Can anyone tell me where I can find information on what are “ideal” arterial and venous pressures? I know this can indicate how fast you can run and how well your fistula/graft is working, however, I can’t find anything on what is a “good” pressure.
home hemo 9/04
LINK: What works best: A review of vascular access monitoring techniques
Try a Google Scholar search for “Monitoring Techniques of Vascular Access” for information besides the above link. Generally you need to look at trends. As far as ideal Venous and Arterial pressures you’d have to look at the pressures at a blood flow of 200 to compare - keeping in mind that the pressure readings vary from machine to machine.
I assume you are really trying to find out how fast to run the blood pump? If that is the question then I think knowing what other people, who use your machine (Fresenius K?), pressures run at Qb 200 would offer some guidance on how good your fistula is but still I’m not sure if you’d be able to predict how your fistula would respond to a given pump speed.
Thanks Bill, what I am looking for is how high I can run the pump speed, how do I know when it is too high?
Right now I run at 300 with AP of -120 to -150 and VP of 130-160. I want to increase speed to 350 in order to get better dialysis but have to convince my center, I’m waiting on permission. I just want to know how high the pressures can go before I might be causing damage. I believe my pressures will increase to around -150/-170 and 170/210 (they tend to go up the first half hour and then decrease to lower levels as the treatment continues).
I have asked my center but don’t quite get a straight answer, simply that my pressures are “fine” but not what would be bad.
Cathy, The machine alarms if the pressure is above 300 so I don’t think you have much to worry about. We use a catheter and dad’s pressure are -200 to -220 arterial 200 venous. It is interesting to note what you see on the screen isn’t exactly what the pressure always is. We are monitored nightly and the center computer shows the pressures they see a constant fluctuation which I don’t see on the machine at home.
Interesting Marty, do you have the home version machine or the in-center version, I have the in-center version 2008K
self home hemo 9/04
I thought the absolute value of the venous pressure should be less than the absolute value of the arterial pressure. My arterial pressure today at Qb 350 was -205 and the venous was about 190, so the absolute values were 205 & 190. I thought the physics involved meant that it should take more force to take the blood from the blood stream (arterial pressure) then it would take to put the blood back in the blood stream (venous pressure). I’ll try to research it.
What are your pressures at Qb 200?
Interesting Bill, my venous is almost always a bit higher than my arterial. I do have both needles inserted with the blood flow and I know some put arterial pointing into the blood flow, don’t know if that makes any difference.
I will have to pay attention to what my pressures are at 200, I’ll have to wait a bit longer to increase to really tell as I will have to wait for all the saline to clear through. I believe though that the arterial is probably around -90 and venous about 110, again higher. I will check for sure tonight and correct this if I am wrong.
And thanks for checking it out for me!!
self home hemo 9/04
Cathy we use the Fresenius 2008H; I was unaware Fresenisus had a home version machine do you know what it is?
I thought the H was the home version. I was told it was very similar to the K but had more screens “talking” you through the set up. I was told it was a bit slower to set up as you had to do things in their order and because of my type A personality they thought I would prefer the non-home model.
Oops, no it is the 2008K At Home. Sorry, thought H stood for Home. There is information on it at the equipment site on this site.
Cathy and Marty: we are training on the 2008H temporarily – but our “mini K” they are calling it – came in this week. it is the machine designed more for home use and we will switch to it as soon as the tech guys get through with it. Hope to be home with it within 3-4 weeks (our trainer will be out of town some so we may get pushed into March). Hey Marty – question about your home set up – I see in your story that you have a movable sink and a movable/adjustable drain. I can’t figure out why. what am I missing?? we are about to have our work down on our room and am wondering if I need that kind of set up – does it give you flexibilty in room or chair arrangement?? please enlighten me! thanks!
Cathy, Michael, Debs husband, and I are using the baby K Fresenus machine. We trained in Scotsdale at Davits. We’re both been on it a little over a month with very good results.
Isn’t there more set up time and tear down time with the baby K as compared to the AKSYS or NxStage? Doesn’t use ultra pure saline? Do you know how many patients are in the program through DaVita in Arizona?
I have the sink in the room because it is a major convenience. With the rinsing and filling the bicarb jug, bleaching that needs to be done it’s a whole lot handier. It also allows me to fill the bicarb jug with RO water and not have to stand there and watch it in case it runs over. The reason it’s movable is so if I have to get back into the closet where the RO is; I can just pick it up and carry it out of the way. The drain line stays in place that isn’t movable. Does the baby K have it’s own RO or is a separate RO or DI tanks
Aksys uses it’s lines, dialyzer up to 30 days, but the machine is on all the time as it’s preparing itself and cleaning disenfecting itself for every treatment but you have to get on once the mcahine is ready…
NxStage takes about 1/2 hour to have ready. There’s no water treatment nor bicarb needed for it. All you need is an electtrical plug and a drain. Schedules are flexible…
Baby K must take a little longer to setup…
Hi Jane, I don’t know much about the ASKY or NxStage except what I’ve read here. It takes me over an hour to get ready and probably close to an hour and a half. I have a RO system and it doesn’t use ultra pure dialysate. Not that I’m aware of anyway. It’s just water from my house ran through the RO system. I don’t know for sure how many people have actually gone home in the Davita program Deb/Michael and I were in. It’s a relatively new program though.
I use the Fresenius 2008K and it takes about 45 minutes from getting supplies to starting dialysis, down from about an hour when I first got home. It uses an RO system that definitely slows things down, waiting til after testing the water to fill the RO and then waiting for it to filll, it probably adds a minimum of 15 minutes.
Cathy, Can you explain what you mean filling the RO?
Oops, sorry, I meant fill the bicarb jug with RO water. We are not supposed to fill it prior to checking the water.