cramps, nausea, vomiting, and headaches: Some patients experience
cramps and flu-like symptoms during treatment. These can be caused by a
number of factors, including the type of dialysate used, composition of
the dialyzer membrane, water quality in the dialysis unit, and the ultra
filtration rate of the treatment.
4. Hypotension: Because of the stress placed on the cardiovascular system
with regular Hemodialysis treatments, patients are at risk for hypotension,
a sudden drop in blood pressure. This can often be controlled by
medication and adjustment of the patient's dialysis prescription.
5. Infection: Patients can also get infections through surroundings. The
room and area used for patients must be kept clean.
6. Infectious diseases: There is a great deal of blood exposure involved in
dialysis treatment, a slight risk of contracting hepatitis B and hepatitis C
exists. The hepatitis B vaccination is recommended for most patients.

17. ADVANTAGES:
• Low mortality rate
• Better control of blood pressure and abdominal cramps
• Less diet restriction
• Better solute clearance effect for the daily hemo dialysis: better tolerance
and fewer complications with more frequent dialysis

18. DISADVANTAGES:
• Restricts independence, as people undergoing this procedure cannot travel
around because of supplies' availability
• Requires more supplies such as high water quality and electricity
• Requires reliable technology like dialysis machines
• The procedure is complicated and requires that care givers have more
knowledge
• Requires time to set up and clean dialysis machines, and expense with
machines and associated staff

19. THANK YOU
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