referring now to fig1 the peritoneal cavity of patient 10 is shown connected to a dialysis solution bag 11 via catheter 12 and a branched tubing set 14 . the dialysis solution bag 11 is coupled to tube set 14 by double lumen piercing spike 18 which may pass into a conventional diaphram port 19 of bag 11 . the tubing set 14 is made of flexible plastic , and branches into tubular branch 20 , which extends from first lumen 21 of spike 18 through filter 22 to y - connection 24 , where it joins set tube 25 which can communicate with catheter 12 through a conventional connector 27 . branch 20 constitutes the &# 34 ; to &# 34 ; or &# 34 ; fill &# 34 ; line for fresh dialysis solution flow from bag 11 , through filter 22 to the patient . second tubular branch 26 is connected to the other leg of y - connection 24 and extends to the second lumen 29 of double lumen spike 18 . it is typically intended that flow in second branch 26 always be in a direction away from the patient , back to bag 11 to carry only spent dialysis solution . slide clamp 30 controls the flow of dialysis solution in branches 20 and 26 to and from the patient . each of branches 20 , 26 can optionally contain a drop forming member 31 to serve as a bubble trap , particularly in the inflow branch 20 , and also to serve as flow rate indicator . also , particularly in the case of outflow branch 26 , drop forming member can provide means where drops are formed which fall through space to serve as a bacteria barrier , to prevent migration of bacteria upstream through the branch toward the patient . during the outflow phase , bag 11 is lowered and set 14 inverted , with drop forming tubes 33 being positioned as shown . branches 20 , 26 may also each carry a one - way valve 35 , positioned to permit flow only in the intended direction through each branch . one - way valve 35 in each case may be a duck - bill type valve or the like . referring now to fig2 clamp 30 includes a slide member 32 and a housing 29 ( fig4 ) which , in the embodiment shown , has two component half sections 34 , 36 . slide member 32 is a symmetrical unitary molded member , and includes elongated body portion 38 carrying two enlarged head sections 40 and 42 at its respective ends . an elongated central slot 44 is provided , with two ribs or shoulders 46 , 48 extending inwardly to define a narrow section of slot 44 . ribs 46 , 48 do not extend the full length of slot 44 , and thus branch tube - receiving openings 40 and 52 are defined at either end of the slot adjacent head sections 40 and 42 respectively . these openings freely receive tubing without constricting flow therein . slot 44 between ribs 46 and 48 defines a branch tube - grasping section that will prevent flow through the grasped tube . housing half sections 34 , 36 may be identical so that when assembled they will form the housing . each section is generally u - shaped and has outwardly extending flanges 54 , 56 . one flange includes a pair of upwardly - extending sonically sealable protrusions 58 , and the other flange includes a pair of protrusion - receiving apertures 62 . legs 64 , 65 of each housing section 34 , 36 are spaced apart a distance slightly greater than the central width of slide member 32 , and bight portion 66 includes a pair of tube - receiving apertures 67 , 68 . apertures 67 and 68 are spaced apart a distance less than the distance between tube - receiving sections 50 , 52 of slide member 32 . in order to assemble the clamp , slide member 52 is placed within the u - shaped section of one half section , such as 36 , and the other half section 34 is then placed thereon in mating relationship . then , protrusions 58 and protrusion - receiving openings 62 are sonic sealed together . tubular branch 26 is threaded through housing openings 68 and section 50 of slide member 32 . branch 20 is threaded through openings 67 and section 52 of slide member 32 , shifting slide member 32 to do it . then set 14 is completely assembled . referring now to fig3 the right - hand portion shows clamp 30 in cavity - drain position , whereby there is spent solution flowing through tubular branch 26 to bag 11 , while branch 20 is sealed . the lefthand position of fig3 shows the cavity - fill condition with branch 20 open and branch 26 in the closed position . referring to fig4 the branches 20 , 26 are shown grasped between flanges 46 , 48 in a no - flow position . fig4 through 6 show branches 20 , 26 both pinched between flanges 46 , 48 in a no - flow position . slide member 32 carries indicator marks 80 , which are preferably of the width of slide housing 33 through which the slide member extends . accordingly , when marks 80 are lined up with slide housing 20 , as shown in fig4 the user can know that both branches 20 and 26 are closed off . alternatively , when shoulder 40 rests against housing 