Abstract: Implantable graft-port systems, devices, and methods for establishing access to a fluid-filled internal body space of a patient including the patient's vascular system for blood treatments are described herein. A port device includes a substantially flat surface. The surface is oriented proximal to and substantially parallel with the patient's skin when the device is subcutaneously implanted. The port device includes a tapered seat disposed in a center of the surface and configured to receive a tip of an access tube. The tapered seat is configured to receive the tip of the access tube therethrough. A lid is configured to couple to the substantially flat surface of the port device and includes a guide configured to engage the tip of the access tube and to facilitate percutaneous introduction of the access tube toward the tapered seat irrespective of an introduction angle. The guide includes a continuous sequence of fluted features.

Abstract: The disclosure relates to a subcutaneously implanted port device for establishing access to the vascular system of a patient requiring multiple blood treatments over an extended period of time. The systems, devices and methods disclosed herein may reduce miscannulation, promote intra-session hemostasis, and decrease the incidence of bacteremia and sepsis among other improvements and advantages. The devices include a port with a tapered seat for receiving an access tube, the first tapered seat having a proximal portion, a distal portion, and a conical section extending between the proximal portion and the distal portion; and an interface surface configured to engage a blood vessel or a vascular access catheter. The proximal portion of the tapered seat is configured to receive the access tube therethrough, and the tapered seat creates a mismatch fit with a diameter of the access tube when in use for an increase in flow during treatment.

Abstract: The disclosure relates to a subcutaneously implanted port device for establishing access to the vascular system of a patient requiring multiple blood treatments over an extended period of time. The systems, devices and methods disclosed herein may reduce miscannulation, promote intra-session hemostasis, and decrease the incidence of bacteremia and sepsis among other improvements and advantages. The devices include a port with a tapered seat for receiving an access tube, the first tapered seat having a proximal portion, a distal portion, and a conical section extending between the proximal portion and the distal portion; and an interface surface configured to engage a blood vessel or a vascular access catheter. The proximal portion of the tapered seat is configured to receive the access tube therethrough, and the tapered seat creates a mismatch fit with a diameter of the access tube when in use for an increase in flow during treatment.

Abstract: The disclosure relates to a subcutaneously implanted port device for establishing access to the vascular system of a patient requiring multiple blood treatments over an extended period of time. The systems, devices and methods disclosed herein may reduce miscannulation, promote intra-session hemostasis, and decrease the incidence of bacteremia and sepsis among other improvements and advantages. The devices include a port with a tapered seat for receiving an access tube, the first tapered seat having a proximal portion, a distal portion, and a conical section extending between the proximal portion and the distal portion; and an interface surface configured to engage a blood vessel or a vascular access catheter. The proximal portion of the tapered seat is configured to receive the access tube therethrough, and the tapered seat creates a mismatch fit with a diameter of the access tube when in use for an increase in flow during treatment.

Abstract: A tilt-tip moldable bed system for the care of immobile patients is provided. The bed system may include a moldable mattress having a casing with a bladder defining an inner volume and a top compliant surface over a top surface of the bladder, the compliant surface configured to conform to a shape of a displacing structure. The bladder may be configured to hold a plurality of beads suspended in a fluid medium. The moldable mattress may be molded while inflated and maintain a resilient shape when evacuated. The system may further include a supporting frame for the moldable support structure having a laterally rigid outer rim with at least one attachment point for the moldable mattress, at least one attachment point for a netted sling, and one or more mounting tracks configured to support at least one peripheral attachment.

Abstract: The present invention relates to subcutaneously implanted graft-port systems, devices and methods for establishing access to the vascular system of a patient requiring multiple blood treatments over an extended period of time. The systems, devices and methods disclosed herein reduce miscannulation, promote intra-session hemostasis, and decrease the incidence of bacteremia and sepsis among other improvements and advantages. The devices include a port with a flattened plateau-like surface for receiving an access tube. The flat surface may include a tactile or visual guide to assist with placement of the access tube into the tapered seat. Optional valve mechanisms reduce the size and form factor of the implantable graft-port device and seals the conduit of the port closed to physiologic pressures until the valve is opened upon percutaneous insertion of the access tube. The access tube does not pass into the conduit.

