Higher Pressures with New 170 Cartridges?

[Black]

We have used 6 of the new cartridges, including the one he's using now, and have noticed pressures are significantly higher than they were with the old 106 -- sometimes 40 to 60 points higher.  Tonight the E (effluent)went over 300 several times, and the V (venous) in the 240's to 270's but no high pressure alarms.  I understood that the high pressure alarm would go off at 300, but maybe I was wrong. 

Also noticed there seems to be more white lines in the filter for the entire runs.  We always have a few, but seems to be more now.

Actually, there was an increase the last time they changed the filter as well.  The filters/cartridges we were using in Feb and part of March were the best.  Both "upgrades" resulted in more air alarms and more white "straws".

After speaking with tech support, we are waiting for a kit and RA numbers to return a couple of the cartridges.

Also the tech said he will request that QA look at the numbers they get on the nightly scan and compare them.

He also said that if we do get any high pressure alarms, lower the blood speed and restart.  We had tried that a few nights ago and we had to lower the speed to 460, down from 500, in order to get the numbers down to where they had been with the old 106 cartridge.  Since we had not had any alarms, we gradually raised it back to 500, and just watched the numbers closely.

Anyone else having this?

[skyedogrocks]

We still have the old cartridges.  I guess the new ones are supposed to help reduce the amount of air, have you noticed that?

Do you find the Effluent and Venous pressure decreasing as the treatment goes on?  I was told that the pressure settings are different with each person.  Rob's Venous is set to 300, so it won't alarm at that rate.  You can always go in and change the settings yourself if you find the pressures are rising.  What does your dialysis nurse advise?

I'll be curious to see what happens when we get the new cartridges.

[Don]

  Did you mean 170 ? That's what they sent me. I will use my first one tomorrow. What I did notice was "No Connector" came with the cartridge ?  And There currently will be none...... so if you have one save them..........


Don

[Black]

Yep, no MLA lines/warmer and no "Mr Peanut".  We have about 50 of each.  Want some? 

[cev]

We find that sometimes the 170 primes better sometimes it is worse, not sure the difference as to why.  What I did notice is the pressure pod does not prime correctly - when I talked to R nurse about it while discussing one of our infamous CSI moments,  she said to do a "reverse prime".  spike the bag, hang the bag, let the saline drain into the pod then attach the pod and insert the filter into the machine.  This has been working so far.  and those stupid little white sharp cornered things on the venous and arterial lines, not sure what the purpose is.  we cut them off. 
Don what are you referring to the "connectors".  Is it the peanut?  I have not used any,  when/what do you use it for?

[skyedogrocks]

We find that sometimes the 170 primes better sometimes it is worse, not sure the difference as to why.  What I did notice is the pressure pod does not prime correctly - when I talked to R nurse about it while discussing one of our infamous CSI moments,  she said to do a "reverse prime".  spike the bag, hang the bag, let the saline drain into the pod then attach the pod and insert the filter into the machine.  This has been working so far.  and those stupid little white sharp cornered things on the venous and arterial lines, not sure what the purpose is.  we cut them off. 
Don what are you referring to the "connectors".  Is it the peanut?  I have not used any,  when/what do you use it for?

The Pressure Pod doesn't always prime correctly for us either.  Our nurse said to wait until after prime and then attach.  This works for us too.

I don't know what the white things are for either, they annoy me!  We cut them off too.

[Black]

... I don't know what the white things are for either, they annoy me!  We cut them off too.

They are to prevent separation of the lines.  The little screw together fittings were sometimes coming apart and causing the entire carteridge to be contaminated and have to be thrown away.  Yes, they are annoying, but are a cost saving measure, and also could possibly prevent an infection from contamination of loose but still connected lines.

[cev]

Well we finally have our night of high pressures with the 170. R usually runs at 480  1st hr we ran 320 and have been creeping up slowly on the speed.  Now after 2+ hours we are at 420 and 45 min to go.  his weight was good tonight and this should have been a quick easy run but has been difficult and frustrating   aghhhhhhhhhhhhh   I am beginning to hate these filters.  a lot more air then the 160, more white streaks

[skyedogrocks]

I don't understand how this can be due to the cartridge though.  I would think it's all related to the fistula.  Rob has been running fine with the pressures.  Albeit, sometimes he does get a high pressure, but we just do the flip of the needle and that helps it. 

[Don]

Black,
Look at the SPEC Sheet that comes in the box. Did  you change the required settings? I had to change maybe 6 or more.

Don

[Black]

Black,
Look at the SPEC Sheet that comes in the box. Did  you change the required settings? I had to change maybe 6 or more.

Don

What settings?   On page 7 there are "suggested system settings for prime", is that what you mean?  Are they different from the ones suggested for the old cartridges?  If so, how did you learn that you needed to change them?  And who taught you how to change them?  Could it be that there has been a breakdown in communication and training and that is why there has been so many problems with the new ones?   

[Don]

Black,

In my training manual it tells how to access the settings. When I left training they gave me a copy of those settings. Now with the new carts. an informational sheet with settings are there. The front page has "Introducing our new and improved system one cartridge" On page 7 it lists the "System Settings" and the Vlaues for Car-170 and Car 171. I would contact Tech Support with any questions. It's an easy process. I would write your default settings down next to the ones you change.

Don