/************************************************************************** * * Copyright (c) 2019-2020 Diality Inc. - All Rights Reserved. * * THIS CODE MAY NOT BE COPIED OR REPRODUCED IN ANY FORM, IN PART OR IN * WHOLE, WITHOUT THE EXPLICIT PERMISSION OF THE COPYRIGHT OWNER. * * @file Dialysis.c * * @author (last) Sean Nash * @date (last) 24-Sep-2020 * * @author (original) Sean * @date (original) 15-Jan-2020 * ***************************************************************************/ #include #include "AirTrap.h" #include "BloodFlow.h" #include "Buttons.h" #include "DGInterface.h" #include "Dialysis.h" #include "DialInFlow.h" #include "DialOutFlow.h" #include "ModeTreatment.h" #include "ModeTreatmentParams.h" #include "OperationModes.h" #include "SystemCommMessages.h" #include "TaskGeneral.h" #include "Timers.h" #include "Valves.h" /** * @addtogroup Dialysis * @{ */ // ********** private definitions ********** #define MAX_UF_RATE_ML_PER_HOUR 2750.0 ///< Maximum ultrafiltration rate in mL/hour #define MAX_UF_RATE_ACCURACY_ERROR_ML_HR 100.0 ///< Maximum ultrafiltration rate accuracy error in mL/hr over each hour of treatment. #define MAX_UF_RATE_ACCURACY_ERROR_PCT 0.05 ///< Minimum ultrafilteration rate accuracy in percentage of set point (5%) over each hour of treatment. #define MAX_UF_ACCURACY_ERROR_ML 250.0 ///< Maximum ultrafiltration accuracy error in mL over the entire treatment. /// Saline bolus data broadcast interval (ms/task time) count. #define SALINE_BOLUS_DATA_PUB_INTERVAL ( MS_PER_SECOND / TASK_GENERAL_INTERVAL ) /// Ultrafiltration rate accuracy check interval count. #define UF_ACCURACY_CHECK_INTERVAL ((1 * MIN_PER_HOUR * SEC_PER_MIN * MS_PER_SECOND) / TASK_GENERAL_INTERVAL) #define MAX_SALINE_VOLUME_DELIVERED 800 ///< Maximum saline volume delivered for a treatment. #define SALINE_BOLUS_RATE_ML_MIN 150 ///< Fixed rate for saline bolus delivery. #define MIN_SALINE_BOLUS_VOLUME_PCT 0.8 ///< Minimum saline bolus volume measured by independent means (as % of target). #define MAX_SALINE_BOLUS_VOLUME_PCT 1.2 ///< Maximum saline bolus volume measured by independent means (as % of target). // ********** private data ********** static DIALYSIS_STATE_T currentDialysisState; ///< Current state of the dialysis sub-mode state machine. static UF_STATE_T currentUFState; ///< Current state of the ultrafiltration state machine. static SALINE_BOLUS_STATE_T currentSalineBolusState; ///< Current state of the saline bolus state machine. static F32 refUFVolume; ///< Current reference volume for ultrafiltration (Where should we be w/r/t ultrafiltration). static F32 measUFVolume; ///< Current total measured volume for ultrafiltration (Where are we w/r/t ultrafiltration). static F32 resStartVolume[ NUM_OF_DG_RESERVOIRS ]; ///< Reservoir start volume for ultrafiltration (i.e. where did we start with each reservoir). static F32 resFinalVolume[ NUM_OF_DG_RESERVOIRS ]; ///< Reservoir final volume for ultrafiltration (i.e. where did we end after switch with each reservoir). static F32 measUFVolumeFromPriorReservoirs; ///< Current total ultrafiltration volume from previous reservoirs in current treatment. static U32 uFTimeMS; ///< Current elapsed ultrafiltration time (in ms). Used for calculating UF reference volume. static U32 lastUFTimeStamp; ///< HD timer value when we last took stock of ultrafiltration time (so we can determine how much time has elapsed since). static U32 setBloodFlowRate; ///< Currently set blood flow rate (from prescription). static U32 setDialysateFlowRate; ///< Currently set dialysate flow rate (from prescription). static F32 maxUFVolumeML; ///< Currently set total ultrafiltration volume for treatment (from prescription). static F32 setUFRate; ///< Currently set ultrafiltration rate (from prescription). static F32 maxUFRateAccuracyError_Ml_hr; ///< Minimum ultrafiltration rate accuracy over 1 hour duration (5% or 100 mL, whichever is greater). static U32 salineBolusBroadcastTimerCtr; ///< Saline bolus data broadcast timer counter used to schedule when to transmit data. static BOOL salineBolusStartRequested; ///< Flag indicates a saline bolus start has been requested by user. static BOOL salineBolusAbortRequested; ///< Flag indicates a salien bolus abort has been requested by user. static BOOL salineBolusAutoResumeUF; ///< Flag indicates UF should be auto-resumed after saline bolus completes. static F32 totalSalineVolumeDelivered; ///< Volume (mL) in total of saline delivered so far (cumulative for all boluses including current one). static F32 bolusSalineVolumeDelivered; ///< Volume (mL) of current bolus delivered so far. static F32 bolusSalineVolumeDelivered_Safety; ///< Volume (mL) of current bolus delivered so far according to safety monitor. static U32 bolusSalineMotorCount; ///< Blood pump motor rev count during saline bolus to calculate saline bolus volume independently for safety. static U32 bolusSalineLastMotorCount; ///< Last blood pump count from last saline bolus volume update. static U32 bolusSalineLastVolumeTimeStamp; ///< Time stamp for last saline volume update. static U32 uFAccuracyCheckTimerCtr; ///< Timer counter to determine when next to check ultrafiltration accuracy. static F32 lastUFVolumeChecked; ///< Starting ultrafiltration volume for accuracy check. // ********** private function prototypes ********** static DIALYSIS_STATE_T handleDialysisUltrafiltrationState( void ); static