The DIY Dialysis Machine

Millie Kelly was born with a condition that required an immediate operation. During this operation her kidneys started to fail and since she was too small for dialysis machines, doctors told her parents that she was unlikely to live. Luckily for Millie, Dr. Malcolm Coulthard and a colleague tried to build a much smaller kidney machine on their own and they were successful. Her mother said, "It was a green metal box with a few paint marks on it with quite a few wires coming out of it into my daughter - it didn't look like a normal NHS one." The girl was hooked up to the machine over a seven day period to allow her kidneys to recover. Two years later, her mother Rebecca says she is "fit as a fiddle." You should see what Dr. Coulthard can build using a postage stamp, a tuning fork, a lawn chair and a jellyfish.

Re:Show us the machine!

[edlinfan]

Ask and you shall receive.

http://www.blogsmithmedia.com/www.hackaday.com/media/2008/08/kidney-machine2.jpg [blogsmithmedia.com]

This is from Hack-A-Day's writeup.

Re:Cut the fat, cut the risk.

[AKAImBatman]

I thought women put on weight during pregnancy?

Only if you count the baby. This idea that women gain ten pounds during pregnancy is a fallacy that was propogated, in part, by an early belief in the medical establishment that women needed to gain weight for a healthy pregnancy. Once that idea was disproven, fewer women forced themselves to gain weight during pregnancy.

In fact, most women only experience a mild increase in food intake while pregnant. My understanding is that it's more important to pay attention to sudden food cravings, as those are often signs of missing minerals and vitamins. (e.g. my wife wanted bananas while she was pregnant)

Re:Wow

[necama]

In theory, there would be no standing to sue under the good samaritan laws.

Not true. One of the things they pound into your head when you take a CPR / First Aid course through the Red Cross is that you are covered by the Good Samaritan laws only if you do not accept a reward or compensation for your help. I guarantee the doctor who built the dialysis machine was paid for the effort.

Re:Show us the machine!

[vecctor]

I don't think that is it. From the article:

When a baby too small for the regular dialysis machine (similar to the one pictured above)

http://www.hackaday.com/2008/08/05/diy-kidney-machine-saves-girl/ [hackaday.com]

Also, it doesn't look nearly ramshackle enough! ;-)

Re:Who would have thought

[fumblebruschi]

If you'd RFTA (but why should you be different?) you would have seen that the UK, just like the US, does indeed have miniature dialysis machines designed for children. However, this child -- weighing less than six pounds at birth -- was too small to use them. Not just the UK ones -- she was too small to use any existing dialysis machine anywhere in the world.

So, had this happened in the US, she would have been OK, just as long as she had a doctor who was willing to spend his own time and his own money inventing a new machine and building it himself in time to save her life.

Re:too big?

[Rene S. Hollan]

I'd rather think that the volume of blood required to be in the machine at any one time would be such that there would be insufficient blood within the body of a patient so small.

I suppose one could transfuse at the same time as starting dialisis, and at the appropriate time "close the loop", removing the source of transfused blood, but that strikes me as rather delicate in this case: IIRC, an infant has maybe two tablespoons of blood total, and the machine might require what, a pint? Maintaining a safe blood pressure range under those conditions would be damn tricky.

Re:too big?

[0100010001010011]

There might have been a minimum flow required to push blood across the cleaning medium. Given how small she was, she might not have had enough blood in her entire body to even use the larger machine.

An electrical analogy: Say you have electrons you want to flow from A to B. If you use a wire too thick in diameter all the current is going to go into resistance of the wire. This girl's current source wasn't powerful enough to drive electrons through the wire, so the doctor swapped in a thinner wire.

And since this is slashdot, a car analogy: Turbo chargers work by using exhaust air to spin a turbine which spins a compressor to compress incoming air. If you put a massive turbo on a small car, there wouldn't even be enough air to spin the blades. So you have to get a smaller turbine.

Re:A painful noisy chair in the mail?

