DE3237016A1 - EXTRACORPORAL BLOOD TREATMENT DEVICE - Google Patents

Description

DESCRIPTION

The invention relates to the treatment of blood as used for healing and providing relief to patients who have difficulties with their blood, namely the invention relates in detail to an extracorporeal one Blood treatment facility, d. H. So a facility that such a blood treatment outside of the living body.

The blood treatment performed outside the living body is known per se. One of the most important examples of a facility for such treatment is an artificial kidney device in which a patient's blood is passed through the device and in which the filtering and cleaning process is carried out, which is no longer adequate by the kidney of the patient Way can be run. The devices of this type currently in use have serious Disadvantage. For example, the appearance is this Facilities terrifying or terrifying. Outside of There are hoses in the facility, each of which runs in one way or another appear to run, and some of which carry blood and some lead to physiological saline solutions.

In addition to being terrifying and terrifying Appearance are the current facilities of this type, which can also be referred to as "machines" when Potentially dangerous to use. For example, diseases such as hepatitis can be caused by the Use of such facilities can be easily disseminated. Therefore, it is before a patient with such a facility connected, it is necessary to fully

constantly clean and sterilize in order to spread to prevent dangerous germs, bacilli, bacteria or other pathogens. To this The purpose is to remove and clean all of the tubes carrying the blood and the physiological saline solution, or discarded and clean or new tubing reconnected to the facility. The cleaning process takes a great deal of time and effort and must be carried out by reliable personnel.

Another disadvantage of the current devices of the type mentioned is that the device is installed in front of or must be reconnected to the cleaned or new hoses after cleaning. This process of reconnecting is an area or process in which serious and dangerous errors can occur. So it can if z. B. a hose is incorrectly routed as a connection from one point to another, come to the fact that causing extensive damage, or at least a truly terrifying experience comes to the patient as the device when they are turned on and the blood begins to flow is supposed to shut down automatically and set off an alarm, which is usually both a visible and a is an audible alarm.

Except for the hoses, parts of the facility become continuous reused, such as the pumping equipment for causing the flow of blood and physiological Saline solutions as well as certain sensor devices, such as B, flow meter assemblies and liquid level measuring and sensing devices. It would be of course, it is preferable that such equipments and facilities of the facility be used for each patient

are new. Of course, that would make the treatment prohibitively expensive. Hence it is necessary to have such equipments and to clean individual facilities appropriately before reuse. The need for such Cleaning equipment and individual facilities by hand leads to an additional considerable expenditure of time in the preparation of the device for blood treatment to their use and therefore leads to additional Stress when using such devices for blood treatment.

Accordingly, there has long been a need for an extracorporeal one Blood treatment facility in which all parts, that come into contact with blood or solution, either assigned to an individual patient and / or disposable without making the facility inappropriately complicated and without incurring inappropriately the cost of the facility increase. There has also long been a need to have such facilities available, in which the connections between the facility and the patient as well as between different parts the facility by means of hoses are made in a way that is fearsome and frightening Impressions for actual and potential users of the facility are avoided. Finally there is there has long been a need to have such facilities available so that the flow connections for Blood, physiological saline solution and / or dialysate under with minimal possibility of error.

Accordingly, the invention aims to provide an extracorporeal blood treatment device are made available, with which the above-mentioned disadvantages are significantly reduced or overcome and which substantially meets the above requirements.

According to the invention, an extracorporeal blood treatment apparatus is made available, the one that also includes a machine to be designated device welche- ¹ is a blood treatment device has, as well as a hose means which are removable from the device or machine and for connecting the blood circuit] aufsystemsdes patients serve with the treatment device, wherein the tube device comprises tube sections within or on a cassette device or cassette, and wherein a device for coupling or connecting the cassette device or cassette with the device or machine and thereby for automatically connecting the hose device to the correct Places which are provided for connection to the blood treatment device and are provided for operating the blood treatment device.

Another preferred feature of the invention is in the possibility of assigning the cassettes to specific patients, for example by using a magnetic, electrical, optical or mechanical coding of the cassettes.

Another preferred feature of the invention is individualized Cassettes for the treatment of solutions, such as dialysate, which are often used in blood treatment, so that a minimum of Tubing is present outside of the cassette, with the external tubing being economically thrown away and thrown through replaced new tubing for each patient or for each use of the facility or machine and system can be.