DIALYSIS_STATE_T handleDialysisSalineBolusState( void ); static UF_STATE_T handleUFStartState( DIALYSIS_STATE_T *dialysisState ); static UF_STATE_T handleUFPausedState( DIALYSIS_STATE_T *dialysisState ); static UF_STATE_T handleUFRunningState( DIALYSIS_STATE_T *dialysisState ); static UF_STATE_T handleUFOffState( DIALYSIS_STATE_T *dialysisState ); static UF_STATE_T handleUFCompletedState( DIALYSIS_STATE_T *dialysisState ); static SALINE_BOLUS_STATE_T handleSalineBolusIdleState( DIALYSIS_STATE_T *dialysisState ); static SALINE_BOLUS_STATE_T handleSalineBolusWait4Pumps2Stop( DIALYSIS_STATE_T *dialysisState ); static SALINE_BOLUS_STATE_T handleSalineBolusInProgressState( DIALYSIS_STATE_T *dialysisState ); static SALINE_BOLUS_STATE_T handleSalineBolusMaxDeliveredState( DIALYSIS_STATE_T *dialysisState ); static void checkUFAccuracyAndVolume( void ); static void updateUFVolumes( void ); static void publishSalineBolusData( void ); /*********************************************************************//** * @brief * The initDialysis function initializes the Dialysis sub-mode module. * Calling this function will reset dialysis and therefore should only * be called when a new treatment is due to begin. * @details Inputs: none * @details Outputs: Dialysis sub-mode module initialized. * @return none *************************************************************************/ void initDialysis( void ) { currentDialysisState = DIALYSIS_START_STATE; currentUFState = UF_START_STATE; currentSalineBolusState = SALINE_BOLUS_STATE_IDLE; refUFVolume = 0.0; measUFVolume = 0.0; resFinalVolume[ DG_RESERVOIR_1 ] = 0.0; resFinalVolume[ DG_RESERVOIR_2 ] = 0.0; measUFVolumeFromPriorReservoirs = 0.0; uFTimeMS = 0; lastUFTimeStamp = 0; setBloodFlowRate = 0; setDialysateFlowRate = 0; maxUFVolumeML = 0.0; setUFRate = 0.0; maxUFRateAccuracyError_Ml_hr = MAX_UF_RATE_ACCURACY_ERROR_ML_HR; salineBolusBroadcastTimerCtr = 0; totalSalineVolumeDelivered = 0.0; uFAccuracyCheckTimerCtr = 0; lastUFVolumeChecked = 0.0; resetSalineBolus(); } /*********************************************************************//** * @brief * The resetSalineBolus function initializes the saline bolus variables * at start of treatment or after stopping a bolus (e.g. alarm). Total * saline bolus volume delivered will not be affected by this function. * @details Inputs: none * @details Outputs: Dialysis sub-mode module initialized. * @return none *************************************************************************/ void resetSalineBolus( void ) { salineBolusStartRequested = FALSE; salineBolusAbortRequested = FALSE; salineBolusAutoResumeUF = FALSE; bolusSalineVolumeDelivered = 0.0; bolusSalineVolumeDelivered_Safety = 0.0; bolusSalineMotorCount = 0; if ( currentSalineBolusState != SALINE_BOLUS_STATE_MAX_DELIVERED ) { currentSalineBolusState = SALINE_BOLUS_STATE_IDLE; } } /*********************************************************************//** * @brief * The transitionToDialysis function prepares for transition to dialysis sub-mode. * This function will reset anything required for resuming dialysis in a * treatment that has already begun. It does not reset everything as dialysis * may be stopped and resumed multiple times due to alarms or user intervention * and we don't want to start the treatment all over again. * @details Inputs: none * @details Outputs: none * @return none *************************************************************************/ void transitionToDialysis( void ) { startAirTrapControl(); // TODO - do we need to start this sooner? After prime? } /*********************************************************************//** * @brief * The setDialysisParams function sets the dialysis treatment parameters. * This function should be called prior to beginning dialysis treatment * and when the user changes one or more parameters during treatment. * @details Inputs: none * @details Outputs: dialysis treatment parameters are set. * @param bPFlow target blood pump flow rate (in mL/min) * @param dPFlow target dialysate inlet pump flow rate (in mL/min) * @param maxUFVol maximum ultrafiltration volume (in mL) * @param uFRate target ultrafiltration rate (in mL/min) * @return none *************************************************************************/ void setDialysisParams( U32 bPFlow, U32 dPFlow, F32 maxUFVol, F32 uFRate ) { setBloodFlowRate = bPFlow; setDialysateFlowRate = dPFlow; maxUFVolumeML = maxUFVol; setUFRate = uFRate; maxUFRateAccuracyError_Ml_hr = MAX_UF_RATE_ACCURACY_ERROR_PCT * uFRate * (F32)MIN_PER_HOUR; maxUFRateAccuracyError_Ml_hr = MAX( maxUFRateAccuracyError_Ml_hr, MAX_UF_RATE_ACCURACY_ERROR_ML_HR ); if ( TREATMENT_DIALYSIS_STATE == getTreatmentState() ) { #ifndef RUN_PUMPS_OPEN_LOOP setBloodPumpTargetFlowRate( setBloodFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); setDialInPumpTargetFlowRate( setDialysateFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); #else setBloodPumpTargetFlowRate( setBloodFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); setDialInPumpTargetFlowRate( setDialysateFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); #endif setDialOutPumpTargetRate( setDialysateFlowRate + (S32)setUFRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); } } /*********************************************************************//** * @brief * The startDialysis function starts/resumes dialysis. This function * will be called by