I would like to gather information re priming lines and dialyser with any other solution but Na Cl, Have a patient with strong symptomalogy nausea and vomiting withing the 30 first minutes of dialysis. Could we prime with dextrose 5%? patient is not diabetic.
What makes you think it’s the saline prime itself that is causing the problem? Have you tried flushing with extra saline bags? Some patients are ultrasensitive to the chemicals used to process or reprocess the dialyzer, and using an extra bag or two of saline takes care of the problem for them.
Yes good point it has been done and didnt work, the question is still unanswered, does any body know any contraindications to prime lines and dialyser with Dextrose 5%?
I am not familliar with anyone using D5W for priming the dialyzer and blood set, so I have no data to help you. Neither have I heard of anyone having an allergic reaction to saline, since it is just water and NaCl. I am assuming that your NS does not contain a preservative.
The timing of the symptoms is consistent with a dialyzer reaction, but those reactions most often include chest and back pain. I have a couple of questions:
What type of dialyzers does she use? Are they sterilized by ETO, GAMMA or EBeam? Does her blood pressure drop when dialysis is initiated? Does she receive the saline prime when you initiate dialysis?
I know you are not supposed to answer a question with a question, let alone several, so please accept my apologies.
Don’t prime with D5W, think about it…dextrose is sugar…sugar is sticky…not what you want in tubing that is going to have blood in it. Especially with dialysis where there is already a risk of clotting the system.
Try priming the dialyzer and tubing with an extra bag of saline.