INTRODUCTION

Nowadays, Information, Communication and Technology (ICT) is widely used in Malaysian general hospital, especially Hospital Putrajaya. According to the overview about the ICT in Hospital Putrajaya, hemodialysis machine has been founded as one of the machines that applies ICT efficiently. Hemodialysis is the process of filtering blood by using an artificial means that replaces the functions of a failed kidney. It is a method for removing waste materials as well as free water from the blood when kidney failure in medicine. Hemodialysis can be out patient or inpatient therapy. Routine hemodialysis is conducted in a dialysis outpatient facility in Hospital Putrajaya. Hemodialysis treatments in Hospital Putrajaya are worked by trained nurses and technicians. It takes about 6 hours, and most patients require 3 treatments per week. The patient is connected by a tube to the machine, which continuously allows the blood to flow out, cleansed and removed excess fluid and then returned back. We need hemodialysis if both of our kidneys stop to function in order to sustain our lives.

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The figures above show that the structure of 2008K hemodialysis machine (front view (above) and rear view (bottom)).

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The picture beside shows that the 2008K hemodialysis machine in Hospital Putrajaya. It is designed to perform hemodialysis. It can be used for patients suffering kidney failure. 2008K hemodialysis machine is produced to give treatment by controlling and monitoring both the dialysate and extracorporeal blood circuits. The blood is circulated non-stop from the patient through a dialyzer, where net diffusion of toxins occurred that the toxins are removed out through a semi-permeable membrane, then returns to the patient. The extracorporeal blood circuit is controlled for blood pressure, and for the presence of air and blood. The dialysate concentrates are mixed with purified water, heated degassed, and delivered to the dialyzer in the dialysate circuit.

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The control panel of the machine is located at the top and front of the 2008K machine. There are four sections on the control panel which include General Operation Section, Treatment Display Section, Extracorporeal Section and Dialysate Control Section.

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The first section is General Operation Section. The General Operation panel contains four keys associated with starting or stopping the basic power and alarm aspects of any dialysis treatment. The function of the power key is to turn the machine on and the key must be hold for one second to turn the power off and if blood is sensed, the machine will power down with an audible alarm. The mute key silence an alarm for two minutes or until another alarm occurs. New Tx key will erase the current treatment information and move the summary information to the previous record in the Tx summary screen. Reset key will reset the alarms and if the key is pressed again and hold for one second to set new arterial and venous pressures.

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Next, the Treatment Display section is used to access and set all parameters. It is organized into three subsections which are the treatment display screen, the screen access buttons, and the data entry keys. The treatment screen display contains the area for viewing the various treatment screens. The screen access buttons below the display area are used to access the various treatment screens. The data entry keys, at the bottom of the treatment display section, are the the menus used to enter treatment parameter values or make selections inside the treatment screen. The function of the home key is to view current treatment data including treatment time remaining, UF data, arterial, venous, and transmembrane pressures, and dialysate data. The trends key is to view charts that provide graphic views of treatment effectiveness (Kt/V), sodium variation system (SVS) and ultra filtration (UF) profiles, and patient’s blood pressure over time. The dialysate key is to view and select acid/bicarbonate concentrate type, bicarbonate, sodium, electrolyte concentrations, and conductivity settings. Test and options key is to view pressure test, Alarm test, and diasafe test options and results. Besides, it view treatment options for pediatric and single needle patients, high flux dialyzers, patient ID numbers, and dialysate sampling. The heparin key is to view options for administering heparin gradually over the course of the treatment or as a bolus injection. Next, the Kt/V AF key is to view estimate of treatment effectiveness based on the actual dialyzer clearance and view the access flow messages and data. BTM/BVM key is to view arterial and venous blood temperature data with machines equipped with the optional Blood temperature Module and view the relative blood volume data and trends with machines equipped with the optional Blood Volume Module. The Blood Pressure key is to view all pulse and blood pressure test results taken during treatment Blood pressure alarm limits and inflation pressure and frequency of blood pressure tests are set in this screen. 1,2,3 keys are to enter numerical values when setting parameters for such treatment options as ultrafiltration rate, times, goal, and volumes. Up arrow and down arrow keys are to scroll up or down a list of parameter choices or to increase or decrease parameter values and to speed up the rate at which the value changes, press and hold the key down. Confirm key is to save a treatment parameter entry or confirm an action initiated on the touch screen. The confirm key is also a backup, safety feature designed to prevent accidental changes to the intended treatment parameters. Escape key is to void the current entry and return to previously entered parameter value before confirm is pressed.

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The Blood Circuit section contains keys and warning lights that are directly related to the transmission and monitoring of the patient’s blood. Override key is to keep the blood pump running for three minutes when a blood-leak alarm is present. The yellow Override light will illuminate. Prime key is to prime the extracorporeal blood circuit. Pressing Prime will keep the blood pump running when air is sensed in the venous blood chamber and an level detector alarm is present (as is the case during initial set up when the blood circuit tubing is empty). The pump will run for two minutes or until an adequate fluid level is detected by the ultrasonic sensors in the level detector module, or until the volume set in service mode is reached. Stat/Deflate key is to start an unscheduled, manual blood pressure measurement when the cuff is deflated, or instantly deflate the inflated blood pressure cuff. Heparin on/off key is to turn the heparin pump on or off. When the heparin pump is on, the green, triangular light is illuminated. This light will flash when heparin pump is interrupted. There are three warning lights in this Blood Circuit section. First indicator light is the air detector which will illuminate when the fluid level has dropped below the sensors in the venous drip chamber. Minor light will illuminate when a minor blood leak has been detected by the blood leak detector. Blood Leak Detector light will illuminate when an amount of blood greater than 0.45 ml/min has been detected in the dialysate by the blood leak detector.

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The Dialysate Control Section includes the keys needed to control the flow of dialysate, the Sodium Variation System (SVS), and ultrafiltration. The Dialysate Flow on/off key is to start and stop the flow of dialysate. The flow is off when the yellow triangular light is solid or flashing and the light is not illuminated when flow is on. The SVS on/off key is to activate the Sodium Variation System (SVS) program. When the SVS is on, the green, triangular light is illuminated. This light will flash when SVS program is interrupted. UF on/off key is to turn the ultrafiltration pump on or off. During ultrafiltration, the green light is illuminated. This light will flash when ultrafiltration is interrupted. Bypass key is to dialysate the flow which is bypassing the dialyzer because dialysate is outside the allowable temperature or conductivity limits, or shunt interlock door is open.

CONCLUSION

As a result, 2008K hemodialysis machine in Hospital Putrajaya has absolute consistent advantages on kidney failure patients. Many patients suffer from long term kidney failure before the invention of hemodialysis machine in the last few centuries. In order to overcome the problem, the scientists had successfully invented the hemodialysis machine and a lot of patients in the world gain benefits from it. Besides, this invention also contributes to the development of Information, Communication and Technology (ICT) in hospital and medical department. Today, 2008K hemodialysis machine is totally produced to update the old model hemodialysis machine and hence Hospital Putrajaya has obtain benefits from it. Therefore, many disadvantages of previous hemodialysis machine had been wiped off and solved. The function of the 2008K hemodialysis machine is to provide hemodialysis treatment by controlling and monitoring both the dialysate and extracorporeal blood circuits. This may be function as well as four main sections in this machine. These four sections include General Operation Section, Treatment Display Section, Blood Circuit Section and Dialysate Control Section.