The Dialog+ Dialysis System
Creating new dimensions in treatment quality
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B. Braun Avitum
B. Braun has been a trusted partner in the supply of high quality,
cost effective dialysis products for more than 30 years.
The Dialog
+
haemodialysis treatment system –
the right option for the future
B. Braun Global Commitment to Healthcare Excellence
Founded in 1839 as a family owned company, B. Braun has advanced to become one of the world’s leading healthcare companies. B. Braun supplies the healthcare community with more than 30,000 different medical and pharmaceutical products for dialysis, anaesthesia, intensive medicine, cardiology and surgery as well as services for hospitals, general
practitioners and the homecare sector.
B. Braun has been a leading provider of dialysis care products for more than 30 years. The B. Braun Avitum product range includes advanced dialysis machines, water treatment systems, dialysis chairs and a full range of dialysis consumables such as dialysers, haemodialysis bloodlines, fistula needles, dialysis concentrates, UltraPureFluid filters and dialysis machine disinfectants.
B. Braun products are backed by comprehensive technical service and support designed to meet the demands of busy dialysis centres, healthcare practitioners and patients.
At B. Braun, innovation and improvement are the driving forces guiding our activities in serving the doctors, nurses and patients who use our products.
The new generation Dialog+ System: Inspired by users, developed by system specialists, to provide high quality cost effective dialysis treatment.
A system with many configuration possibilities and smart accessories so you get exactly the solution suited to your individual requirements.
Available in 3 basic configurations:
Configuration Care Setting Therapy Types Methods of Treatment
Dialog+ Single pump Hospital, health centre, limited care, home Haemodialysis (HD) Isolated Ultrafiltration (ISO UF)
Double-needle procedure Single-needle valve procedure Dialogue+ Double-pump Hospital, health centre, limited care, home Haemodialysis (HD) Isolated Ultrafiltration (ISO UF)
Double-needle procedure Single-needle cross-over procedure Single-needle procedure Dialog+ Mixed HDF-online Hospital, health centre, limited care, home Haemodialysis (HD) Isolated Ultrafiltration (ISO UF) Haemofiltration (HF-online)
Haemodiafiltration (HDF-online), pre-dilution and post-dilution
Double-needle procedure Single-needle cross-over procedure, possible with HD and ISO UF Single-needle procedure
B. Braun Avitum, a global systems provider
with a full rage of dialysis consumables
As a globally active group with an Australian presence for over 30 years, B. Braun offer you the security of an international brand and the support and service of a local partner.
The modular dialysis systems by B. Braun feature all the
components you need for comprehensive therapy from one single source. You also benefit from B. Braun's dependable product quality.
High quality cost effective products
All B. Braun system components are compatible with each other
First-class, international and local logistics network
Global presence: products, services, and support
Intelligent solutions by B. Braun:
One partner to cover all your haemodialysis blood treatment needs
Service and
support
machines
Dialysis
Disinfectants
Dialysers
Fistula needles
Haemodialysis
bloodline systems
Dialysis
Concentrates
Dialysis
fluid filters
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An intelligent investment
A high standard of patient care with economical running costs1
The Dialog+ System is economically efficient in daily running costs through incorporating innovative hardware and software features such as;
a standard standby mode activated at the user’s request, which lowers operation costs by turning off the dialysate flow after a preset rinse time has elapsed. This function lowers costs through lowering the consumption of water, concentrate and electricity.
the auto-priming function lowers costs through decreasing saline solution usage in online systems. This works not only during HDF/HR online treatments but also during standard haemodialysis procedures.
flexibility in your choice of consumables. Our objective is to convince you with our product quality, without limiting your freedom of choice.
cost and environmental conscious thinking is integrated into all Dialog+ models with an energy saving heat exchanger, which uses the counter-flow stream principle to draw thermal energy from flowing water. Less energy is used in achieving the desired temperature for the dialysis fluid, lowering electricity running costs.
Optimising the quality of patient management with bioLogic RR Comfort®and simplifying data management with Nexadia
The bioLogic RR® Comfort biofeedback system through intelligent
regulation of the ultrafiltration rate, helps to monitor and stabilise patient blood pressure while the treatment is still in progress. Nexadia® is a data management system which documents the entire treatment procedure introducing a new dimension of safety and efficiency. The intelligent software facilitates the management of patient data in a perfect workflow and reliably collects all treatment parameters.