Treatment Mode when beginning or resuming dialysis * treatment. * @details Inputs: none * @details Outputs: Dialysis module prepared for immediate resumption. * @return none *************************************************************************/ void startDialysis( void ) { // Set last UF timestamp so UF ref is resumed from this time lastUFTimeStamp = getMSTimerCount(); // Send dialysate outlet pump latest UF volumes setDialOutUFVolumes( refUFVolume, measUFVolume ); // Set valves for dialysis setValvePosition( VDI, VALVE_POSITION_B_OPEN ); setValvePosition( VDO, VALVE_POSITION_B_OPEN ); setValvePosition( VBA, VALVE_POSITION_B_OPEN ); setValvePosition( VBV, VALVE_POSITION_B_OPEN ); // Restart pumps #ifndef RUN_PUMPS_OPEN_LOOP setBloodPumpTargetFlowRate( setBloodFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); setDialInPumpTargetFlowRate( setDialysateFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); #else setBloodPumpTargetFlowRate( setBloodFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); setDialInPumpTargetFlowRate( setDialysateFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); #endif setDialOutPumpTargetRate( setDialysateFlowRate + (S32)setUFRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); // TODO - Heparin pump // Tell DG to start heating dialysate cmdStartDGTrimmerHeater(); } /*********************************************************************//** * @brief * The stopDialysis function stops dialysis. This function will be called * by Treatment Mode when an alarm occurs or the user pressed the stop button. * Dialysis may be resumed later. * @details Inputs: none * @details Outputs: Blood and dialysate pumps stopped. Heparin pump stopped. * @return none *************************************************************************/ void stopDialysis( void ) { // Stop pumps setBloodPumpTargetFlowRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); setDialInPumpTargetFlowRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); setDialOutPumpTargetRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); // TODO - stop Heparin pump // Tell DG to stop heating dialysate cmdStopDGTrimmerHeater(); } /*********************************************************************//** * @brief * The signalStartSalineBolus function handles user request to initiate a * saline bolus. * @details Inputs: TBD * @details Outputs: TBD * @return none *************************************************************************/ void signalStartSalineBolus( void ) { BOOL accept = FALSE; REQUEST_REJECT_REASON_CODE_T rejReason = REQUEST_REJECT_REASON_NONE; U32 salineBolusVolume = getTreatmentParameterU32( TREATMENT_PARAM_SALINE_BOLUS_VOLUME ); HD_OP_MODE_T currOpMode = getCurrentOperationMode(); TREATMENT_STATE_T currTreatSubMode = getTreatmentState(); SALINE_BOLUS_STATE_T currSalineBolusState = getSalineBolusState(); // Must be in treatment mode, dialysis sub-mode, saline bolus in idle state in order to start a saline bolus if ( currOpMode != MODE_TREA ) { rejReason = REQUEST_REJECT_REASON_NOT_IN_TREATMENT_MODE; } else if ( currTreatSubMode != TREATMENT_DIALYSIS_STATE ) { rejReason = REQUEST_REJECT_REASON_INVALID_TREATMENT_STATE; } else if ( currSalineBolusState != SALINE_BOLUS_STATE_IDLE ) { rejReason = REQUEST_REJECT_REASON_SALINE_BOLUS_IN_PROGRESS; } else if ( totalSalineVolumeDelivered >= (F32)MAX_SALINE_VOLUME_DELIVERED ) { rejReason = REQUEST_REJECT_REASON_SALINE_MAX_VOLUME_REACHED; } else { accept = TRUE; salineBolusStartRequested = TRUE; } // Send response sendSalineBolusResponse( accept, rejReason, salineBolusVolume ); } /*********************************************************************//** * @brief * The signalAbortSalineBolus function handles user request to abort a * saline bolus. * @details Inputs: TBD * @details Outputs: TBD * @return none *************************************************************************/ void signalAbortSalineBolus( void ) { BOOL accept = FALSE; REQUEST_REJECT_REASON_CODE_T rejReason = REQUEST_REJECT_REASON_NONE; U32 salineBolusVolume = getTreatmentParameterU32( TREATMENT_PARAM_SALINE_BOLUS_VOLUME ); HD_OP_MODE_T currOpMode = getCurrentOperationMode(); TREATMENT_STATE_T currTreatSubMode = getTreatmentState(); SALINE_BOLUS_STATE_T currSalineBolusState = getSalineBolusState(); // Must be in treatment mode, dialysis sub-mode, saline bolus in delivery state in order to abort a saline bolus if ( currOpMode != MODE_TREA ) { rejReason = REQUEST_REJECT_REASON_NOT_IN_TREATMENT_MODE; } else if ( currTreatSubMode != TREATMENT_DIALYSIS_STATE ) { rejReason = REQUEST_REJECT_REASON_INVALID_TREATMENT_STATE; } else if ( currSalineBolusState != SALINE_BOLUS_STATE_IN_PROGRESS ) { rejReason = REQUEST_REJECT_REASON_SALINE_BOLUS_NOT_IN_PROGRESS; } else { accept = TRUE; salineBolusAbortRequested = TRUE; } // Send response sendSalineBolusResponse( accept, rejReason, salineBolusVolume ); } /*********************************************************************//** * @brief * The getDialysisState function gets the current dialysis state (sub-mode). * @details Inputs: currentDialysisState * @details Outputs: none * @return currentDialysisState *************************************************************************/ DIALYSIS_STATE_T getDialysisState( void ) { return currentDialysisState; } /*********************************************************************//** * @brief * The getUltrafiltrationState