HD Machines

Fact File

B.Braun
Version 2.2
Release: December 2012 Dialog+ ”Evolution”

At a Glance Positioning
• Despite of streamlining their official • Dialog+ is B.Brauns only machine in the field of
communication in brochures and lectures chronic haemodialysis. It is primarily designed
towards treatment quality B.Brauns focus is still for in-centre dialysis and can be ordered in 3
on a low price strategy to gain market shares. different configurations with additional options.
Therapy options Adimea and bioLogicRR are
• Dialog+ is based on the old Dialog that was
available for all configurations, as well as their
introduced to the market in 2001 and mainly
Nexadia network capabilities.
follows a me too strategy to old 4008S features.
• In 2012 B.Braun released the ”Evolution” update • Dialog+ allows an acceptable standard HD.
ONLINE HDF is only an option. Some features
of the existing Dialog+. B.Braun has improved
may address the standard segment but overall
the serviceability of the Dialog+ and updated
not comparable to modern 5008S standards.
some features to optimize the use of resources -
Dialog+ Evolution is still somewhere in between
new water block, new heat exchanger.
Basic and Standard segment.
• Dialog+ ”Evolution” has no obvious benefits in
therapy, user interface or handling compared
to 5008 CorDiax or 5008S CorDiax.
• Be aware of their bioLogicRR option in tenders,
B.Braun positions this option sometimes against
our BVM. bioLogicRR has an inconvenient handling
for the patient and is much inferior to our BVM.
Thus, bioLogicRR is rarely used in daily routine.
• To compete against Dialog+, use 5008S CorDiax
whenever possible. Push the new features of the
5008S CorDiax, especially AutoSub plus and
VAM. When you have to counteract aggressive About the Company
price fights use 4008S classix. • B.Braun is a family owned German supplier of a
• In terms of IT integration there is no major wide range of medical products. B.Braun Avitum,
difference of functionalities, but in contrary to their dialysis business segment, sells dialysers,
us, they have to rely on a third party company. machines and bloodlines. Beside of product
business B.Braun copies FME’s business model
• You should go with confidence in a direct and is strongly growing its provider business.
comparison of 5008 or 5008S machines against
Dialog+ at customer sites. • For further competitive information on B.Braun
also see: http://fmc.intra.fresenius.de/3262.htm
Key features & Functionality
Dialog+ 4008S classix 5008 / 5008S CorDiax

15” touch screen with 10’4” LCD monitor and 15” touch screen with
self-explanatory icons centralised control “intuitive correct” user guidance

Standby mode AdaptedFlow EcoFlow

Various Profiling UF-/Na+ profiling UF-/Na+ profiling,

(BTM – Temp.-profile)

Single-Needle Cross-Over SN double pump SN double pump

Adimea OCM + (BCM) OCM + (BCM)

bioLogicRR comfort UF-Profiles + (BCM) BVM* + (BCM), UF-Profiles, BTM

Nexadia TDMS, UDL network connection TDMS, PatientCard

* only 5008 CorDiax

for internal use only 1

 Fact File
Dialog+ ”Evolution”

Product Range

Single HDF-
pump online

Dialog+ Dialog+ 4008S 5008/5008S

Single-pump or
double-pump HDF-online classix CorDiax

Basic treatment

Hemodialysis (HD) &

   
Isolated ultrafiltration (ISO-UF)

SN („klick-klack“ / double-pump) / / / /

Bicarbonate dry concentrate    

Kt/V Measurement    

Dialysis fluid filter system    

No. of filters / Membrane surface area (1 filter / 1.2 m²) (2 filter / 1.2 m²) (1 filter / 2.2 m²) (2 filter / 2.2 m²)

