Hemo RN
Joined: 24 Feb 2003
Posts: 17
Posted: Tue Nov 04, 2003 4:02 am Post subject: Reuse vs Dry Pack
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Original Article <
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>Reduction of circulating microemboli in the subclavian vein of patients undergoing haemodialysis using pre-filled instead of dry dialysers <
>Dirk W. Droste1,2, Torsten Beyna1, Bernhard Frye3, Volker Schulte1, E. Bernd Ringelstein1 and Roland M. Schaefer4 <
>1Department of Neurology, University of M?nster, Germany, 2Department of Neurology, Centre Hospitalier de Luxembourg, Luxembourg, 3Dialysezentrum Praxisklinik Haus Sentmaring, M?nster and 4Department of Medicine D, University of M?nster, Germany <
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>Correspondence and offprint requests to: PD Dr Dirk W. Droste, Service de Neurologie, Centre Hospitalier de Luxembourg, 4 rue Barbl?, L-1210 Luxembourg, Luxembourg. Email: droste2@uni-muenster.de <
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>Background. Chronic microembolization that can be demonstrated by pulsed Doppler ultrasound may give rise to pulmonary side-effects during haemodialysis by direct vessel obstruction, increased complement activation or platelet aggregation. The objective of the present investigation was to study whether the use of pre-filled instead of dry dialysers would help to minimize the number of microemboli. <
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>Methods. The study cohort consisted of 23 patients undergoing maintenance haemodialysis. Using a 2 MHz pulsed ultrasound device, the subclavian vein downstream to the dialysis fistula was investigated for 10 min during the dialysis session. The ultrasound examination was performed twice during two successive dialysis sessions, using a pre-filled or a dry dialyser in randomized order. <
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>Results. In all patients investigated, numerous microembolic signals (MES) could be observed in the subclavian vein. Treatment with pre-filled dialysers was associated with significantly less MES (82 ? 94) as compared with dry dialysers (268 ? 296; P = 0.002). <
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>Conclusions. In comparison to dry dialysers, the use of pre-filled dialysers leads to a significant reduction in microembolization, which may prevent repeated damage to the pulmonary vasculature and, thus, cause less pulmonary damage. <
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>Key words: dialysis; microemboli; ultrasonography<
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>Copyright ? 2003 by the European Renal Association - European Dialysis and Transplant Association.
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Curious
Joined: 02 Feb 2003
Posts: 39
Posted: Tue Nov 04, 2003 6:37 am Post subject: study
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The study leaves alot to be desired. In my opinion that is 23 patients. What were the condition and age of patients? Investigated for 10 minutes?<
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>Have emailed the researcher and asked questions on the above. I dont personally feel that is a study. More information needs to be gathered. Prefilled with what?
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factual
Joined: 04 Nov 2003
Posts: 1
Posted: Tue Nov 04, 2003 9:37 am Post subject: DUH!!!!
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Let's put on our thinking caps...priming with 2 liters of saline the dialyzer is filled and microembolies are not a problem.
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say what
Joined: 11 Mar 2003
Posts: 29
Posted: Tue Nov 04, 2003 9:49 am Post subject: The dialyizers
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are sterile. Read the package.
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No Reuse
Joined: 04 Nov 2003
Posts: 1
Posted: Tue Nov 04, 2003 11:22 am Post subject: Saline
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The saline used to rinse out the kidneys is also sterile. I'd have to say that we have a pro industry RN posting here. Honey, We choose not to do reuse cause we feel better without that chemical in our blood. Come walk in our shoes for a bit. I hate having the flu!
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Tue Nov 04, 2003 1:35 pm Post subject: dry pack
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only a nut would use a dry pack with out first rinsing out with saline. come use your pea size
ain and give us some credit.
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Coil
Joined: 14 Jan 2003
Posts: 27
Posted: Tue Nov 04, 2003 3:15 pm Post subject: Dailyzers
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I haven't read the whole article, but some dialyzer manufacturer's pack their dialyzer's in sterile water when packaging. Toray does this, and I know some others do, but can't recall names. That might be what the study refers to.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Wed Nov 05, 2003 1:42 am Post subject: Prefilled Dialyzer
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I don't know if this is relative to the subject or not but our unit tried changing patients to prefilled dialyzers and this was the fault we found. Most All of the patients needed to up their heparin to get a decent rinseback. We didn't reuse these.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Thu Nov 06, 2003 12:53 pm Post subject: Huh
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Dialyzers that are properly primed with sterile saline prior to initiation of tx. are not considered "dry". Supposedly the problems occur when not enough saline is run through the dry pack before tx.. Once again, it's user error, and a lack of training and correct procedures being used. Lin.