According to yet another preferred feature of the invention the cassettes are designed so that they a

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allow easy and simple removal of the tube sections within the cassette after each use, The used tube sections and the rigid cassette shell or the rigid cassette body are discarded optionally equipped with a fresh set of hoses or hose sections after cleaning can be. This process is applicable to both disposable type cassettes and individualized ones Cassettes, which are assigned to specific patients, and it has the advantage that the cost of the cassette shell or the cassette body can be saved.

Another preferred feature of the invention consists in a cassette device or a cassette with one or more pump devices or pumps work together, so that the pumping on the hoses or Tubing sections in the cassette is effected so that the individual pump parts before use with each Patients do not require sterilization.

Finally, another preferred feature of the invention is novel flow measuring devices, in which the current measurement is carried out outside the tubes or tube sections of the cassette, so that the sterilization process and the possibility of errors are minimized will.

Finally, there is still another preferred feature of the invention in a novel measuring device in which the Body fluids or treatment solutions are included within the cartridge component so that in this way complete sterilization is maintained and errors are minimized ·. 35

The invention, in particular its operation and use, are below with reference to some in the Pig. 1 to 7 of the drawing shown in principle, particularly preferred Embodiments explained in more detail; it show: 5

Fig. 1 is a pictorial representation of the system or the Device according to the invention, in use as an artificial kidney, wherein after the Representation of both a cassette provided with blood tubes and a dialysate cassette

are provided;

Fig. 2 is a structure and flow diagram for such a System or such a device when used in hemodialysis;

Fig. 3 is a plan view of a typical or preferred Blood cassette;

4 shows a plan view of a typical or preferred dialysate cassette;

5 shows a partial sectional view of a pressure measuring device in the tubing lines in a blood cassette;

Fig. 6 is a sectional view taken along line 6-6 showing

a hand-operated clamping device in the open

shows fenen position; and
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Figures 7A and B are illustrations of the cartridge pump slots

with a pump located in the loading

and in the operating position.

The extracorporeal blood treatment shown in Fig. 1

device or arrangement 11, that is to say a device or device which treats the blood outside of a living body. Arrangement, comprises a base device 12 which has an automatic control device which has an input and output device 13, which is shown as a cathode ray tube 14 and a keyboard 16 for entering instructions. According to the illustration, the basic device has a dialysis filter or a dialyzer 17.

The structure and flow diagram of FIG. 2 shows schematically that which is contained in the blood cassette 18 and in the dialysate cassette 19. Between the cassettes, so in the area indicated by the dashed lines there is a filter 17. Certain other parts of the device are not shown, such as a bubble trap or a bubble separator, a heater and such other parts that are known per se. The flowchart begins with a coupling device 27 and goes to a converter chamber 29 for the arterial blood pressure inside the cassette and an arterial blood pressure reading on an external measuring device. As a result, the transducer chamber of the external meter is a integral part of the cassette.

Near the start of the coupling device 27 outgoing hoses 28, a clamp 31 is provided. The clamp 31 can be any type of "'clamp; however, will in a preferred embodiment by the device logic operated automatically. The clamp closes the hose under certain emergency conditions. Thus, when the cassette is attached to the device, terminal 31 is open but connected to the controller. When an emergency arises it is necessary

makes that the functioning of the facility stopped
the clamp is closed.

It is a device for delivering saline solution
intended for blood. In detail, a hose 32 is connected to a pump 33 which is arranged in series with a Kinlaßkupplung 34, to which a container with
physiological saline solution is connected. the
Connection point between the hoses 28 and 32 is

connected to a main blood pump 37 at 36. The blood pump 37 is only briefly described here, but it is described in more detail in a patent application filed by the applicant on the same filing date with the title
"Peristaltic pump" described.

At the outlet of the blood pump 37, an anticoagulant such as heparin is added to the blood, and the passage for the anticoagulant is at 38
indicated. A pump 39 for the anticoagulant is via a T-coupling 41 by means of a hose 42
connected to the blood pump 37.

The filter 17 is connected to the T-coupling 41 by means of a hose 43. The filter can be any commercial available closed filters of negative pressure type.