Dialog+; simplicity of use driving advanced capability in patient safety monitoring
An intuitive touch screen makes set-up and operation of the system fast and easy. The Dialog+ offers the ability to monitor six combinable profiles:
Ultrafiltration profile
Sodium management profile
Temperature profile
simplifying patient management with reminder functions for tasks such as drug administration, blood pressure measurements and heparin administration.
Other functions also include automatic blood pressure measurement and a patient therapy card reader.
Providing reliable treatment with Xevonta and measurable treatment with Adimea
Xevonta is a new generation dialyser which is characterised by highly
efficient clearance and optimal selectivity. A high percentage of middle-molecular uraemic toxins, such as B2-microglobulin, can be removed with simultaneous extremely low albumin loss. Xevonta is ideally suited to deliver the right dialysis dose – and Adimea can be used to measure it. Adimea measures dialysis efficiency (Kt/V) by determining the reduction in molar concentration of urinary excreted substances in the dialysate drain. As a result, Adimea allows continuous monitoring of dialysis efficiency throughout the treatment procedure.
Bicarbonate profile
Heparin profile
Dialysate flow profile
Our commitment to treatment quality
Dialog+ Dialysis Machine Instructions for Use SW 9.1x, IFU 38910010EN, Rev. 2.12.00, March 2012.
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Please contact us for your free individual business assessment and to discuss how the Dialog+ System can help you to run more economically.
Xevonta - a new dimension in treatment Quality
Xevonta – ensuring treatment quality
Using advanced high-technology production, B. Braun has developed Xevonta, a new high-performance dialyser.
Xevonta’s performance profile is based on the innovative characteristics of the amembris fibre, which is used to form a high-performance, biocompatible, polysulfone-based synthetic membrane.
The amembris membrane has the high hydraulic and diffusive permeability required for high molecule clearance and a clear separation between molecules which have to be eliminated to the maximum extent (eg. B2-microglobulin) and the molecules for which maximum possible retention is required (eg. albumin).
Xevonta – a clearance profile to optimise the dialysis dose
Dialysis adequacy, assessed by urea kinetics, is an important clinical performance indicator2. Xevonta,
through its outstanding clearance profile, helps to optimise the dialysis dose and improve treatment outcome.
Xevonta demonstrates exceptionally high phosphate clearance values, which may contribute to increased phosphate removal.
With its outstanding selectivity, Xevonta efficiently eliminates middle molecules and also shows impressive albumin retention in achieving recommended serum albumin target ranges3.
Patients who are elderly, malnourished or who have co-morbidities may especially benefit from the performance characteristics of Xevonta. Outstanding performance profile:
to optimise the dialysis dose
Optimal selectivity: maximal B2m-elimination with
simultaneous minimal albumin loss Highly efficient phosphate clearance Excellent biocompatibility
Complete product range:
6 high flux and 6 low flux variants
2 Couchoud C et al.: Assessment of urea removal in haemodialysis and the impact of the European Best Practice Guidelines, NDT 24: 1267-1274 (2009).
3 European Best Practice Guidelines for Haemodialysis (Part 2): EBPG guideline on nutrition, NDT 22: ii45-ii87 (2007).
QD = 500 ml/min, QF = 0 ml/min
Data from manufacturer‘s published specification sheets
Option of Xevonta Hi 2.3 with a 2.3m2 surface area for
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Adimea - Real-time monitoring of the dialysis
dose for optimising treatment quality
Precise, innovative determination of the reduction of urinary excreted substances in the spent dialysate using UV technology Real-time monitoring during the entire treatment period via continuous effectiveness measurement
Configurable and clear display of URR, spKt/V, eKt/V as well as result prognosis
Changes to treatment parameters possible at any time Only one input parameter: “patient weight pre-dialysis“
Focus on the patient:
One of B. Braun’s aims is to provide doctors and nursing teams with the best possible support for giving patients the optimum dialysis dose. The basis for this is continuous precise measurement and display of the dialysis
effectiveness during treatment.
To achieve this, B. Braun has developed the Adimea real-time monitoring system. Adimea measures dialysis efficiency by determining the reduction in molar concentration of urinary excreted substances in the spent dialysate.
Adimea is an innovative measurement method for reliable and continuous dialysis dose control (Kt/V) throughout the entire treatment. Medical and nursing staff can selectively adjust the treatment parameters during treatment, which is of great benefit to the patient. In other words, the equipment provides an optimum means for reaching the set treatment goals.
This means that time can be saved because the urea distribution volume (V) no longer needs to be determined and entered. Various treatment indices, from the simple urea reduction ratio through spKt/V, or alternatively, eKt/V, are available for continuous real-time measurement and control.