function gets the current ultrafiltration state. * @details Inputs: currentUFState * @details Outputs: none * @return currentUFState *************************************************************************/ UF_STATE_T getUltrafiltrationState( void ) { return currentUFState; } /*********************************************************************//** * @brief * The getSalineBolusState function gets the current saline bolus state. * @details Inputs: currentSalineBolusState * @details Outputs: none * @return currentSalineBolusState *************************************************************************/ SALINE_BOLUS_STATE_T getSalineBolusState( void ) { return currentSalineBolusState; } /*********************************************************************//** * @brief * The getUltrafiltrationVolumeCollected function gets the current ultrafiltration * volume collected so far for current treatment. * @details Inputs: measUFVolume, measUFVolumeFromPriorReservoirs * @details Outputs: none * @return currentUFState *************************************************************************/ F32 getUltrafiltrationVolumeCollected( void ) { F32 result = measUFVolume; return result; } /*********************************************************************//** * @brief * The pauseUF function pauses ultrafiltration. * @details Inputs: currentDialysisState, currentUFState * @details Outputs: currentUFState, outlet pump set point * @return TRUE if pause successful, FALSE if not *************************************************************************/ BOOL pauseUF( void ) { BOOL result = FALSE; REQUEST_REJECT_REASON_CODE_T rejectReason = REQUEST_REJECT_REASON_NONE; TREATMENT_STATE_T trtState = getTreatmentState(); HD_OP_MODE_T currMode = getCurrentOperationMode(); if ( ( MODE_TREA == currMode ) && ( TREATMENT_DIALYSIS_STATE == trtState ) && ( DIALYSIS_UF_STATE == currentDialysisState ) && ( UF_RUNNING_STATE == currentUFState ) ) { result = TRUE; // Set outlet pump to dialysate rate setDialOutPumpTargetRate( setDialysateFlowRate, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); // Go to UF paused state currentUFState = UF_PAUSED_STATE; } else { if ( MODE_TREA != currMode ) { rejectReason = REQUEST_REJECT_REASON_NOT_IN_TREATMENT_MODE; } else if ( TREATMENT_DIALYSIS_STATE != trtState ) { rejectReason = REQUEST_REJECT_REASON_INVALID_TREATMENT_STATE; } else if ( DIALYSIS_UF_STATE != currentDialysisState ) { rejectReason = REQUEST_REJECT_REASON_SALINE_BOLUS_IN_PROGRESS; } else { rejectReason = REQUEST_REJECT_REASON_UF_NOT_IN_PROGESS; } } // Send response w/ reason code if rejected sendUFPauseResumeResponse( result, rejectReason, currentUFState ); // Send state data immediately for UI update broadcastTreatmentTimeAndState(); return result; } /*********************************************************************//** * @brief * The resumeUF function resumes ultrafiltration. * @details Inputs: currentDialysisState, currentUFState * @details Outputs: currentUFState, outlet pump set point * @return TRUE if resume successful, FALSE if not *************************************************************************/ BOOL resumeUF( void ) { BOOL result = FALSE; REQUEST_REJECT_REASON_CODE_T rejectReason = REQUEST_REJECT_REASON_NONE; TREATMENT_STATE_T trtState = getTreatmentState(); HD_OP_MODE_T currMode = getCurrentOperationMode(); if ( ( MODE_TREA == currMode ) && ( TREATMENT_DIALYSIS_STATE == trtState ) && ( DIALYSIS_UF_STATE == currentDialysisState ) && ( UF_PAUSED_STATE == currentUFState ) ) { result = TRUE; // Set outlet pump to dialysate rate + set UF rate setDialOutPumpTargetRate( setDialysateFlowRate + FLOAT_TO_INT_WITH_ROUND( setUFRate ), MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); // Restart UF time accumulation for reference volume calculation lastUFTimeStamp = getMSTimerCount(); // Go to UF paused state currentUFState = UF_RUNNING_STATE; } else { if ( MODE_TREA != currMode ) { rejectReason = REQUEST_REJECT_REASON_NOT_IN_TREATMENT_MODE; } else if ( TREATMENT_DIALYSIS_STATE != trtState ) { rejectReason = REQUEST_REJECT_REASON_INVALID_TREATMENT_STATE; } else if ( DIALYSIS_UF_STATE != currentDialysisState ) { rejectReason = REQUEST_REJECT_REASON_SALINE_BOLUS_IN_PROGRESS; } else { rejectReason = REQUEST_REJECT_REASON_UF_NOT_PAUSED; } } // Send response w/ reason code if rejected sendUFPauseResumeResponse( result, rejectReason, currentUFState ); // Send state data immediately for UI update broadcastTreatmentTimeAndState(); return result; } /*********************************************************************//** * @brief * The execDialysis function executes the Dialysis sub-mode state machine. * @details Inputs: currentDialysisState * @details Outputs: currentDialysisState * @return none *************************************************************************/ void execDialysis( void ) { // Check ultrafiltration max rate and accuracy during dialysis (even when ultrafiltration is paused). checkUFAccuracyAndVolume(); // Dialysis state machine switch ( currentDialysisState ) { case DIALYSIS_START_STATE: currentDialysisState = DIALYSIS_UF_STATE; break; case DIALYSIS_UF_STATE: currentDialysisState = handleDialysisUltrafiltrationState(); break; case DIALYSIS_SALINE_BOLUS_STATE: currentDialysisState = handleDialysisSalineBolusState(); break; default: SET_ALARM_WITH_2_U32_DATA( ALARM_ID_HD_SOFTWARE_FAULT, SW_FAULT_ID_DIALYSIS_INVALID_STATE, currentDialysisState ) break; } // Publish saline bolus data at set interval (whether we are delivering one or not) publishSalineBolusData(); } /*********************************************************************//** * @brief * The handleDialysisUltrafiltrationState function handles the ultrafiltration * state of the Dialysis state machine. * @details Inputs: currentUFState * @details Outputs: currentUFState * @return next Dialysis state. *************************************************************************/ static DIALYSIS_STATE_T handleDialysisUltrafiltrationState( void ) { DIALYSIS_STATE_T result = DIALYSIS_UF_STATE; switch ( currentUFState ) { case UF_START_STATE: currentUFState = handleUFStartState( &result ); break; case UF_PAUSED_STATE: currentUFState = handleUFPausedState( &result ); break; case UF_RUNNING_STATE: currentUFState = handleUFRunningState( &result ); break; case UF_OFF_STATE: currentUFState = handleUFOffState( &result ); break; case UF_COMPLETED_STATE: currentUFState = handleUFCompletedState( &result ); break; default: SET_ALARM_WITH_2_U32_DATA( ALARM_ID_HD_SOFTWARE_FAULT, SW_FAULT_ID_DIALYSIS_INVALID_UF_STATE, currentUFState ) currentUFState = UF_COMPLETED_STATE; break; } return result; } /*********************************************************************//** * @brief * The handleDialysisSolutionInfusionState function handles the solution * infustion state of the Dialysis state machine. * @details Inputs: currentSalineBolusState * @details Outputs: currentSalineBolusState * @return next Dialysis state. *************************************************************************/ static DIALYSIS_STATE_T handleDialysisSalineBolusState( void ) { DIALYSIS_STATE_T result = DIALYSIS_SALINE_BOLUS_STATE; switch ( currentSalineBolusState ) { case SALINE_BOLUS_STATE_IDLE: currentSalineBolusState = handleSalineBolusIdleState( &result ); break; case SALINE_BOLUS_STATE_WAIT_FOR_PUMPS_STOP: currentSalineBolusState = handleSalineBolusWait4Pumps2Stop( &result ); break; case SALINE_BOLUS_STATE_IN_PROGRESS: currentSalineBolusState = handleSalineBolusInProgressState( &result ); break; case SALINE_BOLUS_STATE_MAX_DELIVERED: currentSalineBolusState = handleSalineBolusMaxDeliveredState( &result ); break; default: SET_ALARM_WITH_2_U32_DATA( ALARM_ID_HD_SOFTWARE_FAULT, SW_FAULT_ID_DIALYSIS_INVALID_SALINE_BOLUS_STATE, currentSalineBolusState ) currentSalineBolusState = SALINE_BOLUS_STATE_MAX_DELIVERED; break; } return result; } /*********************************************************************//** * @brief * The handleUFStartState function handles the Start state of the * ultrafiltration state machine. * @details Inputs: maxUFVolumeML * @details Outputs: if ultrafiltration prescribed, ultrafiltration time is * initialized. * @param dialysisState next dialysis state * @return next ultrafiltration state. *************************************************************************/ static UF_STATE_T handleUFStartState( DIALYSIS_STATE_T *dialysisState ) { UF_STATE_T result; if ( maxUFVolumeML < NEARLY_ZERO ) { result = UF_OFF_STATE; } else { lastUFTimeStamp = getMSTimerCount(); uFTimeMS = 0; result = UF_RUNNING_STATE; } return result; } /*********************************************************************//** * @brief * The handleUFPausedState function handles the Paused state of the * ultrafiltration state machine. * @details Inputs: none * @details Outputs: if ultrafiltration resumption requested, UF time is set to resume. * @param dialysisState next dialysis state * @return next ultrafiltration state. *************************************************************************/ static UF_STATE_T handleUFPausedState( DIALYSIS_STATE_T *dialysisState ) { UF_STATE_T result = UF_PAUSED_STATE; // Calculate UF volumes and provide to dialysate outlet pump controller updateUFVolumes(); // Handle saline bolus start request from user if ( TRUE == salineBolusStartRequested ) { salineBolusAutoResumeUF = FALSE; // Go to saline bolus state if we can if ( SALINE_BOLUS_STATE_IDLE == currentSalineBolusState ) { *dialysisState = DIALYSIS_SALINE_BOLUS_STATE; } else { salineBolusStartRequested = FALSE; } } // Handle auto-resume after saline bolus else if ( TRUE == salineBolusAutoResumeUF ) { salineBolusAutoResumeUF = FALSE; // Set outlet pump to dialysate rate + set UF rate setDialOutPumpTargetRate( setDialysateFlowRate + FLOAT_TO_INT_WITH_ROUND( setUFRate ), MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); // Restart UF time accumulation for reference volume calculation lastUFTimeStamp = getMSTimerCount(); // Resume UF result = UF_RUNNING_STATE; } return result; } /*********************************************************************//** * @brief * The handleUFRunningState function handles the Running state of the * ultrafiltration state machine. * @details Inputs: ms timer, lastUFTimeStamp * @details Outputs: UF timer incremented, UF volumes updated and provided to DPo * pump controller. * @param dialysisState next dialysis state * @return next ultrafiltration state. *************************************************************************/ static UF_STATE_T handleUFRunningState( DIALYSIS_STATE_T *dialysisState ) { UF_STATE_T result = UF_RUNNING_STATE; U32 newTime = getMSTimerCount(); U32 msSinceLast = calcTimeBetween( lastUFTimeStamp, newTime ); // Update UF time uFTimeMS += msSinceLast; lastUFTimeStamp = newTime; // Update UF ref volume in UF running state only refUFVolume += ( ( (F32)msSinceLast / MS_PER_SECOND ) / SEC_PER_MIN ) * setUFRate; // Calculate UF volumes and provide to dialysate outlet pump controller updateUFVolumes(); // If we have reached target UF volume, UF is complete if ( measUFVolume >= maxUFVolumeML ) { result = UF_COMPLETED_STATE; } // Handle saline bolus start request from user else if ( TRUE == salineBolusStartRequested ) { if ( SALINE_BOLUS_STATE_IDLE == currentSalineBolusState ) { // Since we were doing UF prior to saline bolus, we want to auto-resume when done salineBolusAutoResumeUF = TRUE; // Go to UF paused state result = UF_PAUSED_STATE; // Go to saline bolus state *dialysisState = DIALYSIS_SALINE_BOLUS_STATE; } else { salineBolusStartRequested = FALSE; } } return result; } /*********************************************************************//** * @brief * The handleUFCompletedOrOffState function handles the UF Off state * of the ultrafiltration state machine. * @details Inputs: none * @details Outputs: UF volumes updated and provided to DPo pump controller. * @param dialysisState next dialysis state * @return next ultrafiltration state *************************************************************************/ static UF_STATE_T handleUFOffState( DIALYSIS_STATE_T *dialysisState ) { UF_STATE_T result = UF_OFF_STATE; // Calculate UF volumes and provide to dialysate outlet pump controller updateUFVolumes(); // Handle saline bolus start request from user if ( TRUE == salineBolusStartRequested ) { salineBolusAutoResumeUF = FALSE; // Go to saline bolus state if ( SALINE_BOLUS_STATE_IDLE == currentSalineBolusState ) { *dialysisState = DIALYSIS_SALINE_BOLUS_STATE; } else { salineBolusStartRequested = FALSE; } } return result; } /*********************************************************************//** * @brief * The handleUFCompletedState function handles the UF Completed * state of the ultrafiltration state machine. This is a terminal state. * @details Inputs: none * @details Outputs: UF volumes updated and provided to DPo pump controller. * @param dialysisState next dialysis state * @return next ultrafiltration state *************************************************************************/ static UF_STATE_T handleUFCompletedState( DIALYSIS_STATE_T *dialysisState ) { UF_STATE_T result = UF_COMPLETED_STATE; // Calculate UF volumes and provide to dialysate outlet pump controller updateUFVolumes(); // Handle saline bolus start request from user if ( TRUE == salineBolusStartRequested ) { salineBolusAutoResumeUF = FALSE; // Go to saline bolus state if ( SALINE_BOLUS_STATE_IDLE == currentSalineBolusState ) { *dialysisState = DIALYSIS_SALINE_BOLUS_STATE; } else { salineBolusStartRequested = FALSE; } } return result; } /*********************************************************************//** * @brief * The handleSalineBolusIdleState function handles the idle state of the * saline bolus state machine. * @details Inputs: none * @details Outputs: * @param dialysisState next dialysis state * @return next saline bolus state *************************************************************************/ static SALINE_BOLUS_STATE_T handleSalineBolusIdleState( DIALYSIS_STATE_T *dialysisState ) { SALINE_BOLUS_STATE_T result = SALINE_BOLUS_STATE_IDLE; // Handle saline bolus start request from user if ( TRUE == salineBolusStartRequested ) { salineBolusStartRequested = FALSE; // Cmd all pumps to stop #ifndef RUN_PUMPS_OPEN_LOOP setBloodPumpTargetFlowRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); setDialInPumpTargetFlowRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); setDialOutPumpTargetRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); #else setBloodPumpTargetFlowRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); setDialInPumpTargetFlowRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); setDialOutPumpTargetRate( 0, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); #endif // Begin saline bolus result = SALINE_BOLUS_STATE_WAIT_FOR_PUMPS_STOP; } return result; } /*********************************************************************//** * @brief * The handleSalineBolusWait4Pumps2Stop function handles the wait for pumps * to stop state of the saline bolus state machine. * @details Inputs: none * @details Outputs: * @param dialysisState next dialysis state * @return next saline bolus state *************************************************************************/ static SALINE_BOLUS_STATE_T handleSalineBolusWait4Pumps2Stop( DIALYSIS_STATE_T *dialysisState ) { SALINE_BOLUS_STATE_T result = SALINE_BOLUS_STATE_WAIT_FOR_PUMPS_STOP; if ( ( FALSE == isBloodPumpRunning() ) && ( FALSE == isDialInPumpRunning() ) && ( FALSE == isDialOutPumpRunning() ) ) { // Reset bolus data before we start bolusSalineVolumeDelivered = 0.0; bolusSalineVolumeDelivered_Safety = 0.0; bolusSalineMotorCount = 0; bolusSalineLastMotorCount = getBloodPumpMotorCount(); bolusSalineLastVolumeTimeStamp = getMSTimerCount(); // Bypass dialyzer setValvePosition( VDI, VALVE_POSITION_C_CLOSE ); setValvePosition( VDO, VALVE_POSITION_C_CLOSE ); // Switch to saline bag setValvePosition( VBA, VALVE_POSITION_C_CLOSE ); // Start blood pump at saline bolus rate #ifndef RUN_PUMPS_OPEN_LOOP setBloodPumpTargetFlowRate( SALINE_BOLUS_FLOW_RATE, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); #else