Detecting hemolysis on dialysis
Thanks, Peter, yes the jet lag has gone but off to Sysdney tonight for the 3 day ANZ Home Therapies (HD and PD) Conference which we hold here biennially.
As for hemolysis on dialysis, there is quite a nice discussion of this relatively rare occurrence at …
This site contains a summary of the 2007 Spring EDTNA/ERCA Journal Club … for those who do not know, EDTNA stands for the European Dialysis and Transplant Nurses Association/European Renal Care Association … where the topic was:
Guarding against hidden hemolysis during dialysis: An overview.
The conclusion of the discussion summary reads as follows (= direct quotation)
[B]Significant hemolysis is a very rare problem in modern day dialysis, however, when it does occur the results are often extremely serious. As well as the classical hemolysis, presenting as strangely coloured or translucent venous blood and often associated with back-pain, there also exists a level of RBC damage that may be visually hidden from clinical staff.
Of the factors that can cause hemolysis, such as inadequate water treatment (eg: chloramine exposure … my words) and faulty dialysis machines or defective consumables, most are likely to affect more than one patient. It is therefore vital that clinical staff are aware of the potential risks and use all the tools and information at their disposal.
From the evidence and practical experience presented in the report, and the ensuing discussion, it may be that a single nurse, recognising one or two patients with slightly unusual back pain towards the end of dialysis, could save the entire next patient shift from far more serious consequences. That the nurse may only see this situation once in their entire career puts into perspective how difficult a task it is we are asking them to perform.
To that end all signs of hemolysis must be acted upon, and organisations should have reporting mechanisms to rapidly decide if any action is required.[/B]
I would suggest you read the discussion as several detection ‘methods’ are discussed in the text.