Advanced dialysis technology
The innovative Adimea system utilises the principles of spectroscopy for determining the reduction in molar
concentration of urinary excreted substances in the dialysate drain. A light source 1 transmits ultraviolet (UV) light 2 through the dialysate. The particles contained in the dialysate, which were removed from the plasma during dialysis, absorb the light. This absorption is measured by a sensor 3 .
The pioneering technology enables measurement in the spent dialysate. Adimea continuously analyses the changes in molar concentration and is therefore in direct contact with the patient. On the basis of this characteristic, Adimea is a highly reliable and accurate instrument for the online determination of the current Kt/V value during treatment.
Adimea is impressive, not only in terms of its technology, but also with regard to its simple and clear operation: The application merely requires the input of a single
patient-specific parameter – the patient’s weight before dialysis.
Clinical trials4 demonstrate very close correlation between the
laboratory-determined blood-spKt/V and the spKt/V determined by Adimea.
During a total of 64 treatments, blood was serially taken every twenty minutes for urea testing to determine the spKt/V from the blood as accurately as possible. The spKt/V value determined by Adimea was recorded at the same time.
An analysis of the degree of correlation between the Adimea method for determining Kt/V and the reference method for determining Kt/V gave a correlation coefficient of r = 0.93, which demonstrates excellent correlation between the two methods and reinforces the high degree of accuracy of the Adimea method for determining Kt/V. The measurement error recorded in these studies for the overall determination of the Kt/V is only 7%.
Adimea – a technical innovation in Kt/V monitoring.
Fig.: Scatter diagram: correlation between blood spKt/V and Adimea spKt/V Correlation coefficient r = 0.93; n = 64
4 Werner, Günthner et al: data on file (B. Braun Avitum AG, Melsungen), 2009.
Precise, innovative real-time measurement of the dialysis dose
Easy and flexible operation
bioLogic RR® Comfort biofeedback system
bioLogic RR® Comfort is a reliable system for managing haemodialysis patients who frequently suffer from hypotensive episodes during treatment.
bioLogic RR® Comfort biofeedback system can prevent excessive drops in blood pressure during treatment through automatically and predicatively adjusting the ultrafiltration rate. Intelligent guideline technology manages patient blood pressure by monitoring real-time blood pressure readings and referencing stored blood pressure curves from previous treatments. The system is easily operated by just two key settings on the Dialog+ touch screen, thus providing nursing staff more time for patient care.
Clinical studies show bioLogic RR® Comfort achieves an outstanding reduction in the need for hypotensive treatment
during dialysis5: Simple operation, leaving nursing staff more
time for patient care
Significant reduction of hypotensive episodes
Improvement in treatment quality
52% reduction in treatments with hypotensive episodes (HE)
82% reduction in treatments with at least one HE symptom
64% reduction in treatments with at least one HE-induced therapeutic measure
bioLogic RR
®
Comfort
Innovation in significantly reducing hypotensive episodes
Roeher O, Schmidt R, Korth S et al.: bioLogic RR® Comfort reduces hypotensive episodes in patients prone to intradialytic hypotension. 38th Congress of the German Society of Nephrology, Munich, 2007.
Dialog
+
– peace of mind in managing
hypotensive patients
dialysis treatment including dates, medication and UHF rates. Functions include the editing and archiving of all treatment data and preparation of documents required for quality control.
Increased cost efficiency
Less administration activities and more time for patient care
Consistent documentation to meet quality assurance requirements
Simple to use
Automated saving and filing of data
Nexadia – streamlining processes and quality
control in dialysis
Nexadia® considerably reduces the time required for the administration of various workflows – time which
nursing staff can devote to patient care.6
6 Osterkorn D.: “Networking for success in dialysis centers: A prospective comparative analysis“. Gesundheitsökonomie und Qualitätsmanagement 2006; 11: 112-116.
Nexadia is a new modular patient data management system designed to simplify dialysis processes and maintain the documentation required for quality control.
Nexadia Monitor collects data from dialysis machines, analysers and patient scales. Data collected during treatment can be visualised, analysed and monitored to optimise treatment and improve treatment outcome.