[sm62704]

I was rather disappointed. Samzepus goes for some cheap nerdy laughs while neither he nor the article said anything about how a Dialysis machine works, or why a conventional one can't be used on a 6lb baby. Wikipedia says [wikipedia.org]

In hemodialysis, the patient's blood is pumped through the blood compartment of a dialyzer, exposing it to a semipermeable membrane. The cleansed blood is then returned via the circuit back to the body. Ultrafiltration occurs by increasing the hydrostatic pressure across the dialyzer membrane. This usually is done by applying a negative pressure to the dialysate compartment of the dialyzer. This pressure gradient causes water and dissolved solutes to move from blood to dialysate, and allows removal of several litres of excess fluid during a typical 3 to 5 hour treatment. In the US, hemodialysis treatments are typically given in a dialysis center three times per week (due in the US to Medicare reimbursement rules), however, as of 2007 over 2,000 people in the US are dialyzing at home more frequently for various treatment lengths.[2] Studies have demonstrated the clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. These frequent long treatments are often done at home, while sleeping but home dialysis is a flexible modality and schedules can be changed day to day, week to week. In general, studies have shown that both increased treatment length and frequency are clinically beneficial.[3]

Rather than the picture of the mom and her kid, I think a diagram of how one works [wikipedia.org] would be a lot more helpful.

Not only was the summary bad, TFA was bad as well. Why couldn't a conventional dialysis machine be used? It doesn't say.

Is there a doctor in the house?

Re:Cut the fat, cut the risk.

[B Nesson]

It was my experience when I became a vegetarian that paying attention to cravings was just good practice in general. Not necessarily caving in to them all the time, but to this day, if I'm really craving a bean burrito, I know I could probably use more protein.

Re:Show us the machine!

[Qzukk]

I don't think that is the homemade kidney machine, the article says

the regular dialysis machine (similar to the one pictured above)

regarding that picture.

Re:Cut the fat, cut the risk.

[geekoid]

That's not true.
A healthy woman who is the normal weight for her height can gain 25-35 pounds. This is normal.
Baby weighs 5-10 pounds.

Re:For that matter...

[Bearpaw]

...you should see what miracles occur when you're not oppressed by an onerous "single-payer" socialist-welfare-state "health" care system like the NHS.

Infant mortality rate in the US: 6.3 per 1,000 live births
Infant mortality rate in the UK: 4.9 per 1,000 live births

Personally, I'd rather not see the "miracle" of more dead babies.

Blood volume

[Anonymous Coward]

The normal adult has about 70 ml blood per kg body weight, or about 5 L total. An infant has something like 90 ml/kg, IIRC (I'm a doctor but not a neonatologist), so that would be about 270 ml for a 3 kg newborn. Two tablespoons would be about 10% of that, which is about what someone can lose suddenly without serious symptoms.

Re:this lady need DIY plastic surgery and lyposuct

[Anonymous Coward]

Troll? You morons, he posted lyrics to a Spinal Tap song!

Most women gain more than the weight of baby

[drerwk]

Sorry AKA - very much depends on starting size.
http://www.babycenter.com/pregnancy-weight-gain-estimator [babycenter.com] Pregnancy weight gain estimator
Estimate for my wife:

You should gain roughly 25-35 lbs. during your pregnancy. Over the last two trimesters you should gain about 4 lbs. every 4 weeks. How it breaks down If you gained the average of range above, this is where the weight would go (totals are rounded): Maternal: Uterus 2.39 lbs. Breasts 1.0 lbs. Blood 3.09 lbs. Water 4.15 lbs. Fat 8.27 lbs. Subtotal 18.89 lbs. Fetal: Fetus 7.5 lbs. Placenta 1.6 lbs. Amniotic Fluid 1.97 lbs. Subtotal 11.07 lbs. Total 29.96 lbs.

And even though you are posting on /. - I'll trust the baby center site over your own experience.

Re: Not News -- Parent is not joking!

[Shux]

From the first comment here: http://www.amazon.com/MacGyver-Complete-Season-Charles-Correll/dp/B000CNESLW [amazon.com]

5.) Second Chance First aired: 10/16/1989
In China,Macgyver and his old friend Jesse Colton help with a Phoenix Foundation funded hospital for sick children. While there,they discover a gang stealing supplies (including a dialysis machine vital to the survival of a girl name Susie) from the hospital,and something even more surprising: a Amerasian boy who is the son of Jesse Colton. A son he never knew he had. When he and Mac find out the boy helped the gangsters steal the supplies,they must get them back,before Susie dies....

Re:Cut the fat, cut the risk.

[AKAImBatman]

When a woman is pregnant she is not only carrying a baby, but a very large uterus, enlarged breasts, and probably other stuff that I can't remember.

