Single needle better for Nocturnal/Extended

[Dannyboy]

I've been moving toward extended/nocturnal for some time, but haven't made the jump.
I posted under "News Articles" a press release from NxStage about getting FDA approval for a single-needle system.


I know that single needle is not a new technology, just new to NxStage's needle-making subsidiary MediSystems.
I'm wondering if this is a step toward getting FDA "on-label" ok for nocturnal??   [as opposed to current need for Neph to write scrip 'off label']
Just *pure* speculation on my part.

[noahvale]

^

[Simon Dog]

In a single needle system, the blood is obviously flowing only in or out at one time.   It would be reasonable to assume that this would be more practical with the longer times of nocturnal, but it's hard to imagine any reason why it would be "better" (other than fewer fistual sticks).

The single needle systems I have read about run an arterial and venous line to the needle and connect with a "Y".  This is done so that when the blood reverses direction, the amount that is in the line between the needle and the bifurcation into arterial or venous is minimal.

Ever notice how the Fresenius 2008 machines have four "modules" that are replaceable.  In a typical configration, one of these is a dummy module (it holds one of the pressure chambers), and one is for the blood pump.    These machines can support single needle, however, in order to do so, the dummy module must be replaced with a second blood pump module.

I doubt that the cost of a single needle per treatment is the driving factor.  I believe in the "follow the money" approach to analyzing just about anything, and in this case, I suspect the motivation is one more technique to try to grab market share.