Nexadia Expert is a powerful and user-friendly database for dialysis centre therapy management. Data from other medical information systems can be imported and managed from areas such as the patient master database, the laboratory and external physicians‘ offices. Nexadia expert allows scheduling of future
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Important information at a glance
General data
Nominal voltage: 230 V (option: 120/240 V) Nominal frequency: 50 Hz (230/240 V) or 60 Hz (120 V) Nominal current (max.): max. 11 A for 230 V or 16 A for 120 V Dimensions (W x D x H): approx. 510 x 637 x 1678 mm Weight (empty): approx. 85 kg in the basic design Water intake
Pressure range: 0.5 to 6 bar Temperature range: +10 to +30 °C
Concentrate supply: Canister/central supply/bicarbonate cartridge Pressure range: 0 to +1 bar
Standards: EN 60601-1: (IEC 601-1) EN 60601–2–16: (IEC 601-2-16) EN 60601–1–2: (IEC 601–1–2) Produced in conformity with directive 93/42/EEC
Dialysis fluid system
Temperature working range: selectable between +33 and +40 °C Conductivity processing: conductivity regulated
Working range: - Conductivity of bicarbonate 2 to 4 mS/cm or 4 to 7 mS/cm
- Total conductivity 12.5 to 16 mS/cm Measurement tolerance: ±0.2 mS/cm
Flow: 300 to 800 ml/min Tolerance: ±5%
Blood leakage detector: optical, colour-specific
Alarm limit value: > 0.50 ml/min (HCT 45%) > 0.35 ml/min (HCT 25%) Ultrafiltration: - volume regulated through the balance chamber,
ultrafiltration through ultrafiltration pump - sequential ultrafiltration (Bergström) Working range: 0 to +3000 ml/h
Measurement tolerance: 0.2 ml per chamber cycle, UF-pump tolerance <1% Degassing device: mechanical, through regulated degassing low
pressure
Disinfection
Chemical disinfection/cleaning: automatic running of program with minimal free rinse time; various disinfection means may be installed.
Thermal disinfection/cleaning: automatic running of program at approx. 85 °C Central thermal/chemical for cleaning/rinsing the feed connection Cleaning/rinsing: for the device with simultaneous chemical or
thermal (> 85 °C) disinfection of the ring connection
Extracorporeal circulation
Blood pump: 2-roll pump Transportation rate: 50 to 600 ml/min
Transportation tolerance: < 10% with pressure up to -150 mm Hg Heparin pump: injection pump for 10, 20 and 30 ml syringes Transportation rate: 0.1 to 10 ml/h
Transportation tolerance: < 10%
Safety air detector: Ultrasound measurement in the tube Protection system: Ultrasound detector, automatic cyclical testing
during the entire operating phase Pressure measurement at the
arterial feed into the dialyser
(PBE) Working area: 0 to +700 mm Hg Measurement tolerance: ±10 mm Hg Arterial input pressure measurement
(PA) working area: -400 to +400 mm Hg Measurement tolerance: ±10 mm Hg Venous backflow pressure measurement
(PV) working area: 20 to +390 mm Hg Measurement tolerance: ±10 mm Hg
Machine Item number*
Dialog+ (Single pump) 7102005 Dialog+ (Dual pump) 7102013 Dialog+ HDF-online 7102072
Option Item number
Adimea 7105233 bioLogic RR® Comfort f. Card Reader 7105324
ABPM 7102226
Emergency current supply 7102244
Option Item number
Dialog computer interface 7107218 Crit-Line interface 7106604 Nexadia® BSL 7102230 Card reader (includes 5 cards) 7105230 Patient treatment card (5 pieces) 7105232 Bicarbonate cartridge 7105171 Centralised supply of concentrate 7105196 Sterile filter 7102102 Staff call 7102315 Roll runner for pump segment 7x10 7102340
Accessories Item number
Box 7107320 Box comfort 7107322 Monitor tray 7102872 Protocol storage 7102873 Flat combination storage facility 7102890 Universal socket storage 7105500
*More configurations possible under different item numbers.
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Peace of mind in service excellence
B. Braun: a trusted partner in dialysis treatment for
more than 30 years.
As your healthcare partner, B. Braun is committed to supporting you with the level of service you need to provide the highest standard of care for your patients.
From our reliable worldwide logistics and supply chain to our clinical education programs and technical service support, our commitment is to provide service excellence.
At all times, innvovation and improvement are the driving forces
guiding our activities in serving doctors, nurses and patients who
use our products.
<10 A for 240 V
Thermal disinfection/cleaning: automatic running of program at approx. 85°C Central thermal/chemical for cleaning/rinsing the feed connection Cleaning/rinsing: for the device with simultaneous chemical or
thermal (> 85°C) disinfection of the ring connection
B. Braun Australia Pty Ltd | Bella Vista NSW 2153 | Tel: 1800 251 705 | Fax: 1800 628 045 | www.bbraun.com.au | [email protected]