The outlet of the filter 17 is through a hose 44 and an inlet coupling 46 of the cassette 18 led back to the latter. It should be pointed out at this point that, although the connecting lines are each referred to as a hose for the sake of simplicity, because it is necessary in many cases that they are flexible, these connecting lines where they are permanently laid are not intended as part of a hose pump are, each can also be designed as a tube. Of the

Inlet 46 of filter 17 is connected to tube 47 in the cassette. The hose leads to a drip chamber 48. The drip chamber 48 is connected to a hose 53, which is used to draw air through the pump 52, the hose 51 and suction passage 49 from the drip chamber to maintain the desired level of liquid in the chamber. The pressure in chamber 48 is indicated by measuring instrument 57.

A blood level detector 58 is connected to the drip chamber. Any type of blood level detector can be used. In a preferred embodiment, however, a blood level detector according to the invention used, as it is in the on the same filing date as the present application filed patent application of the applicant is described, which is entitled "measuring sensor arrangement for measuring and Controlling a fluid "has.

A flow meter 59 is provided at the outlet of the drip chamber and is connected to the detector 58 through the hose 61 connected is. In a preferred embodiment a nexiar tiger flow meter 59 used without the any internal instrumentation in contact with the blood works. This will of course maintain it the sterility of the arrangement promoted. Such a novel flow meter is just above mentioned parallel patent application.

A bubble detector device 64 is provided for any bubbles created by the drip chamber could determine. In addition, it is immediately at the end the hose 61 is provided with an automatic clamping device, which is shown as a vein clamp 62. The hose 61 leads to an outlet coupling 63, - with the Hose 26 (see Fig. 1) is connectable to a

Needle in a patient's vein or any other device that connects to the venous system of a patient produces leads.

In the structure and flow diagram of FIG. 2 is also the part of the flow system shown in the dialysate cartridge or cassette 19 is located. A source of dialysate 66 is represented by various devices such as heaters and meters in general are collectively designated 67, connected at 68 to the cartridge or cassette. Immediately behind it is a variable throttle point 70 for controlling or Control of the negative pressure provided in the dialysate solution. After the throttle point 70 is in the flow direction Device for measuring the pressures provided, such as. B.

a dialysate pressure transducer and meter assembly The transducer and meter assembly 69 is connected to a T-coupling 71 extending from the hose 72 to the Hoses 73 and 74 extends. The tube 73 leads to an automatically operated clamp 76 for the dialysate inlet. The hose 73 downstream of the clamp 76 is through a coupling 77 and a filter hose 78 connected to the filter 17.

The outlet of the filter 17 is through a filter hose 79 led to a coupling 81. A hose 82 leads from the coupling 81 in the cassette to or through a Flow monitoring arrangement 83. The flow monitoring arrangement can be a monitoring arrangement of a type known per se. However, in a preferred embodiment an ultrasonic flow meter used as described in more detail in the above Patent application is described. In the shunt to the filter, a hose 74 is provided, ^ the with a Device for blocking the shunt, such as both

For example, using the shunt terminal 97 shown is provided. The hose 74 is connected to the hoses 87 and 84 at a coupling 98. The outlet of the flow monitoring arrangement 83 is connected to a dialysate suction pump 88 via the hose 87. From the pump 88 the fluid is forced through a hose 89 and a blood leak detector, the latter serving to do so it is ensured that the membrane in the filter 17 has not cracked or otherwise damaged by immediately indicating such a condition. Of the The outlet of the detector 91 is through a hose 92, a check valve 93 and a hose 94 to the one at 96 outflow shown.

The facility goes z. B. every 3 minutes by switching to the shunt mode that the shunt terminal 97 opens and closes inlet and outlet clamps 76 and 86, respectively, to measure the ultrafiltration rate. In this way the ultrafiltration rate measurement carried out by sampling. It should be noted that the negative pressure in or on the filter is caused by the flow monitoring arrangement 83 is maintained. The measurement of the samples forms the input value for the computer, the negative pressure is calculated and the throttle point is controlled in order to maintain the desired ultrafiltration rate required negative pressure is maintained.