Therapy features

HDF – with bags & scale  − − −

ONLINE HDF – post or pre − 1 / 1,2 − /

Automatic regulation of Sub-rate − − − improved

ONLINE HDF during SN double pump − − − 

MIXED HDF − − − *

Safety features (VAM / VenAcc) − − − /

Blood Temperature Monitoring &

− − − 
Recirculation Measurement

Blood Volume Monitoring − − − *

Paediatric Software − − − *

Eco-friendly features

Heat exchanger improved improved  

AutoFlow / EcoFlow −/− 3 −/− 3 4 / 4 /

Central delivery (CDS) / Nr. of acid pipes  / 1x  / 1x  / 1x  / 2x

ONLINE priming and reinfusion

−  / 1 − /
in HD / HDF

ONLINE bolus in HD / HDF / SN − − / 1 / − − //

Key :  : standard,  : option, − : not available, * only 5008, CorDiax , 1 additional ONLINE tubing set required, 2 adaptor required, not
part of the ONLINE tubing set, 3 idle mode with zero flow, 4 adapted flow available in particular countries

for internal use only 2


Counter Argumentation
Feature What is this?
Adimea Real-time monitoring
of dialysis dose
(Kt/V) over the
entire course of the
treatment.
Adimea is measuring
the uric acid in the
waste dialysate by
UV spectroscopy and
is assuming a
constant clearance.
bioLogicRR Biofeedback-System
comfort with measurement of
blood pressure to
control the UF-rate.
Measurements are
done between 18 to
44 times during
treatment with a cuff.
SN Single Needle double
Cross-Over pump method of
B.Braun.
Standby Turning off the
mode dialysate flow after a
preset rinse time has
elapsed.
Flexible Six different types of
Profiling profiles, including
UF/Na+, Dialysate
flow and temperature,
BIC and Heparin,
can be selected,
individually adjusted
and freely combined.
Diacap Ultra Ultrafilter to produce
ultrapure dialysis
fluid.
[1] Harris,Yuill,Chesher: Correcting Acidosis in Hemodialysis: effect on Phosphate Clearance and Calcification Risk, J. Am.Soc. Nephrol.
1995 (6); 1607-1612
Claimed Benefit
Simple and reliable
verification of dialysis
dose with simple
handling.
No entry of V is
needed to measure
Kt/V. Only dry weight
data are required.
Urea reduction rate
(URR) is displayed.
Auto regulation of
blood pressure to
reduce intradialytic
hypotensive episodes
and symptoms.
Operation of both
pumps at the same
time avoids pressure
fluctuations and
achieves nearly a
constant blood flow in
the dialyser.
Standby mode with
zero flow reduces
water, energy and
concentrates
consumption to
minimum
Individual adjustments
to the needs of each
patient.
Filter life span of
150 treatments.
for internal use only
Fact File
Dialog+ ”Evolution”
FME response
Simple and reliable measurement of
dialysis dose with OCM is a standard in all
FME dialysis systems.
Observation of V (e.g. with BCM) is a basic
task to improve the Fluid Management of
the patient.
Kt/V is based on clearance assessment.
We do not need the URR to get the Kt/V.
This is just another way of measuring Kt/V.
Display of clearance K itself, beside of Kt/V,
gives information if the course of treatment
is on track or if considerable disturbances
occur. You won’t get the same information
from URR.
The principal task to reduce intradialytic
hypotensive symptoms is to achieve water
extraction in reference to physiological
principles. Therefore BVM, BTM and UF-
profiles are available with the advantage of
a higher patient comfort. BCM completes
the FME concept of Fluid Management.
Studies have shown that a pulsatile flow
has no medical disadvantage [1]. It is a
technical challenge our machines can
perfectly deal with. Auto Single Needle
procedure with 60 mL stroke volume
simplifies the handling of 5008 CorDiax and
5008S CorDiax.
With EcoFlow or AdaptedFlow dialysate flow
is adjusted to an optimized level that
reduces consumption and the risk of
germination in stagnant dialysate, at the
same time.
Any profiles (e.g. UF-profiling) that are
necessary to fulfil acknowledged
international quality standards are
integrated. All other parameters can be
adjusted manually or with superior
concepts (e.g. BTM to adjust the
temperature of the dialysate).
DIASAFE plus provides 80 % more surface
area. In addition DIASAFE plus ultrafilters
are designed to prolong their capability six
times longer than Diacap Ultra when using
hypochlorite.
3
 Fact File
Dialog+ ”Evolution”

Sales Argumentation
5008 / 5008S CorDiax – Pitch the benefit ”Best Therapy for your Patients”
Advantages Features Limitation of Dialog+ Talk about

