PD cyclers-Low drain volume alarm


#1

My husband is a new user with the Baxter cycler and it seems to alarm all night long. It alarms with the Low Drain Volume notice. When he is on manual PD during the day he always gets 200-300mls off more than he puts in. At night with the cycler this is not the case. He can never reach the required drain volume. We have tried lowering the machine and having him sleep more upright than prone and nothing seems to work. Does anyone have any suggestions? The unit is going out the window soon!!!


#2

Have you talked with your home training nurse about the alarms? Some things you might want to discuss include:
– How many alarms you’re getting every night (record it)?
– What was your husband’s sleeping position when the alarm sounded?
– How much higher/lower than the bed surface is your cycler?
– Is the line was crimped in any way (is he lying on the outflow line)?

Since the drain works well during the day, it seems to either have something to do with the machine and its settings or it’s a problem related to his sleeping position or the location of the cycler in relation to him.


#3

Talk w/the PD nurse - the drain volume on the machine can be changed to where you won’t be getting so many alarms. I’ve had the same problems myself & we finally changed my drain volume all the way to zero - thus no alarms unless I’m laying or kinking the line in some way. This is VERY easy to do - and your nurse can walk you through the process over the phone.


#4

I have been having the same problem with too many alarms. What is the ideal position of the cycler to the patient, higher or lower? Should there be NO tangles or lines on the floor? Currently, the Baxter HomeChoice model is on a table the hieght of the bed a yard away, so the lines lie on the floor on the way to the bed. The drain lines lie on the floor all the way to the bathroom sink in the next room.

What is the best solution to stop the alarms, as the nurse has given suggestions that have not succeeded consistenetly.


#5

Call Baxter and complain. They will most likely send you another machine.
I had the same problem and got a new machine.


#6

Please call you PD nurse. A little HEPRIN might help. Have you checked the drain bags for “FLOATIES”. These tiny little bits of omentum can clog the lines causing alarms and sometime it’s as simple as adding a Heprin to the bags.

We do have a Baxter cycler, we have a Fresenius cycler. I am sure they are much the same so call your PD nurse about the alarms, I know they can make for LONG nights. Best of luck.


#7

My husband had to have his catheter “revisioned” twice and that finally helped. The first revision was to stitch down the catheter within the pelvic and the second time was to create a new exit sight because he was leaking at the original sight after the first revision. Now the only time the alarm goes off is when the machine is on “drain” and he is lying on his right side. Once he turns over, everything is OK.


#8

I get a Low drain volume alarm in only 1 of 5 cycles and about 2 times a week. Other times everythings fine. I take Colace everyday to move my bowels and in any case, this alarm seems to happen only on one cycle (usually the last one - but I have seen it happen on other cycles as well). The PD nurse and nephrologist are puzzled as well. When this happens, I move around like crazy: turning left/right, stand up, walk around, almost stand on my head (inverted arch) - but still it continues.

Any ideas as to what could be causing this? Is this something wrong with the machine?

Thanks
-hpa


#9

This happens to me perhaps once a night, but I can usually overcome it with a new position and with a few moments of “pinching” the catheter a bit to cause things to flow. I have not seen any signs of fiberin for many months, so I don’t think that is a cause. The machine (for Baxter models anyway) really only has about 3 PSI of drain pressure. The machine seem to have some sort of fuzzy logic in it, it will pump/drain aggressively for a period of time then seems to go into a more relaxed drain scheme, finishing up with another aggressively drain cycle when done.


#10

How can you set the drain volume to zero??? Is that just for that one cycle? Eventually you have to drain that fluid. My husband has at least one drain alarm a night, sometimes 3 or more. I had to move to the guest room to get any sleep. He’s had his catheter removed and replaced laproscopically to make sure its positioned correctly and the same thing is happening. Its quite frustrating but we’ve become resigned to it.


#11

That DOES sound frustrating! To make sure that you haven’t missed anything that could be done to help, you might want to post this question to Judith Bernardini, our Expert PD nurse. You can do that here: http://forums.homedialysis.org/forumdisplay.php/18-Judith-Bernardini-PD-Nurse.


#12

Thanks Dori. We saw the PD nurse here today and she said that its hard to diagnose because there is no pattern to it. She looked at his IQ card records too. ITs different each night and no one position makes it better consistently. She suggested that he switch from the Fresenius Newton IQ to the Liberty which actually pumps out the drain. Heparin doesn’t seem to help either so its not fibrin. I may ask Judith, thanks. We’re snowbirds and when we get back north soon, we might try that Liberty cycler.


#13

My husband started with the Liberty Cycler the first week in May. He has 3 -4 alarms a night during the drain. So we are all sleep deprived. The PD nurse wasn’t any help because she is new, and I called the company, and they referred me back to the PD nurse to change from treatment to cycle based.

I haven’t spoken with her yet, but I envision little help. Unless you are living with an alarm that goes off all the time, you have little sympathy for the patient and spouse.


#14

Hi Cheryl, You may also want to post your question to Judith, as I suggested for someone else in this thread. Being short on sleep is not not good for your health or your temper! It’s important to get good rest, and finding answers can help you do that. Another option may be to see if your PD nurse has someone else to call on to help her learn the ropes–or to see if there is another clinic near you that offers PD and that your health plan will pay for. We have an article here that you may find helpful about choosing a home dialysis clinic: http://www.homedialysis.org/resources/tom/200904/. About 40% of the dialysis clinics in the US offer PD, so most towns, even small ones, may have more than one.


#15

I wonder if you had an answer to LOW DRAIN. I used the cycler but I had to stop it because of this problem. I am doing the tween bags.


#16

Hi my name is Bj and I am a PD nurse; I’m only familiar with the Baxter cycler.
One thing that really helps my patients is when they position the cycler six to twelve inch above their abdomen… this was a miracle for one of my patients that had been going crazy with alarms. Yes, the machine can be programmed to zero but this is only for the first drain. It assumes you are going on dry or have reabsorbed the fluid (dehydrated?). The subsequent drains will go for 85% of the fill volume but this too can be lowered with great caution to prevent overfilling. Hope this helps!


#17

Thank you so much for posting this, BJ! As you can see, this thread started in 2007, and folks have been posting to it for 5 years, so the topic is still relevant. We really appreciate your expertise. :slight_smile:


#18

Low drain alarms

Hi I had a lot of low drain alarms and it turned out it was the low charge of the battery on the machine. Did you know a low battery charge on your machine can help cause low drain alarms? Keep machine plugged into a heavy duty surge protector during the day. DO NOT UNPLUG. Keep the surge protector on but the machine turned off during the day. The machine remains in the surge protector and is charged all day then at night I have no low drain alarms. Hope this helps someone :grinning:


#19

I’ve never heard of a low battery charge causing the low volume alarm. It seems like if the machine is plugged in at all times, the battery would stay charged.

Here’s information on alarm troubleshooting for the Baxter cycler that lists common reasons for a low volume alarm and what to do to troubleshoot it…

Here’s Fresenius’ Handi-Guide that answers a number of patient questions about the Liberty cycler. This document says to plug that cycler into the wall and not into a surge protector.

What PD cycler are you using?