Low volume drain alarms

Husband has been on cycler, first on the one with the card and the second one without. With each one, the first couple of nights went well, but on succeeding nights, there were more alarms. He has tried changing positions without getting out of bed, but the only thing that seems to work is if he sits up or stands up. The PD nurse ordered abdominal x-ray which showed catheter to be in correct position. He is not constipated as I have seen other people note. He has decided to stay on the cycler no matter what as he disliked the 4 times a day exchanges. Would appreciate any other suggestions. Thanks.

Interesting problem. I don’t know why he was changed from cycler with card to one without, but the one with the card would have been most helpful in determining the problem with the alarms. I am assuming the alarms occur during drain. Since we know that the catheter is in the correct position from the xray, we know it has not “flipped” up in the abdomen but that the lower portion is in the area called the true pelvis. And you say he is not constipated—this is the most common cause of poor drains. It might be important to note that even though many patients say they are not constipated, they actually are. I would recommend several days of laxatives to see if it has any effect on drains because the fact that he only drains when sitting or standing indicates the problem is positional. I do not know how much residual fluid is in the abdomen when his alarms occur, but one remedy is to reset the cycler prescription for “tidal” dialysis. The nurse can do this for you. This therapy does not require a full drain but allows a residual amount (prescribed) to remain, usually just a few hundred cc’s. It usually does not affect the efficiency of the dialysis significantly but may eliminate the alarms. Since you no longer have a card in your cycler, the nurse could determine the amount of residual for you by running a cycle in the clinic and seeing how much fluid has drained when the alarm occurs. If neither of these suggestions works, let me know.

I have been on Baxters Homechoice machine for just over 2 weeks and have had the same problm with low drain volume alarms. I have seen no real answer to this problem on any web site, so maybe there isn’t a simple answer. I change position, get up, walk around and eventually the machine sorts itself out. Is there anyone out there with an answer

Your alarm limits are set too low, or you need to go into a Tidal therapy. If you have repositioned yourself and tried everything else, you need to log what the drain volume is when the machine alarms. Do this for a few days. You’ll then be able to reset your alarm limits, or change therapy to what suits you. Truly, your nurse should really be looking at this for you and helping you out.

I agree with the previous response that you probably need to go to Tidal prescription which allows a small volume in the peritoneum at all times. Your nurse can change the prescription for you. Also, be sure you are not constipated as that will interfere with drains. Hope this works,
Judy Bernardini

I had the same problem since starting with the cycler - it seemed I would only drain properly if I was sitting or standing. I lost so much sleep setting my alarm to wake me every hour and a half I almost went crazy…and no I wasn’t constipated (I take Miralax every day). I had set up my cycler too high above my bed. Your table top or whatever you use for your cycler should be level with your mattress. Mine was about 20" above my bed - I had just bought a microwave cart to use without any regard to its height. After lowering my machine I drain just fine laying down. Was upsetat my clinic for not solving this year long problem - I figured it out myself but it they had done a home visit when I received my cycler (like they did when I started manuals) they probably would have noticed that I didn’t set up the cycler properly…

Make sure your Baxter pdu machine, is the same height from the floor as you. Gravity plays a large part in the drainage.

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