I have worked in a very successful home hemo dialysis program for several years. We are exploring the option of nocturnal dialysis and am wondering about the basics: dialysate flow rate, blood flow rate, length of treatment, monitoring during, etc. We use the Baxter 1550 machine currently. I’d appreciate any feedback available.
I suggest that you consider starting by looking in the “Find a center” database for a nocturnal home hemo program near you (or check out our new maps), and then contact the nurse manager at that clinic to ask some questions. From what we’ve seen, folks who are running these programs seem very willing to help others get started.
I am the Chief tech at a FMC unit and we offer noc dialysis for both home and in-center. The flows are dropped down as low as 400 ml/min and the pt runs for 8 hrs. You will want to run labs on the pt after their first 8 hr run to make sure theie K is stable. We complete their first 8hr in clinic where they can be monitored.
Im currently on noturnal doing 10hrs every second night, or 4 nights a week if I feel up to it. Dialysate flow runs at 500, pump speed 225 (initially was on 200). We do our first 2 nights in centre at 9.5hrs each night. Several bloods are taken before, after, and during treatment. Blood pressure, temperature, and weight are all done before hooking up. Once on the machine, BP is checked, as well as the usual machine obs to make sure everything is ok. If things are ok, you are right to go to sleep. BP, temp, and weight are again done post Dx.
It is important to know your dry weight, and do your calculations correctly. This way, you shouldnt go “flat” whilst on the machine. We are not to do a UF rate of any more than 400ml/hr, to ensure fluid is not being moved too quickly.
Hope this has answered some of your questions
I run at Dialysate flow rate of 300ml/min for around 8 hours 15 mins, any more and my Part A runs out. Blood pump 225-250ml/min. I am currently doing 3-4 nights per week but can do more if my blood teasts start to not look so terrific and I can stand doing any more nights attached to a washing machine!! 8)
All of those combined heather! It basically means when your BP goes very low and you may pass out if not caught quickly. General signs are cramps, nausea, dizzyness, and of course, low BP. As soon as you get some saline into you, you should feel right again.
beachy, we use a 10 ltr container to pour the dialysate into. And the 950g bi bag. Con does 8 -8.5 hours.
Now, with this new bicarbonate fluid. Apparently they are coming in 5ltr containers which last 3 hours each. So that will be 3 changes a night.
The manufacturer say’s it cant be decantered ( put in larger container) like the dialysate is. Because of a bacterial issue. But, the head clinic nurse says it can. Have you heard anything about this?
well I won’t be taking the risk. I will get up and change the bottles for my husband. I guess i will get use to it. We have 5 months supply of bibags left. So I don’t have to worry until then.
Nooooooo Queenie, dont make yourself get up, you need your rest just as much as he does. I dont mean to sound harsh, but I think the person on dialysis should be playing an active roll in their health care. Of course if they are very ill then thats different. Its not hard to get up with needles in, you are aloud to move! But if you want to do it, well thats ok, thats just my opinion. I hate things being done for me, well I mean I like it, but I feel bad about it.
thanks Amba, but really I want to do it for him. He does move around with the needles in. rolls over the time.
how we do things is.
I set up the machine, while he cannulates and then he connects himself. Then, hops into bed then I hop into bed. When coming off I get up, set up his stuff 6 mins before the machine goes off. while he removes all the tape, I remove his needles he holds them off. I clean up the machine while he weighs in, bp check, temp check. then we both hop back into bed until the machine is finished the disinfect cycle. its a good system
Amba, Con also feels bad when I do things, but I chose to do them. We have been together for like 26 years now. So, it is part and parcel of our friendship to help each othe. Actually Amba I am like you, I feel bad and never ask for help for myself.
Awww thats sweet Queenie. Sounds like you have a good system going on there. Deep down I would love someone to help me, but my family arent close and my fiance does shift work, so when Im setting up or coming off the machine, he is either at work, or in bed after working late.
He hasnt done any of the training either, so that makes it hard. He carries all my boxes in, and cuts up all the empty boxes, so he is at least doing something. Not to mention he also drives me around whenever I need it as I dont drive. One time I got him to take one of my needles out as for some reason I couldnt get it out, and as he had no experience, he kind of freaked, and pulled it out too slow. Thus resulting in a bleed and big hematoma and calling the ambulance :?
He is younger than me, and at that age where I guess he doesnt really understand how I feel. Most of his family dont understand.
I just really want a successful transplant, so I dont have to stress about any of this dialysis stuff.
Queenie, you would of got married when I was born, Im 26, 27 this sunday Or as we like to say 21+6 lol
[QUOTE=R. Wilson,RN;1671]I have worked in a very successful home hemo dialysis program for several years. We are exploring the option of nocturnal dialysis and am wondering about the basics: dialysate flow rate, blood flow rate, length of treatment, monitoring during, etc. We use the Baxter 1550 machine currently. I’d appreciate any feedback available.