The cassettes 18 and 19 contain the majority of the tubing of the assembly which is intended for an individual patient assigned. The rest of the tubing and equipment is with such things as the filter heater assembly and concentrate mixers connected in one cleaned in a minimal time and sterilized by certain subsequent sterilization processes in the facility without the need to

to replace a large part of the hoses and / or to sterilize and then connect the tubing appropriately to the device. Al] e hoses that are are not located within the respective cassette, do not come into contact with the blood or the blood extracts of the Patients and are therefore less critical of stimulation requirements subject.

Referring to Figure 3, there is a blood cassette generally designated 18 shown. In a preferred embodiment the cassette 18 is a plastic unit that comes in many In respect of cassettes is similar to how they are used in audio tape cassette devices. In this preferred embodiment two mounting holes 99 and 101 are arranged at diagonally opposite corners of the cassette. It bolts or pins (not shown) are of course provided on the device, whereupon the cassettes can be attached so that they are positioned so that the bolts or pins through the holes 99 and go through 101. The cassette is then depressed until it is adjacent to the device. The cassette operates certain switches (not shown) when in the intended position. The operation the switch unlocks the pumps, the automatic clamp or the automatic clamps and certain sensors, so that it is in the "ON" position in response to the actuation of an "ON-OFF" switch (not "shown") work. The cassette is then locked in place. As can easily be seen, the cassette contains the hoses required for each case. A feature of the cassette is that it is provided therein Openings and slots in the cassette allow other equipment such as clamps, pumps and sensors to operate together in the facility. There are slots provided

ζ. B. the slot 31A at the point at which the patient's blood is first directed into the arrangement. The slot 31A is adapted to receive a clip on the device which may be a solenoid or a pneumatic actuator for the purpose of automatically mechanized actuation of the clamp surfaces Has. In the present case, as can be seen when comparing FIGS. 2 and 3, this clamp is the clamp 31. In a corresponding manner Thus, openings 33A, 37A, 39A and 52A are formed in the cassette so that those to the peristaltic pumps 33, 39, 37 and 52 hoses belonging to it are received or run through these openings, that the hoses are in engagement with the rotary or hose pump rollers or rollers and the stators of these Rotary or peristaltic pumps attached to the facility are engaged. The uniform rotary or hose pumps used have movable stators, which are automatically operated in response to the operation of the aforementioned switches. pump of this type serve both to force the flow of fluid and as a valve to enable and block the flow of fluid to work.

Pumps for the physiological saline solution, for the anticoagulant solution and the like are shown. It should be pointed out at this point that these solutions can also be fed in with controlled valves using gravity. However the solution volumes are in a preferred embodiment in a controlled manner using Pumps fed or controlled.

The pressure transducers and measuring instruments are shown in «Fig. 5 in shown in more detail. The pressure transducers, like both

For example, the pressure transducer chamber connected to the viewing tube 28 29, are designed to prevent an impurity or the risk of contamination of the .fluid, which flow in the tube of the cassette is minimized will.

As shown, the cassette 18 is with two for Pressure measurement serving converter chamber arrangements 29 and 57 equipped. They both operate in the manner illustrated in FIG Way. There, the pressure transducer assembly 29 includes some soft narrow hoses as shown, such as the hose 106 shown. It is a cylindrical section of the hose containing the hose 106 connected hose 107 from the hose line separated by a membrane 108. Above the membrane a fluid indicated at 109 is stored. If the pressure in hose 106 changes, changes the pressure on the fluid 109, whereby the measured value to be read on the measuring instrument 111 is changed.

In addition, an opening 103 is provided in the cassette, which is used to receive a buffer or collecting container 30. The buffer or collecting container 30 is made of an elastic material so that it can go through the T-connector 36 in the pump 37 fluid flowing a certain volume is available. The buffer tank acts to ensure that the flow from the pump is steady.

It filters or compensates for shock waves caused by the rollers of the pump. The buffer or collecting container is also used for volumetric Storage for a mode of operation in which with a single Needle is worked.

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In addition, openings 113 and 114 are provided in the cassette, which relate to the drip chamber 48. These openings take the instrumentation for locating the Liquid levels in the drip chamber. Similarly, there is an opening 59A below the drip chamber shown, which serves to accommodate the unit of blood flow meter and air bubble detector.