I'm counting that toward the baby weight as most of that stuff will be gone as soon as the baby is born.

Here's the Mayo Clinic page on weight gain during pregnancy. [mayoclinic.com]

Here's the breakdown:

        * Baby: 7 to 8 pounds
        * Larger breasts: 1 to 3 pounds
        * Larger uterus: 2 pounds
        * Placenta: 1 1/2 pounds
        * Amniotic fluid: 2 pounds
        * Increased blood volume: 3 to 4 pounds
        * Increased fluid volume: 2 to 3 pounds
        * Fat stores: 6 to 8 pounds

Here's the information on how much your caloric intake needs to increase:

If you start out at a healthy weight, you need to gain only a few pounds in the first few months of pregnancy. You can do this with an extra 150 to 200 calories a day, about the amount in 12 ounces of calcium-fortified orange juice or a serving of low-fat yogurt. A normal appetite will typically provide these calories.

Steady weight gain is more important in the second and third trimesters -- especially if you start out at a healthy weight or you're underweight. This often means 3 to 4 pounds a month until delivery. An extra 300 calories a day might be enough to help you meet this goal.

Emphasis is mine.

The expectation is that once the baby is born, the remaining weight will disappear on its own through a normal diet. Much of the extra fat put on supports breast feeding of the child. Once weened, many women actually find themselves slightly lighter than they were before, even if they were not overweight. (Which is also what happened to my wife. ;-)) I've heard some women refer to pregnancy as a good way to shed the pounds. I don't recommend it, but it does seem to work.

Re:For that matter...

[ivan256]

The costs are lower, in part, because less treatments are provided.

For example, half of all the joint replacement surgeries done in the entire world are done on US patients. That's 50% of the procedures on less than 5% of the world population. Either people in the US blow out their joints way more frequently than Europeans with socialized health care (unlikely), or their system isn't providing them with that option.

So our "inferior" privatized system is providing more people with life-improving treatments, and when something goes wrong the error rate (not the treatment rate) is used to tell people our system sucks. If you don't get the procedure, the system has failed you, but it wasn't screwed up, so you're a positive statistic!

Sorry, but I'd rather pay more, and pay for myself.

Re:A painful noisy chair in the mail?

[iserlohn]

Just another stab at it, but infants are frequently treated with peritoneal dialysis rather then hemodialysis. This is due to the poor performance of hemodialysis on infants and the risk it induces.

The peritoneal procedure requires fluid to be pumped into the abdominal cavity of the patient. In this case, one would suspect that it would be inappropriate with her bowel irregularity, and therefore, a different type of dialysis machine is needed.

Re:Well, maybe, but

[Anonymous Coward]

would you expect this to happen in a country with "socialized medicine"?

You mean, like in England, where this story took place? That place has a "socialized medicine" [wikipedia.org] system, so it would never happen--oh, wait.

Re:Well, maybe, but

[VJ42]

This happened here in the UK, we have the NHS [wikipedia.org]. Indeed this appears to have been done by a doctor working in the NHS.

Re:Well, maybe, but

[comp.sci]

I don't think the motivation for building this had anything to do with compensation or payment. Socialized medicine really just means to provide equal care to all. (and in Western states this means excellent care - check life expectancy statistics!)

Re:hereditary

[Anonymous Coward]

"And they will likely need access to practitioners of our advanced medical science to survive."

that's beginning to require a lot of "likely"

"a species that is genetically weakened and hence increasingly dependent upon the availability of expensive medical caregivers."

genetically weakened ? next to what ? Some genetic disease allow for unique strengths ( resistance to malaria, ability to process lactose ) or unique personnalities ( like hawking's )
the important thing is : we don't know what we will become, we just know that we will change. we will maybe become dependant on technology, but that dependance may be what allow us to become smarter. ( Beside on could argue that weakness depend of the environnement )

beside eugenics don't work, you know ? Sex is a great way of fixing what can't work in DNA.

Re:Truly, medical geeks are the alpha geeks.

[Sentry21]

Nah, you just need to make sure you have a fresh backup of the baby in case it doesn't work. Then you refine your design and try again. This is why checking your baby into version control is always a good idea, ESPECIALLY after first being released into the wild.

Why is this news?

[Myrkridian42]

While a DIY dialysis machine is pretty awesome; it was successfully designed, built and put into use 2 years ago. Shouldn't this story have come out then?