Abstract: A tilt-tip moldable bed system for the care of immobile patients is provided. The bed system may include a moldable mattress having a casing with a bladder defining an inner volume and a top compliant surface over a top surface of the bladder, the compliant surface configured to conform to a shape of a displacing structure. The bladder may be configured to hold a plurality of beads suspended in a fluid medium. The moldable mattress may be molded while inflated and maintain a resilient shape when evacuated. The system may further include a supporting frame for the moldable support structure having a laterally rigid outer rim with at least one attachment point for the moldable mattress, at least one attachment point for a netted sling, and one or more mounting tracks configured to support at least one peripheral attachment.

Abstract: A tilt-tip moldable bed system for the care of immobile patients is provided. The bed system may include a moldable mattress having a casing with a bladder defining an inner volume and a top compliant surface over a top surface of the bladder, the compliant surface configured to conform to a shape of a displacing structure. The bladder may be configured to hold a plurality of beads suspended in a fluid medium. The moldable mattress may be molded while inflated and maintain a resilient shape when evacuated. The system may further include a supporting frame for the moldable support structure having a laterally rigid outer rim with at least one attachment point for the moldable mattress, at least one attachment point for a netted sling, and one or more mounting tracks configured to support at least one peripheral attachment.

Abstract: A tilt-tip moldable bed system for the care of immobile patients is provided. The bed system may include a moldable mattress having a casing with a bladder defining an inner volume and a top compliant surface over a top surface of the bladder, the compliant surface configured to conform to a shape of a displacing structure. The bladder may be configured to hold a plurality of beads suspended in a fluid medium. The moldable mattress may be molded while inflated and maintain a resilient shape when evacuated. The system may further include a supporting frame for the moldable support structure having a laterally rigid outer rim with at least one attachment point for the moldable mattress, at least one attachment point for a netted sling, and one or more mounting tracks configured to support at least one peripheral attachment.

Abstract: A tilt-tip moldable bed system for the care of immobile patients is provided. The bed system may include a moldable mattress having a casing with a bladder defining an inner volume and a top compliant surface over a top surface of the bladder, the compliant surface configured to conform to a shape of a displacing structure. The bladder may be configured to hold a plurality of beads suspended in a fluid medium. The moldable mattress may be molded while inflated and maintain a resilient shape when evacuated. The system may further include a supporting frame for the moldable support structure having a laterally rigid outer rim with at least one attachment point for the moldable mattress, at least one attachment point for a netted sling, and one or more mounting tracks configured to support at least one peripheral attachment.

Abstract: A tilt-tip moldable bed system for the care of immobile patients is provided. The bed system may include a moldable mattress having a casing with a bladder defining an inner volume and a top compliant surface over a top surface of the bladder, the compliant surface configured to conform to a shape of a displacing structure. The bladder may be configured to hold a plurality of beads suspended in a fluid medium. The moldable mattress may be molded while inflated and maintain a resilient shape when evacuated. The system may further include a supporting frame for the moldable support structure having a laterally rigid outer rim with at least one attachment point for the moldable mattress, at least one attachment point for a netted sling, and one or more mounting tracks configured to support at least one peripheral attachment.

Abstract: A tilt-tip moldable bed system for the care of immobile patients is provided. The bed system may include a moldable mattress having a casing with a bladder defining an inner volume and a top compliant surface over a top surface of the bladder, the compliant surface configured to conform to a shape of a displacing structure. The bladder may be configured to hold a plurality of beads suspended in a fluid medium. The moldable mattress may be molded while inflated and maintain a resilient shape when evacuated. The system may further include a supporting frame for the moldable support structure having a laterally rigid outer rim with at least one attachment point for the moldable mattress, at least one attachment point for a netted sling, and one or more mounting tracks configured to support at least one peripheral attachment.

