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The Next Generation 4008S

Key features

Assuring quality in operations

Operational efficiency Hemodialysis involves a large number of demanding manual operations all around the hemodialysis machine. The ergonomic design and the logical operating structure of The Next Generation 4008S permit easy handling as well as fast and intuitive programming of the treatment parameters. Important treatment values are represented graphically on the 10.4” TFT-LCD monitor, which supports easy comprehension of the ongoing treatment, and provides a fast overview of the treatment history. The Blood Pressure Monitor (BPM) is fully integrated, which further simplifies handling for the therapy providers. In combination with the Therapy Data Management System (TDMS) daily dialysis practice can be organized in a more effective and efficient manner taking full advantage of an online data acquisition and management tool.

Assuring quality in operations

Settings for Blood Pressure Monitor (BPM)

OCM® – Online Clearance Monitor

In the meantime numerous studies have demonstrated that morbidity and mortality rates are closely correlated to the delivered dialysis dose.2,3 The Online Clearance Monitor (OCM®) enables the continuous monitoring of:

  • The effective in-vivo urea clearance (K)
  • The accumulated cleared plasma (Kt) or the current dialysis dose administered (Kt/V)
  • The plasma sodium concentration: possible deviations to the prescribed therapy goal can be detected and corrected immediately during treatment* without incurring additional expenses for disposables or staff efforts

The non-invasive and precise Kt/V assessment is consistent with conventional blood sample-based methods enabled by urea distribution volume V measured with the BCM-Body Composition Monitor.4

OCM® – Online Clearance Monitor

Settings for Online Clearance Monitor (OCM®)

Delivering quality in therapy

DIASAFE®plus – Dialysis Fluid Filter

The quality and purity of the dialysis fluid are of major concern in modern-day renal replacement therapies, as large volumes of dialysis fluid come into contact with the patient’s bloodstream during each treatment. Endotoxins present in contaminated dialysis fluid may elicit undesirable acute reactions and influence the long-term outcome of patients on chronic hemodialysis. The DIASAFE®plus dialysis fluid filter enables the production of ultrapure dialysis fluid. This is attributed to the excellent endotoxin-retention capabilities of its Fresenius Polysulfone® fibers and an intelligent safety concept, based on:

  • Functional control of filter integrity
  • Automatic surveillance of filter lifetime
  • Aseptic connection technology

Ultrapure dialysate fluid is acknowledged to be an integral part of all contemporary dialysis equipment. Naturally the DIASAFE®plus is an essential part of the basic configuration of all current Fresenius Medical Care dialysis machines.

DIASAFE®plus – Dialysis Fluid Filter

DIASAFE®plus – Dialysis Fluid Filter

bibag® – Dry Bicarbonate Concentrate

To avoid the potential risk of microbiological contamination through liquid bicarbonate concentrate, the bicarbonate buffer is always supplied as a dry substance. In addition to this excellent hygienic standard, the bibag® is characterized by:

  • Easy and ergonomic handling
  • Minimum storage space required
  • Ecological benefits due to reduced waste volume and less transport weight
bibag® – Dry Bicarbonate Concentrate

bibag® – Dry Bicarbonate Concentrate

Quality treatment to suit your budget quality

Almost one in two patients with ESRD dies as a result of cardiovascular disease. That is why Cardioprotective Hemodialysis is a core principle of Fresenius Medical Care, as we work and strive to solve the challenges of modern dialysis. Each step we take is focused on minimizing cardiovascular risks and extending patients’ lives. The Next Generation  4008S continues the success story of the well-known 4008 series, by combining best quality HD treatment, proven reliability and operational efficiency.

Proven quality

The latest member of a long established and highly successful 4008 series

  • Advanced dialysis fluid circuit with highly-precise volumetrically controlled ultrafiltration
  • Consistently reliable hydraulics

Advanced treatment

High-quality HD treatment to protect your patient

  • OCM® (Online Clearance Monitor)
  • DIASAFE®plus (Dialysis Fluid Filter)
  • bibag® (Dry Bicarbonate Concentrate)
  • Single needle or SN Click-Clack
  • ISO-UF program

Operational efficiency

Cost effective use of resources

  • Easy, fast and intuitive handling
  • TDMS (Therapy Data Management System)
  • BPM (Blood Pressure Monitor)
  • CDS (Central Concentrate Delivery System)
  • Adapted flow1
Quality treatment to suit your budget quality

Performance data

General data

General data

Dimensions 4008S Weight

1370 x 500 x 650 mm (H x W x D) (including shunt interlock and pedestal) approx. 86 kg