CorDiax therapy ONLINE HDF as standard Designed as HD machine A constantly growing

systems are afterwards supplemented number of patients
aligned to by an ONLINE HDF option. worldwide is profiting
facilitate Further details please see from ONLINE HDF,
ONLINE HDF below. is no longer a niche

CorDiax therapy Easy change of treatment modes AV sets are not fully Chose the best
systems provide during treatments: equipped to perform all therapy for your
a maximum of HD ↔ HDF, possible treatments. patients whatever
flexibility in HDF pre ↔ HDF post, Customers have to pay individually is
therapies DN ↔ SN (if equipped with SN extra for the supplementary necessary, even
blood tubing) online tubing set within the course of
treatment

ONLINE HDF in combination with Not possible,

SN only 2 pumps as maximum

MIXED HDF with simultaneous pre Not available

and post dilution

Validated HomeHD software with Used for HHD without

adapted patient/user guidance at special concept
screensaver (wireless interaction of
remote control with machine)

Paediatric software officially No special concept for

validated for treatments from Paediatrics
10 - 40 kg and special paeediatric
bloodlines

CorDiax therapy AutoSub plus automatically Not available. Achieving effective

systems are maximizes substitution volume
designed to individual for every patient while
deliver simultaneously avoiding
high volume haemoconcentration and filter
ONLINE HDF clotting.
as easy as Dynamic signal analysis of pressure
standard HD
pulses enables a permanent
adaptation of the sub-rate to the
current treatment conditions.
No need for pre-filter pressure and
user interaction.
Substitution rate has to be
controlled manually,
resulting in a significantly
higher workload for the
nurses.
Lower substitution rates are
set to avoid pressure alarms
and haemoconcentration.
removal of middle
molecular toxins by
high volume HDF.
How to maximize
substitution volumes
in HDF therapy
without alarms?

The effective blood flow is Effective blood flow is only

automatically adapted to the displayed, all adjustments
required blood flow through a have to be done manually
compensation in regard to the
arterial pressure

Assessment of recirculation rates Not available, additional

with BTM external devices needed

for internal use only 4

 Fact File
Dialog+ ”Evolution”

Sales Argumentation
5008 / 5008S CorDiax – Pitch the benefit ”Best Therapy for your Patients”
Advantages Features Limitation of Dialog+ Talk about

Knowledge of OCM enables the monitoring of Adimea offers no additional Limitation of

variations in plasma sodium during the
physiologic treatment, beside standard
parameters clearance measurement.
during the
treatment
simplifies all BTM offers the possibility to monitor
efforts to and regulate the body temperature
provide with positive effects on
physiological hemodynamic stability.
dialysis
The 5008 offers with the BVM the
possibility to monitor blood volume
changes online and regulate the
UF –rate accordingly.
The online measurement of Hb/Hct
is used automatically to improve
other system functionalities, i.e. a
more precise Kt/V measurement.
benefits beside Kt/V treatment
monitoring effectiveness due to
patient specific
variation of
physiologic
Not available parameters
The bioLogicRR is using the
blood pressure to regulate
UF, which is an
uncomfortable intervention
for the patient (interval BP-
measurements at least 18
times during treatment or
every 5 minutes) and not a
predictive parameter

Facilitating the The integration of BCM into therapy No BCM or similar device in How to assess and
prescription of concepts offers a precise and B.Brauns portfolio. achieve the optimal
an adequate reliable determination of the urea dry weight?
dialysis therapy distribution volume for dialysis dose Inconvenient handling of
contributes to measurement, correct assessment two separate patient cards
an improvement of the patient’s dry weight and due to missing integration
in the quality of nutrition status. of BCM parameters in
life for every Together with the BVM we offer a B.Brauns PatientCard
patient concept for fluid management.