29 , the user knows that branch 26 is open and branch 20 is closed . when shoulder 42 rests against housing 29 , then the user knows that branch 20 is open and branch 26 is closed . referring to fig7 a preferred embodiment of the clamp system of this invention is disclosed in which the clamp system is permanently retained in a single position on the tubing . it is similar to the fig1 embodiment except as otherwise shown . as shown , tubular branch 20a carries an intermediate tubular section 82 which may be made out of a cross - linked elastomeric material such as silicone rubber or other cross - linked organic rubber . tubular section 82 is connected to the respective lengths of tubular branch 20a by a conventional tubular connector member 84 , each of which carry a flange 86 for retention of the connected housing halves 34a , 36a , which may be of analogous design to housing halves 34 , 36 , forming housing means 29a . flanges 86 are positioned in corresponding recesses 88 at opposed ends of housing halves 34a , 36a , so that housing 29a is firmly retained on flanges 86 . connectors 84 may , in turn , be solvent sealed or otherwise adhered to the respective lengths of tubing 20a and 82 . tubing 20a may be made of a polyvinyl chloride formulation or other thermoplastic material . slide member 32a is provided , and may be of a structure similar to slide member 32 in the previous embodiment . slide member 32a is shown to be at one of its terminal positions , in which tubing 82 passes through an enlarged end aperture of slot 44a . flanges 46a , 48a are also provided to define slot 44a which is proportioned so that tube 82 may be closed in a similar manner to that of the previous embodiment . as a further advantage of this embodiment , since tubular branch section 82 is made of a thermoplastic material such as silicone rubber , there is little or no cold flow to worry about when it is forced into slot 44a , so the clamp shown in fig7 operates in improved manner . inner prong members 90 are also provided in housing 29a to serve as guides for slide member 32a . as a further embodiment , fig8 is also similar in structure to the fig1 embodiment , except as otherwise shown . housing 29b of clamp 30b is carried in a fixed position on tubular branch 20b ( and the other tubular branch ) between a pair of retaining sleeve members 92 , which may be suitably attached by gluing or solvent sealing to sections of tubular branch 20b . if desired , branch tubing portion 94 may be a separate piece adhering to sleeves 92 at opposed ends , being made of silicone or the like . alternatively , branch tubing portion 94 may be an integral part of the entire tubular branch 20b , which may be made of a conventional thermoplastic material such as a polyvinyl chloride formulation or the like . slide member 32b is also shown as being of similar construction to slide members 32 , 32a of the previous embodiments so that the tubular branches may be closed or opened in a manner dependent upon the position of slide member 32b . in use , the set of this invention may be set up as shown in fig1 . double lumen spike 18 penetrates into communication with solution container 11 through an access port . slide member 32 is positioned to permit flow through tubular branch 20 so that peritoneal dialysis solution passes from container 11 through lumen 21 and branch 20 , being filtered by filter 22 and permitted to flow through one - way valve 35 of branch 20 into the peritoneal cavity through catheter 12 . at the termination of flow , slide member 32 can be moved to its centered position so that both branches 20 , 26 are closed as in fig4 . when it is desired to remove the spent peritoneal dialysis solution , slide member 32 is moved to its opposite extreme position to open tubular branch 26 , while branch 20 remains closed . in this instance the spent solution bypasses filter 22 and passes through lumen 29 of spike 18 back into container 11 , so that lumen 21 of spike 18 connecting with branch 20 does not convey spent dialysis solution . thus , when more fresh dialysis solution is to be added , the process can be repeated without any spent dialysis solution retained in lumen 21 being forced into contact with filter 22 . the above has been offered for illustrative purposes , and is not intended to limit the scope of the invention of this application , which is as defined in the claims below .
there is disclosed herein a dual flow control clamp for use in continuous ambulatory peritoneal dialysis wherein a patient is connected to the source of dialysis solution through a branched flow path . one branch controls flow to the patient and the other branch controls flow from the patient . the clamp provides for selectively controlling flow in one or both flow paths , while never permitting flow simultaneously in both flow paths .