Water supply

Water inlet pressure

1.5 to 6.0 bar

Water inlet temperature

5°C to 30°C; for “integrated hot rinse” 85°C to 95°C

Max. drain height

1 m

Concentrate supply

Supply pressure

0 to 100 mbar; 1 m max. suction height

Central supply

1 central acid concentrate (optional) 0 to 500 mbar

Electrical data

Power supply

100 to 240 V AC, 50 to 60 Hz

Current consumption

Approx. 9 A (at 230 V) and 15 A (at 110 V)

External connections

Network interface for data exchange with Therapy Data Management System (optional); input/output for connection of external auxiliary equipment; alarm input/output (e.g. for nurse call); diagnosis for in-house computer diagnosis

Battery

18 V; 3 Ah (maintenance free)

Extracorporeal circuit

Extracorporeal circuit

Arterial pressure monitoring

Display range

- 300 mmHg to + 280 mmHg

Accuracy

±10 mmHg

Resolution

20 mmHg

Venous pressure monitoring

Display range

- 60 mmHg to + 520 mmHg

Accuracy

±10 mmHg

Resolution

20 mmHg

Transmembrane pressure monitoring

Display range

- 60 mmHg to + 520 mmHg

Resolution

20 mmHg

Arterial blood pump

Blood flow range

15 to 600 mL/min

Accuracy

± 10%

Resolution

5 mL/min

Single needle system (optional)

With 2 blood pumps, internal pressure/pressure control with variable stroke volume (max. 50 mL/min)

Air bubble detector

Ultrasonic transmission measurement on blood line, additional optical monitoring in venous clamp

Heparin pump

Delivery range: 0 to 10 mL/h Bolus function: max. 5 mL per bolus Syringe size: 20 mL

Dialysis fluid circuit

Dialysis fluid circuit

Dialysis fluid flow range

Selectable

0 – 300 – 500 – 800 mL/min

AdaptedFlow*(selectable)

Dialysate flow adapted to the effective blood flow

Dialysis fluid temperature

Selectable

35°C to 39°C

Dialysis fluid conductivity  

Range

12.8 to 15.7 mS/cm (25°C)

Accuracy

± 0.1 mS/cm

Resolution

0.1 mS/cm

Dialysis fluid acid component  

Mixing ratio

Adjustable, e.g. 1+44, 1+34

Adjustment range

125 to 150 mmol/L

Dialysis fluid bicarbonate component

Default mixing ratio

1 + 27.6 (others possible)

Adjustment range

- 8 to + 8 mmol/L

OCM®

Online Clearance Monitoring

Accurate Clearance K

± 6%

Bicarbonate dry concentrate

bibag®

Dialysis fluid filter system

DIASAFE®plus

Balancing accuracy

± 0.1 % according to the total dialysate volume

Pressure holding tests

Cyclic

Ultrafiltration

UF rate

0 to 4000 mL/h (in steps of 1 mL/h)

Pump volume accuracy

± 1%

Parameters displayed

UF goal, UF time, UF rate, UF volume

Blood leak detector 

Sensitivity

≤ 0.5 mL blood/min (Hct = 25) at max. flow 800 mL/min

BPM (optional)

Display range

Systole: 30 mmHg to 280 mmHg

Diastole: 10 mmHg to 240 mmHg

MAP: 20 mmHg to 255 mmHg

Pulse: 20 to 245 1/min

Accuracy

± 3 mmHg

Resolution

1 mmHg

Disinfection and cleaning programmes**

Disinfection and cleaning programmes**

Rinse
Temperature/flow

37 °C / 600 mL/min

Hot rinse (recirculation)
Temperature/flow

84 °C / 450 mL/min

Integrated hot rinse
Temperature/flow

84°C / 450 mL/min

Cleaning Sporotal®100 (recirculation)
Temperature/flow

37 °C / 600 mL/min

Heat disinfection Diasteril®/Citrosteril® (recirculation)
Temperature/flow

84° C / 450 mL/min

Disinfection Puristeril® 340/plus (recirculation)
Temperature/flow

37 °C / 600 mL/min

* Not available in all countries.
** Various programme combinations selectable. Technical changes reserved.

1 Not available in all countries

2 Hakim R, Breyer J, Ismail N, Schulmann G: Effects of dose of dialysis on morbidity and mortality. American Journal of Kidney Diseases (1994); 23:661-669

3 Port F, Ashby V, Dhingra R, Roys E, Wolfe R: Dialysis dose and body mass index are strongly associated with survival in hemodialysis patients. Journal of the American Society of Nephrology (2002); 13:1061-1066

4 Lindley EJ, Chamney PW, Wuepper A, Ingles H, Tattersall JE, Will EJ: A comparison of methods for determining urea distribution volume for routine use in on-line monitoring of hemodialysis adequacy. Nephrology Dialysis Transplantation (2009); 24(1):211-6