Intelligent Integrated Venous Access Not available How to achieve

safety features Monitoring (VAM) – increased highest level of
that ease daily probability to detect venous needle safety for patients
routines, whilst dislodgements and nurses?
supporting
nurses
responsibility as Dynamic pressure monitoring – Not available
care providers detection of paravasal bleeding
(„infiltration“)

VenAcc – external device for Not available

detection of venous needle
disconnections (fully integrated to
alarm management of the machine,
including blood pump stop)

Direct access to emergency function Not available

at main screen

Leakage sensors in hydraulics and Not available

EBM

for internal use only 5

 Fact File
Dialog+ ”Evolution”

Sales Argumentation
5008 / 5008S CorDiax – Pitch the benefit ”Best Handling for all Users”
Advantages Features Limitation of Dialog+ Talk about

Well designed Optimal sensitivity of the touch No good response of the Optimised work-flow,
user interface screen touch screen easy to learn,
with intuitively support in critical
correct user Chronologically arranged workflow Complex and non- situations,
guidance elements systematic icon concept higher numbers of
simplifies patients for each
practice and To a minimum reduced menu layers Time consuming menu nurse, routine has
treatment structure become increasingly
control at any hectic, reduced
Innovative alarm management and Misleading help functionality
time stress and workload
help functionality enables smoother and messages that does not
for nurses
trouble-shooting in times of stress guide the user *
and emergency

Optimised One-hand connection of bibag is Two hands are needed for Simple and safe
ergonomics carried out in a standing upright most of the actions routines
posture concerning the preparation,
e.g. handling of SolCart and
of concentrate couplings

Colour and form coded connectors Substitution line is not

of bloodlines to assure correct clearly coded: how to
installation insert? Which parts to
connect?

Clearly structured and well laid-out Substitution line is to short,

extracorporeal blood circuit setting the infusion line in
the line holder creates a
strong kinking

DIAFIX technology for DIASAFE plus Change of Diacap

allows an easy and hygienic change ultrafilters takes long and is
of dialysis fluid filters complicated

Minimum of Automatic switch on with Two handling steps instead After installation of
required subsequent performance of initial of one the blood line there is
interaction test no need to stay at the
during the machine. It’s only
process of Automatic insertion of bloodlines The insertion of the needed to come back
preparation, into pump segments bloodline to the pump one single time after
filling and segment is fully manual and T1-test to connect
rinsing the not easy ONLINE port, rinse
blood system Automatic filling of blood lines with Not available port and dialysate
offers maximum automatic setting of level at venous couplings.
flexibility drip chamber Dialog+ requires the
active participation of
a nurse during the
Automatic detection and venting of Not available whole preparation
heparin syringe phase

Automatic filling of the dialyser Different settings for rinsing

including removal of air, no need the dialyser membrane with
for turning the filter in priming or without ultra filtration

* may be improved in the new ”Evolution” update of Dialog+, feedback from field required

for internal use only 6

 Fact File
Dialog+ ”Evolution”

Sales Argumentation
5008 / 5008S CorDiax – Pitch the benefit ”Best Use of Resources”
Advantages Features Limitation of Dialog+ Talk about

ONLINE priming ONLINE priming allows saline bag Not feasible in all machine Cost of saline,
makes saline free priming in all treatment modes configurations, complicated storage space, safe
and waste bags handling, risk of and hygienic
obsolete during contamination handling, less
priming, even in operating steps
HD-mode

Less EcoFlow provides significant savings The standby mode of the Water and energy
consumption of of dialysate and energy as it is Dialog+ completely costs, hygiene and
dialysate, reducing the dialysate flow to switches off the dialysate patient safety
concentrates 100ml/min, BIC to 25mol/l while flow, which increases the
and energy maintaining a rinsing flow of risk of calcification and
makes ONLINE 50ml/min. contamination (even stated
HDF affordable in the user manual)

Dedicated Auto Flow factors Not available Water and energy

depending on selected treatment saving without
mode (HDF 1.2, HD 1.5). compromising Kt/V

AutoFlow is adapting the dialysate

flow to the effective blood flow
while maintaining an effective
therapy. This results in significant
savings of concentrate, water and
energy.