The cross-section of Fig. 6 gives an idea of the thickness of the cassette and also shows how the tubes fitted into the plastic cassette or in the plastic cassette are attached. The hose shown in Fig. 6 is that hose, which from a passage 116 is led away, the for adding drugs and the like to the blood being processed. The passage 116 leads to the hose 117, which can be clamped shut with a clamp 118 as shown. The hose 117 goes directly to the drip chamber 48. The clamp 118 is considered manual actuatable clamp of the clip or spring clip type is shown which has a clip or spring clip portion 119 for receiving and holding an elastic lever portion 121; if the latter is from the clip or spring clip section 119 is recorded and held, the clamping points 122 and 123 exert sufficient pressure on the Hose 117 to close the hose. The passages, such as passages 116, 126, 127 and 128 are designed to accommodate bacterial filters in series with the respective hose.

The cartridge also has coding identification means or a coding identification means, which or generally as an identification means 129 is indicated. In the case shown, identification is carried out by means of known series of ma-

gnetised surfaces. The patient is provided with a card that also magnetizes such holes or Has surfaces. The card is in a slot of the device arranged. If the codes match, the device is unlocked. Each for assignment Serving coding can have the most varied of forms known per se and is of course not possibly magnetic Technology limited.

The dialysate cassette 19 is shown in greater detail in FIG. Again there are mounting holes provided at diagonally opposite corners, namely the holes 137 and 139. In the cassette 19 are also Slots and openings are provided. So is z. Legs Opening 88A for dialysate pump 88 provided therein. In addition, clamp openings are adjacent to the inlet and the outlet hose. The clamp opening for the inlet hose is designated as opening 76A and serves to receive the clamp 76. The changeable Throttle point 70, which is shown in FIG. 2, is received in opening 70A. Next is an opening 97A intended for the shunt terminal 97. The opening 86A is used to receive the clamp located at the outlet 86. Finally, there is also an opening 91A for the blood leak detector 91 provided. The check valve 93 is coupled into the line on the right, and it is an extended one Slot 93A is formed in the cassette for receiving the check valve 93.

The cassette 19 contains means for measuring the water extraction rate of the filter. According to the state of Technique there are many ways to measure the rate of water extraction. It is conceivable that each of these possibilities according to the prior art can be used in the present cassette system. However, in one

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ner preferred embodiment a uniform or uses a novel water extraction rate measuring device which has an ultrasonic transducer. The rate monitor or the water extraction rate measuring device is shown in the arrangement and flow diagram of FIG Fig. 2 drawn in, and in connection with the monitoring device or the extraction rate measuring device a cavity 83A is provided in the cassette 19 for receiving an ultrasonic transducer located in the device is located in which the cassette 19 is attached. A sample passage 85 can be provided. Further a manually operated clamp 80 is shown cooperating with a hose 90 extending from a T-connector 82 to passage 85 extends. An opening 80A in the cassette receives the clip 80. Further An opening 91A in the cassette 19 serves to receive the blood leak detector unit 91.

The reference numerals of the hoses in FIGS. 3 and 4 are the same as the reference numerals of the hoses in FIG the arrangement and flow diagram of FIG. 2, so that for the sake of clarity and brevity their arrangement and Function is not specified repeatedly here; the same applies to the T-connectors, couplings, etc. 25th

The dialysate pressure transducer 69 operates in the manner already described.

As a result, the dialysate cartridge 19 is just like that Blood cassette 18 is relatively small and compact, it is easy to clean, contains such devices or elements, as is the assignment coding device or the assignment coding element 129 for assigning the cassette to an individual patient. The hose connectors 68, 77 and 81 facilitate the use of the cash

by automatically connecting their hoses to the device, on which the cassette is attached.

The pump 37 of the cassette 18 is to understand the usability and advantages of the cassette, too facilitate, shown in Figures 7A and 7B; in the same The remaining pumps 33, 39, 52 and 88 can also be designed. The pump 37 has a rotor 141 on. A plurality of rollers 146, 147 and 148 are mounted on the rotor by means of connecting parts 142, 143 and 144 attached, namely one on each connector Roller or roller attached. The rollers describe a cylindrical geometric location when the rotor is rotates about rotor axis 149; in particular describe the radially outermost points of the rollers 146, 147 and 148 a cylindrical body of revolution when the rotor turns around its axis.