Abstract: The present invention relates to subcutaneously implanted graft-port systems, devices and methods for establishing access to the vascular system of a patient requiring multiple blood treatments over an extended period of time. The systems, devices and methods disclosed herein reduce miscannulation, promote intra-session hemostasis, and decrease the incidence of bacteremia and sepsis among other improvements and advantages. The devices include a port with a flattened plateau-like surface for receiving an access tube. The flat surface may include a tactile or visual guide to assist with placement of the access tube into the tapered seat. Optional valve mechanisms reduce the size and form factor of the implantable graft-port device and seals the conduit of the port closed to physiologic pressures until the valve is opened upon percutaneous insertion of the access tube. The access tube does not pass into the conduit.

Abstract: Methods, compositions and kits are disclosed for infusing a hydrophobic catheter lock solution into an indwelling catheter. The combination of a tocopherol compound and at least one saturated mid-chain fatty acid provides a broad spectrum antimicrobial solution with optimal viscosity for effectively locking a catheter. The lock can effectively reduce or eliminate the risk of infection and prevents tainting the catheter, particularly clotting and thrombus in intravascular and extravascular catheters. The potential for this discovery is for maintaining or reestablishing the viability of an intravascular or extravascular catheter, as well as topical formulations for promoting healing.

Abstract: Methods, systems, and kits for extracorporeally circulating and processing blood are described. The systems include a pump, a processing unit, and blood drawn return lines for accessing a patient's vasculature. Blood flow through the return line is measured and pump speed controlled to maintain a desired blood flow rate. Alarm conditions can be initiated when expected pump performance differs from that needed to maintain the control point flow rate. By using a ultrasonic flow detector, gas bubbles in the blood flow can be detected.

Abstract: Implantable ports and other devices are disinfected by the injection of an anti-microbial agent into a region in the device or in a tissue pocket surrounding the device. In a first embodiment, the anti-microbial agent is injected through an aperture in the device to flush internal regions of the device before infusing the tissue pocket and flushing outwardly through a tissue tract leading to the device. In other embodiments, the anti-microbial agent is injected directly to a target site on the exterior of the device. Implantable devices may include special, usually hardened, target regions for receiving the sharpened end of a needle used to inject the anti-microbial agent. Kits will include devices, syringes, access devices, and instructions for disinfection according to the methods of the present invention.

Abstract: Methods, systems, and kits for extracorporeally circulating and processing blood are described. The systems include a pump, a processing unit, and blood drawn return lines for accessing a patient's vasculature. Blood flow through the return line is measured and pump speed controlled to maintain a desired blood flow rate. Alarm conditions can be initiated when expected pump performance differs from that needed to maintain the control point flow rate. By using a ultrasonic flow detector, gas bubbles in the blood flow can be detected.

Abstract: Methods, apparatus, and kits are provided for performing peritoneal dialysis. In a first aspect, subcutaneous and transcutaneous systems are described for performing continuously cycling peritoneal dialysis. In a second aspect, fully implanted systems are described for performing flow-through peritoneal dialysis.

Abstract: Systems for draining retained body fluids comprise an implantable port in an access tube. Usually, a drainage cannula for connecting the implantable port to a site of fluid retention is also provided. The implantable port and drainage cannula are implanted subcutaneously with one end of the cannula within the site of fluid retention and the port located remotely from such site. Drainage may then be effected by percutaneously introducing the access tube to the port and optionally applying a vacuum. Kits comprise the implantable port together with instructions for implanting the port as described above. Kits also comprise an access tube with instructions for use for accessing an implanted port as described above.

Abstract: Methods and apparatus for percutaneously accessing an implanted port use an access cannula which is periodically introduced to an aperture on the implanted port so that the cannula passes through the same tissue tract. It has been found that repeated passage of the cannula through the same tissue tract reduces patient trauma, with minimized bleeding, reduction in sensitivity. The tract may be initially formed by percutaneously placing a penetrating element through intact skin to the port and leaving the element in place for a time sufficient to created the tract.