Service friendly Technical Safety Check and Interval of 12 months How to ensure a
machine preventive maintenance in an sustainable
concept reduces interval of 24 months investment?
service costs to
a minimum
Exchange of spare parts with plug & Improved arrangement of
play technology (SNAP-LOCK) components, due to
Evolution update*

Advanced service tools for fast Improved concept, due to

diagnostic and maintenance with Evolution update*
interactive hydraulic and pneumatic
flow charts and remote access
* feedback from field required

for internal use only 7

 Fact File
Dialog+ ”Evolution”

Sales Argumentation
4008S classix – Pitch the benefit ”Reliability in Therapy, Quality and Service”
Advantages Features Limitation of Dialog+ Talk about

Best in class 4008S classix is especially ”Evolution” update of Up to date concepts,

concept to redesigned to deliver best quality
ensure a HD treatment and prepared for
sustainable latest IEC standard
investment
4008S classix is the successor of
the 4008B and 4008S systems,
which are the most successful
haemodialysis machines ever. The
new system continues the proven
reliability and cost efficiency of the
4008 HD platform.
Dialog+ only improves the reliability in therapy,
hydraulic part, no technical quality and
improvement of therapy service
They may have copied
some features, but they
don’t have the experience
of the large number of
overall treatment hours
performed by FME machines

Technical Safety Check and Interval of 12 months

Preventive Maintenance Intervals of
24 months

Precisely OCM: Kt/V measurement as a Adimea is an expensive Confidence of having

tailored to fulfil standard including plasma sodium, option and only focused on a good dialysis even
the proven clearance and cleansed blood Kt/V measurements in routine
standards for applications
HD therapies bibag as standard Only optional, canister
reliably in every supply as standard
treatment
Na+ / UF-profiles Individualisation of all kind
of treatment profiles is
error prone and demands
extensive control, without
acknowledged results

Dialysis fluid filter (DiaSafe plus) Only 1.2 m² surface area,

with membrane surface area of 2.2 disinfection is limited to
m² grants high retention capacity citric acid and hypochlorite,
for endotoxins hypochlorite only two times
during lifetime permitted

Advanced Additional leakage sensor at the Not available Exceptional situations

patient safety bottom of hydraulics require fast action

Blood pump design with embedded External pump handle, may

handle for manual turning be missing when it counts

Improved T1 Autostart after switching on, Many handling steps and Automated and
ergonomics and priming during T1-test little flexibility before standardised
easy handling starting the treatment routines, efficient
leads to higher handling of devices
operational One-hand connection of bibag is Two hands are needed for
efficiency carried out in a standing upright most of the actions
posture concerning the preparation

Automatically adjusted dialysate No comparable functionality

consumption based on effective available during treatment
blood flow (Adapted Flow)

for internal use only 8

 Fact File
Dialog+ ”Evolution”

Differentiation Opportunities
Phrases you may use to differentiate our machines from the competitor

Therapy 5008 / 5008S 4008S Dialog+

CorDiax classix ”Evolution”
Lower limit of blood flow
minimum minimum minimum
30 ml/min 15 ml/min 50 ml/min

Compensation of effective blood flow

only only

displayed displayed

Dialysate flow range 100 - 1000 ml/min HD:

HD:
in all treatment modes 300 - 800
300 - 800
ml/min
ml/min

HDF:
no ONLINE
500 - 800
option
ml/min

Kt/V monitoring with display of in vivo urea

clearance K and cleansed blood K x t (OCM)   −

Monitoring of plasma sodium (OCM)

  −

ONLINE HDF with automatic regulation of

substitution rate (AutoSub plus) improved − −

ONLINE bolus in all treatment modes, including HD,

HDF, SN  − −

Integrated online measurement of relative blood


volume, Hb, Hct and automatic regulation of UF- − −
5008 CorDiax
rate (BVM)

Integrated online monitoring and regulation of the

body temperature (BTM)  − −

Integrated recirculation measurement (BTM)

 − −

SN double pump with ONLINE HDF

 − −

MIXED HDF
new
− −
5008 CorDiax

Paediatric software officially validated for

new
treatments from 10 - 40 kg and special paediatric − −
5008 CorDiax
bloodlines

Validated HomeHD software enables wireless

new
interaction of remote control with machine − −
5008S CorDiax

Key :  : standard,  : option, − : not available

for internal use only 9

 Fact File
Dialog+ ”Evolution”

Differentiation Opportunities
Phrases you may use to differentiate our machines from the competitor

Handling 5008 / 5008S 4008S Dialog+

CorDiax classix ”Evolution”
Centralised brake system
  −

Monitor tiltable and rotatable in 3 axes only rotatable

 −
(1 axis)