The stator 151 is movable between a loading position (FIG. 7A) and an operating position (FIG. 7B). In the loading position the stator is so removed from dent by the rollers or rollers described geometric location that the tube 152, when the cassette is mounted on the device, automatically between the rotor and the stator fits or is inserted.

In the operating position, the geometric location described by the rollers or cylinders rests on the hose 152, so that the desired pumping effect is achieved. The stator is turned into one by the rotation of a cam member 153 Slot 154 moved. A device, presently including slots 156 and 157 with pins 158 and 159, the extending from the device on which the cassette is mounted through slots 156 and 157 holds the Linearity of the stator movement upright. Therefore, if the

Cassette is mounted on the device, the Sch] also fits 152 between the stator and the rotor. By pushing the cassette in the intended position, a solenoid (not shown) is actuated, which the cam member 53 rotates so that the stator is moved to the operative position.

In operation of the device, the patient is prepared and the device is brought to the patient; the Cassettes are placed in or on the device. The coding is also checked to ensure that it is the cassette or cassettes that are assigned to the respective individual patient or are. The appropriate needles (for removing and supplying blood) are inserted into the patient's arm, and the device is started by operating a start switch. The clamps and pumps work in such a way that blood is drawn from the patient and the blood is used to extract toxins from the same is passed into the filter in a manner known per se in automatic kidney devices. In addition to Enable and cause the automatic operation of the Clamps, by placing the cassettes on the device, automatically make the pumps operate properly arranged and controlled. The pumps are operated or controlled in response to a program which into a memory of the device using the keyboard by means of the cathode ray tube shown in FIG shown is entered.

One of the advantages of the cartridges is that they make it safer to use a dialysis machine at home will. When using the cassettes, there is no need to be on the correct connection ^ of the hoses to pay attention. It should be noted in this regard

sen that more compact devices can be used in the patient's home using the equipment described herein, although a relatively large device is shown in the drawing (Fig. 1).
5

Another advantage of the cassettes is that they
can be easily washed and sterilized while
they are still at the facility. after the
Device has been separated from the patient, it becomes

connected for washing, with the pumps on the

Means are used to force the washout fluid through the cassettes.
A sterilizing solution is then pumped through the cassettes. The cartridges can be stored with the sterilizing fluid therein between use.

Of course, the invention is not limited to the described and illustrated embodiments and applications, but can be used within the scope of the subject matter of the invention as specified in the claims, as well as within the scope of the general inventive concept,
as can be found in the entire documentation, modify and implement in a variety of ways.

Claims (14)

