Paige
New Member
Total Posts: 2
Joined: March 2008
From: USA
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Posted: August 14 2008 11:27 AM  
Sara Sue,
I have noticed the same thing; however, I think that it is more related to the patient than the machine (I know it cannot be anything I am doing...). I think patients that are hypotensive and require vasopressors or have access issues produce very labile or dynamic intracircuit pressures that impact the therapy pumps. Also, there have been some interesting studies regarding inconsistent circuit flow (periods of stasis) despite stable circuit pressures. In large variances, I would suspect it is more related to failure to deliver a therapy solution while the effluent pump continues to meter off the anticipated input volumes (in integrated CRRT pumps, effluent pump removes the sum of the dialysate and/or replacement set rate plus any extra UF ordered). Example: leave clamp on dialysate line after bag change. Fluid does not infuse, but effluent pump continues to pull off volume. The math of it is that fluid does not go in, but volume is pulled off, therefore, patient volume removal is greater than set. Effluent pump will pull from the path of least resistance, which is the patient (plasma water). Make sense?
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