I use a Home Choice Pro cycler and I often see air bubbles in the patient line after priming. I’ve seen anywhere from one to five or six bubbles in the line. They are usually about 1/4 inch in diameter or less. Repriming does not seem to affect these bubbles unless they are near the top of line where it’s mounted in the organizer. So far I haven’t had any obvious ill effects. What guidelines would you recommend for preventing or dealing with these bubbles? Is a small number of them OK? Should I try to flush them out by lowering the end of the patient line during priming? Thanks very much for any suggestions.
That is a curious event as the entire system is designed to be free of air. The only way air can be introduced into the lines (patient and/or cycler) is if a line clamp is opened when the transfer set is disconnected from the patient line or minicap—this would allow air to enter the line if negative pressure was in the open line. So please first check your technique and be sure all lines are clamped before opening. If this is not the answer, I suggest you review your procedure with the PD nurse at the clinic to further troubleshoot.
Judy
[QUOTE=jbernardini;21857]That is a curious event as the entire system is designed to be free of air. The only way air can be introduced into the lines (patient and/or cycler) is if a line clamp is opened when the transfer set is disconnected from the patient line or minicap—this would allow air to enter the line if negative pressure was in the open line. So please first check your technique and be sure all lines are clamped before opening. If this is not the answer, I suggest you review your procedure with the PD nurse at the clinic to further troubleshoot.
Judy[/QUOTE]
Thanks for the information! As far as I can tell, I am following the procedure in the Baxter manual exactly. But when priming occurs, the system is in the state you mention, i.e. the transfer set is not yet connected and the clamp on the patient line is open. Also, the cap at the end of the patient line in the organizer is not airtight, so I wonder if air is being drawn in during priming? I also noticed that the sides of the drain bag can stick together, creating some resistance to filling. Could this produce the negative pressure you describe, or allow bubbles in the drain line to back up into the patient line? Thanks again for your feedback.
I don’t know how small these bubbles are. I would not recommend trying to flush them out, but I would recommend calling the Baxter Hotline to discuss this. THey are really pros when it comes to technical issues which is what I think this is. So call them, and let us know what happens. Good luck,
Judy Bernardini
I’ve seen the same thing, I don’t think it’s dangerous but I don’t think it’s quite right either.
I found this issue tonight. The patient line had lots of bubbles. I moved ahead and noticed (significantly more) air bubbles during the fill. I paused the machine and when checking lines found the heated cycler bag line was not tight at all. Everything is fine now, but I’m uncomfortable from the infusion of air.
I hear that the best option is to lay down with your feet up (think back on the floor feet up on your bed). The air raises can hopefully be evacuated.