PATEOTÄNWAnt AND APPROVED REPRESENTATIVE IN FRONT OF THE EUROPEAN MATTNTAMT DR. WALTER KRAUS D I PLO MC H EM I K E R · D R.-I N G. ANNElKAI E WEISEHT DIPL.-INCä. EXPERT IMPACT CHfMIT IRMGARDSTRASSE 15 · D-8000 MUNICH 71. TELEPHONE O ti i) / 7 9 7 O 77-7 S 7O 78 · T Γ. LC X OfS- 31-2 1 & l> kpnl ij 3469-I ^ / RR ELMAR MEDICAL SYSJTEMS LTD. Haifa / Israel Extracorporeal blood treatment facility PATENT CLAIMS 1. Extracorporeal blood treatment facility, d a through characterized in that it includes: a device (12) which is a blood treatment device (11) has; a hose device (28, 32, 42, 43, 44, 47, 51, 53, 61, which can be removed or detached from the device (12), 72, 73, 74, 79, 82, 84, 87, 89, 92, 94, 106, 117) to Connect a patient's cardiovascular system to the blood treatment device (11); wherein the hose device (28, 32, 42, 43, 44, 47, 51, 53, 61, 72, 73, 74, 79, 82, 84, 87, 89, 92, 94, 106, 117) hose sections within or on one or more Cassette means (18, 19). 2. Extracorporeal blood treatment device according to claim 1, characterized in that it has an individualized coding device (129) having, wherein the hose device (28, 32, 42, 43, 44, 47, 51, 53, 61, 72, 73, 74, 79, 82, 83, 87, 89, 92, 04, 106, 117) individual cassettes (18, 19), and wherein these cassettes (18, 19) branch or union parts (36, 41, 71, 81, 98) of those located therein or thereon Hoses or hose sections (28, 32, 42, 43, 44, 47, 51, 53, 61, 72, 73, 74, 79, 82, 84, 87, 89, 92, 94, 106, 117) included. 3. Extracorporeal ¹ blood treatment device according to claim 1 or 2, characterized in that the blood treatment device (11) is a hemodialysis treatment filter. 4. Extracorporeal blood treatment device according to claim 3, characterized in that in addition to a blood system or circulation cassette (18) a dialysate system or circulation cassette (19) is provided. 5. Extracorporeal blood treatment facility after einin of claims 1 to 4, characterized in that that the? Hoses or hose sections (28, 32, 42, 43, 44, 47, 51, 53, 61, 72, 73, 74, 79, 82, 84, 87, 89, 92, 94, 106, 117) in or on the cassettes (18, 19) of pump devices or pumps (33, 37, 39, 52, 88) are operated in such a way that a forced flow of blood and dialysate is effected. 6. Extracorporeal blood treatment device according to claim 5, characterized in that that they work in conjunction with the cassettes (18, 19) - de flow meter (59, 83). 7. Extracorporeal blood treatment device according to a of claims 1 to 6, characterized in that g e k e η η, that a liquid level measuring device operating in connection with at least one cassette (18) (58) for measuring the liquid level in a Drip device (48) is provided. 8. Extracorporeal blood treatment device according to one of claims 1 to 7, characterized in that the cassette device or the cassettes (18, 19) have slots, perforations, openings O. the like. (31A, 33A, 37A, 39A , 52A, 59A, 62A, 7OA, 76A, 8OA, 83A, 86A, 88A, 113, 114) to accommodate devices (31, 33, 37, 39, 52, 59, 62, 70, 76, 80, 83, 86, 88) therein, which are located on or in the device (12), so that an operation of the devices (31, 33, 37, 39, 52, 59, 62, 70, 76, 80 , 83 _r 86, 88) with the hoses or hose sections (28, 32, 42, 43, 44, 47, 51, 53, 61, 72, 73, 74, 79, 82, 84, 87, 89, 92, 94, 106, 117) in the cassette or the cassettes (18, 19) is made possible. 9. Extracorporeal blood treatment device according to claim 8, characterized in that that the devices (31, 33, 37, 39, 52, 59, 62, 70, 76, 80, 83, 86, 88) pump devices or pumps (33, 37, 39, 52, 88) for causing fluid movement through the hoses or hose sections (28, 32, 42, 43, 44, 47, 51, 53, 61, 72, 73, 74, 79, 82, 84, 89, 92, 94, 106, 117). 10. Extracorporeal blood treatment device according to claim 9, characterized in that that the fluid comprises physiological saline solution or is or contains. 11. Extracorporeal blood treatment device according to claim 5 or 9, characterized in that that the pump devices or pumps (33, 37, 39, 52, 88) a rotor device (141) and a Stator device (151) comprise, wherein the stator device (151) has a loading position in which it from the rotor or the rotor device (141) is removed, so that as a result, the associated hose automatically between the rotor or the rotor device (141) and the stator or the stator device (151) are positioned can, and an operating position in which the rotor or the rotor device (141) the associated hose presses against the stator or the stator device (151), so that there is a pumping effect when the rotor or the rotor device (141) rotates. 12. Extracorporeal blood treatment device according to one of claims 1 to 11, characterized in that that a measuring device (83) is provided for determining the amount of water withdrawn from a patient is. 13. Extracorporeal blood treatment device according to claim 12, characterized in that the measuring device (83) has a device (74, 94) for In addition to closing the dialysate flow around the filtering device (17), as well as a device (76, 86) for maintaining a negative pressure in the dialysate part the filtering device (17), and a dialysate pump device or pump (88), which has a flow monitoring device in the connection between the dialysate part of the filtering device (17) and a Trigger (96) is provided. 14. Extracorporeal blood treatment device according to claim 5 or 9, g e k e η η ζ e j e h η t? t you r c h a device for subsequent connection of washout fluid and sterilization fluid having the Device (12) so that this by means of the pump devices or pumps (33, 37, 39, 52, 88) forcibly guided or pumped through the cassettes (18, 19) can be. .