It is now possible to do long hemodialysis runs without periodic manual heparin injections with NxStage if an infusion pump for heparin is incorporated into the system. Even though the FDA has not approved any form of home nocturnal hemodialysis, the use of NxStage and an external heparin pump has been documented somewhat in several forums and websites such as:
http://www.nxstageusers.com/videos.htmlhttp://ihatedialysis.com/forum/index.php?topic=12367.0http://www.billpeckham.com/photos/dialysis_photo_archive/heparin_pump.htmlThe pump of choice invariably mentioned is the Medfusion 2010 and 2010i. It is worth mentioning that this particular pump has been involved in the overdosage of propofol in a cancer patient undergoing surgery. The patient "should (had been) deliver(ed) 21 mg of propofol. Instead, the patient actually received 56 mg (2.68 × 21 mg), enough to cause apnea" They noted that "Significant risks can arise when the syringe is not correctly secured within the infusion pump device ... In this case, the infusion pump did not warn of improper syringe placement. The attentive anesthesiologist noted that the syringe pump software had detected the wrong size of syringe."
http://www.anesthesia-analgesia.org/content/102/4/1154.fullThis is probably not unique to the Mefusion syringe pumps. Just something more to watch out if you are contemplating using syringe pumps for nocturnal hemodialysis.
I Hate Dialysis Message Board
Author