User guidance with graphical support

 − −
for preparation of blood lines

Form coded connectors to assure correct

 − −
installation of blood lines

Automatic insertion of bloodlines into

 semi-automatic −
pump segments

Automatic filling of blood lines with automatic

setting of the level in venous drip chamber  − −

Automatic detection and automatic venting of

 − −
heparin syringe

Possibility to mount dry concentrate (bibag) 72 hrs

  −
before treatment starts

Automatic performance of initial test after

  −*
automatic switch on (Auto-T1)

Centralised adjustment of pre-settings in separate only service only service

operator and service setup 
setup setup

Automatic residual disinfectant detection**

new − −

HomeHD software allows interaction with machine new

− −
in case of alarms via remote control 5008S CorDiax

Dimming of screen and status indicator new

− −
5008S CorDiax

IT 5008 / 5008S 4008S Dialog+

CorDiax classix ”Evolution”
Network interface
  

Integrated bedside monitoring via 

data Xchange panel (dXp) for the use with a data only display

management system to handle e.g. prescription, UF − messages,
via TDMS
management, used consumables and predialysis medication,
weight incl. history at the machine checklist

Offline PatientCard functionality

 (−) 

Key  : standard,  : option, − : not available, (−) : intended with limited functionality, * feedback from field required, ** not available for Puristeril 340

for internal use only 10

 Fact File
Dialog+ ”Evolution”

Differentiation Opportunities
Phrases you may use to differentiate our machines from the competitor

Safety 5008 / 5008S 4008S Dialog+

CorDiax classix ”Evolution”
System to indicate drops of 15 mmHg of the venous
pressure, when the venous pressure does not new − −
exceed alarm limits

Dynamic venous alarm settings

new − −

External device to detect venous needle

disconnections, integrated into the alarm new − −
management of the machine

Volumetric proportioning system

  −

Leakage sensors in hydraulics

  −

Additional leakage sensors in EBM

 − −

Automatic detection of wet transducer protectors

 − new

Direct access to emergency function at main screen

 − −

Individual setting of emergency function

(ultrafiltration OFF, variable bolus rate, blood  − −
pressure measurement) in all treatment modes

Monitor failure sensor and automatic activation of

 − −
emergency mode in case of monitor failure

Blood pump design with embedded handle for additional external


manual turning external cap pump handle

Access authorisation concept to adjust pre-settings

 − −
(UserCard, ServiceCard)

Hygiene 5008 / 5008S 4008S Dialog+

CorDiax classix ”Evolution”
Concentrate connectors covered during use
  −

Shunt-interlock for dialysate couplings

  −

Adapter that avoids direct contact between venous no ONLINE

 −
line and rinse port option

Dialysis fluid filter system with at least 2.0 m²

  −
surface area of each ultrafilter

Dialysis fluid filter has to withstand at least

  −
10 degreasing cycles

Key  : standard,  : option, − : not available

for internal use only 11

 Fact File
Dialog+ ”Evolution”

Differentiation Opportunities
Phrases you may use to differentiate our machines from the competitor

Use of resources 5008 / 5008S 4008S Dialog+

CorDiax classix ”Evolution”
Reduced dialysate consumption during preparation only
 
in single path stand-by mode
EcoFlow Adapted Flow
= zero flow

Automatic switch to reduced dialysate consumption

 
after priming −
EcoFlow Adapted Flow

Automatically adjusted dialysate consumption

based on effective blood flow
 
−
AutoFlow Adapted Flow

Dedicated Auto Flow factors depending on

selected treatment mode new − −

Heat exchanger with high efficiency

  improved

ONLINE priming, bolus and reinfusion without

additional disposable tubing sets  − −

Central supply of two acid concentrates

 − −

Technical service 5008 / 5008S 4008S Dialog+

CorDiax classix ”Evolution”
Technical Safety Check and Preventive Maintenance
only
Interval of 24 months  
12 months

Software updates of machine

via local clinic network  − −

Exchange of spare parts with plug & play


technology (SNAP-LOCK)  improved,*
partly

Auto-Calibration without reference solutions

(e.g. for blood leakage)   −

Interactive hydraulic and pneumatic flow charts only interactive

improved − hydraulic flow
chart
Key  : standard,  : option, − : not available, * feedback from field required

for internal use only 12