setBloodPumpTargetFlowRate( SALINE_BOLUS_FLOW_RATE, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); #endif // Start dialysate inlet pump at re-circ rate #ifndef RUN_PUMPS_OPEN_LOOP setDialInPumpTargetFlowRate( DIALYSATE_FLOW_RATE_FOR_RECIRC, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_CLOSED_LOOP ); #else setDialInPumpTargetFlowRate( DIALYSATE_FLOW_RATE_FOR_RECIRC, MOTOR_DIR_FORWARD, PUMP_CONTROL_MODE_OPEN_LOOP ); #endif // Begin saline bolus result = SALINE_BOLUS_STATE_IN_PROGRESS; } return result; } /*********************************************************************//** * @brief * The handleSalineBolusInProgressState function handles the in-progress state of the * saline bolus state machine. * @details Inputs: none * @details Outputs: * @param dialysisState next dialysis state * @return next saline bolus state *************************************************************************/ static SALINE_BOLUS_STATE_T handleSalineBolusInProgressState( DIALYSIS_STATE_T *dialysisState ) { SALINE_BOLUS_STATE_T result = SALINE_BOLUS_STATE_IN_PROGRESS; BOOL errorFound = FALSE; F32 timeSinceLastVolumeUpdateMin = (F32)calcTimeSince( bolusSalineLastVolumeTimeStamp ) / (F32)( MS_PER_SECOND * SEC_PER_MIN ); F32 bolusTargetVolume = (F32)getTreatmentParameterU32( TREATMENT_PARAM_SALINE_BOLUS_VOLUME ); F32 bldFlowRate = getMeasuredBloodFlowRate(); // TODO - should I use raw flow instead of filtered here??? F32 volSinceLastUpdateMl = bldFlowRate * timeSinceLastVolumeUpdateMin; U32 bldPumpMotorCount = getBloodPumpMotorCount(); U32 bldPumpMotorDelta = u32DiffWithWrap( bolusSalineLastMotorCount, bldPumpMotorCount ); // Update saline bolus volumes bolusSalineLastVolumeTimeStamp = getMSTimerCount(); bolusSalineVolumeDelivered += volSinceLastUpdateMl; totalSalineVolumeDelivered += volSinceLastUpdateMl; bolusSalineMotorCount += bldPumpMotorDelta; bolusSalineLastMotorCount = bldPumpMotorCount; bolusSalineVolumeDelivered_Safety = ( (F32)bolusSalineMotorCount * VOLUME_PER_BP_MOTOR_REV_ML ); // TODO - include upstream pressure compensation to this calc #ifndef DISABLE_SALINE_BOLUS_CHECKS // TODO - check for empty saline bag if ( 0 ) { SET_ALARM_WITH_1_F32_DATA( ALARM_ID_EMPTY_SALINE_BAG, 0.0 ); // TODO - give data supporting empty bag detection errorFound = TRUE; } #endif // Determine if we have reached maximum saline delivery volume if ( ( totalSalineVolumeDelivered >= (F32)MAX_SALINE_VOLUME_DELIVERED ) ) { result = SALINE_BOLUS_STATE_MAX_DELIVERED; } else { // Determine if bolus is complete if ( bolusSalineVolumeDelivered >= bolusTargetVolume ) { // If safety thinks we have under-delivered the bolus, throw a fault if ( bolusSalineVolumeDelivered_Safety < ( bolusTargetVolume * MIN_SALINE_BOLUS_VOLUME_PCT ) ) { #ifndef DISABLE_SALINE_BOLUS_CHECKS SET_ALARM_WITH_2_F32_DATA( ALARM_ID_SALINE_BOLUS_VOLUME_CHECK_FAILURE, bolusTargetVolume, bolusSalineVolumeDelivered_Safety ); errorFound = TRUE; #endif } result = SALINE_BOLUS_STATE_IDLE; } // User is aborting saline bolus else if ( TRUE == salineBolusAbortRequested ) { salineBolusAbortRequested = FALSE; result = SALINE_BOLUS_STATE_IDLE; } // Determine if safety thinks we have over-delivered the bolus else if ( bolusSalineVolumeDelivered_Safety > ( bolusTargetVolume * MAX_SALINE_BOLUS_VOLUME_PCT ) ) { #ifndef DISABLE_SALINE_BOLUS_CHECKS SET_ALARM_WITH_2_F32_DATA( ALARM_ID_SALINE_BOLUS_VOLUME_CHECK_FAILURE, bolusTargetVolume, bolusSalineVolumeDelivered_Safety ); errorFound = TRUE; result = SALINE_BOLUS_STATE_IDLE; #endif } } // Are we stopping the bolus? if ( result != SALINE_BOLUS_STATE_IN_PROGRESS ) { // Hard stop blood and dialysate pumps signalBloodPumpHardStop(); signalDialInPumpHardStop(); // Send last saline bolus data bolusSalineVolumeDelivered = 0.0; salineBolusBroadcastTimerCtr = SALINE_BOLUS_DATA_PUB_INTERVAL; publishSalineBolusData(); // Dialysis back to UF state *dialysisState = DIALYSIS_UF_STATE; // End dialyzer bypass and resume dialysis if no alarms triggered if ( FALSE == errorFound ) { // Resume UF if appropriate if ( TRUE == salineBolusAutoResumeUF ) { currentUFState = UF_RUNNING_STATE; } // Resume dialysis startDialysis(); } } return result; } /*********************************************************************//** * @brief * The handleSalineBolusMaxDeliveredState function handles the max saline delivered * state of the saline bolus state machine. This is a terminal state. * @details Inputs: none * @details Outputs: * @param dialysisState next dialysis state * @return next saline bolus state *************************************************************************/ static SALINE_BOLUS_STATE_T handleSalineBolusMaxDeliveredState( DIALYSIS_STATE_T *dialysisState ) { SALINE_BOLUS_STATE_T result = SALINE_BOLUS_STATE_MAX_DELIVERED; // This is a terminal state for a given treatment - no more saline may be delivered to patient // If we get here, pop back to UF *dialysisState = DIALYSIS_UF_STATE; return result; } /*********************************************************************//** * @brief * The publishSalineBolusData function handles the max saline delivered * state of the saline bolus state machine. This is a terminal state. * @details Inputs: none * @details Outputs: * @param dialysisState next dialysis state * @return next saline bolus state *************************************************************************/ static void publishSalineBolusData( void ) { if ( ++salineBolusBroadcastTimerCtr >= SALINE_BOLUS_DATA_PUB_INTERVAL ) { SALINE_BOLUS_DATA_PAYLOAD_T data; data.maxSalineVolumeMl = MAX_SALINE_VOLUME_DELIVERED; data.cumSalineVolumeMl = totalSalineVolumeDelivered; data.bolSalineVolumeMl = bolusSalineVolumeDelivered; broadcastSalineBolusData( data ); salineBolusBroadcastTimerCtr = 0; } } /*********************************************************************//** * @brief * The checkUF function checks ultrafiltration accuracy for the last * hour and checks total UF volume. Triggers an alarm if out of spec. * @details Inputs: uFAccuracyCheckTimerCtr, lastUFVolumeChecked, measUFVolume * @details Outputs: uFAccuracyCheckTimerCtr, lastUFVolumeChecked * @return none *************************************************************************/ static void checkUFAccuracyAndVolume( void ) { F32 uFMeasRate = measUFVolume - lastUFVolumeChecked; // Volumes are at start/end of 1 hour period, so implied rate is per hour // Check UF rate diff from target in last hour if ( uFMeasRate > maxUFRateAccuracyError_Ml_hr ) { #ifndef DISABLE_UF_ALARMS SET_ALARM_WITH_1_F32_DATA( ALARM_ID_UF_RATE_TOO_HIGH_ERROR, uFMeasRate ); #endif } // If actively performing ultrafiltration right now, increment timer and see if time to start another 1 hour check period if ( UF_RUNNING_STATE == currentUFState ) { if ( ++uFAccuracyCheckTimerCtr >= UF_ACCURACY_CHECK_INTERVAL ) { // Reset for next check interval lastUFVolumeChecked = measUFVolume; uFAccuracyCheckTimerCtr = 0; } } // Check total UF volume error if ( ( fabs( refUFVolume - measUFVolume ) ) >= (F32)MAX_UF_ACCURACY_ERROR_ML ) { #ifndef DISABLE_UF_ALARMS SET_ALARM_WITH_2_F32_DATA( ALARM_ID_UF_VOLUME_ACCURACY_ERROR, refUFVolume, measUFVolume ); #endif } } /*********************************************************************//** * @brief * The updateUFVolumes function updates the ultrafiltration volumes based on * set UF rate, latest UF elapsed time, and the latest load cell weight for the * currently used reservoir. Updated UF volumes are then sent to the dialysate * outlet pump controller. * @details Inputs: setUFRate, uFTimeMS, load cell weight * @details Outputs: refUFVolume, measUFVolume * @return none *************************************************************************/ static void updateUFVolumes( void ) { DG_RESERVOIR_ID_T activeRes = getDGActiveReservoir(); F32 latestResVolume = getReservoirWeightSmallFilter( activeRes ); // Calculate UF volumes and provide to dialysate outlet pump controller measUFVolume = measUFVolumeFromPriorReservoirs + ( latestResVolume - resStartVolume[ activeRes ] ); resFinalVolume[ activeRes ] = latestResVolume; setDialOutUFVolumes( refUFVolume, measUFVolume ); } /*********************************************************************//** * @brief * The setStartReservoirVolume function updates the baseline volume of the * next reservoir to be drawn from before it is switched to (i.e. while it * is the inactive reservoir) in order to get a more stable volume. * @details Inputs: active reservoir, load cell reading from inactive reservoir * @details Outputs: resStartVolume[] * @return none *************************************************************************/ void setStartReservoirVolume( void ) { DG_RESERVOIR_ID_T inactiveRes = getDGInactiveReservoir(); F32 resVolume = getReservoirWeightLargeFilter( inactiveRes ); // Set starting baseline volume for next reservoir before we switch to it resStartVolume[ inactiveRes ] = resVolume; } /*********************************************************************//** * @brief * The signalReservoirsSwitched function informs this module that the * reservoirs have been switched. The UF volume from prior reservoirs is * tentatively added to with a load cell reading of the inactive reservoir. * @details Inputs: resFinalVolume[], resStartVolume[] * @details Outputs: measUFVolumeFromPriorReservoirs * @return none *************************************************************************/ void signalReservoirsSwitched( void ) { DG_RESERVOIR_ID_T activeRes = getDGActiveReservoir(); DG_RESERVOIR_ID_T inactiveRes = ( activeRes == DG_RESERVOIR_1 ? DG_RESERVOIR_2 : DG_RESERVOIR_1 ); // Update UF volume from prior reservoirs per tentative res volume for last reservoir measUFVolumeFromPriorReservoirs += ( resFinalVolume[ inactiveRes ] - resStartVolume[ inactiveRes ] ); } /*********************************************************************//** * @brief * The setFinalReservoirVolume function updates the UF volume from prior reservoirs * with a more stable final reservoir volume of the prior reservoir after it * had a moment to settle. * @details Inputs: active reservoir, load cell reading from inactive reservoir * @details Outputs: measUFVolumeFromPriorReservoirs, resFinalVolume[], resStartVolume[] * @return none *************************************************************************/ void setFinalReservoirVolume( void ) { DG_RESERVOIR_ID_T inactiveRes = getDGInactiveReservoir(); F32 resVolume = getReservoirWeightLargeFilter( inactiveRes ); // Update UF volume from prior reservoirs per final res volume for last reservoir a bit after we have switched and reservoir has settled measUFVolumeFromPriorReservoirs -= ( resFinalVolume[ inactiveRes ] - resStartVolume[ inactiveRes ] ); resFinalVolume[ inactiveRes ] = resVolume; measUFVolumeFromPriorReservoirs += ( resFinalVolume[ inactiveRes ] - resStartVolume[ inactiveRes ] ); } /**@}*/