Low Effluent, Venous and Arterial Pressures.

[alrightstill]

As stated in another post, over the weekend I had to swap out machines as I kept getting a 602 alarm.

I noticed it wasn't as easy to "snap & tap" with the new machine on Sunday night.  Meaning, after it was in stage 23. and I went to the tap the lines and dialyzer before hookup - there seemed to be resistance and the little bubbles didn't want to travel as easily as they have in the past up to the saline bag.  (Sorry for not using the correct terminology).   I also noticed the dialyzer seemed to be doing a strong jerking motion when I lifted it up to flip and tap it.

Once on the machine, no matter what blood flow rate, all the pressures stayed extremely low (below 90).   I was able to get thru the treatment fine bypassing only one 22 alarm.

Tonight though, the same thing with the resistance when 'tapping'.. but tonight the pressures were even lower.  Running at BFR of 450 - my V was 52, E 12, and A 13.  Needless to say, I was getting constant 22's that I was unable to bypass, so I just disconnected and plan on calling NXSTAGE in the morning.

My question is - could the new machine be faulty even though its new?  I'm pretty sure its NOT my access causing the problems as the pull & push from both sides of the cath are normal.  I did call my clinic earlier today after the first night, and she said "If your pressures were high then we'd be worried..."  but I can't help be worried anyway.

Any insight or similiar experience would be greatly appreciated.  As always - I'll keep everyone updated with the results. 

[Roadrunner]

Why wait for morning?  NxStage is there 24 hours a day. 

The only time I had low readings like that is when I forgot to take off my husbands tourniquet.  Luckily I figured this out before too long.

When you get a new machine it can be programmed.  Our nurse came and set up all the values.  Perhaps something is at the factory setting and not the right setting for you.

Each box of cartridges has a booklet in it which lists suggested system settings for prime.  See if your machine matches these.  Also check with your center and NxStage if they don't.  You can change the settings by:

• Turn on the Cycler
• When you hear a beep QUICKLY press the treatment (kidney) key
• The 8's will flash twice and then a beep.  You are now in the System Setting mode
• The TOP window displays the setting, the MIDDLE window displays the current value
• Move the top window arrows till you get to the system setting in the booklet, then press the middle buttons to change the value.  The booklet has setting 9 Bolus Rate as the first setting which should be 0.  The next setting is 12 "Blood Side Filter Volume" which should be 110.  Go through the rest of the settings
• When done shut off the cycler to save your changes.

All system settings are in Appendix A in the users guide, but you probably only need the ones for the prime which is the booklet in your cartridge package.

Hope this helps.

Roadrunner

[alrightstill]

Hi Roadrunner.

Thanks for the reply.  I did program the parameters into my machine when I received it - and then I even did a double and triple check (with my nurse on the phone) to verify the correct settings.

The tech this morning originally suggested it was the drain line - because #22 = low eflluent = drain line could be clotted.  So I got on the machine with a new drain line and the problem still persisted.

From here to there and after several trouble shooting attempts (checking for kinks, resetting the access pod)  I'll be getting yet another machine in the morning.  The troubleshooting results werent matching up with what they should - which is why the tech doesn't believe it's my access causing the problem. 

And honestly, I dont think its my access either, as I wasn't experiencing any problems like this with my old machine.  Hopefully, the tech and myself are right.    Wish me luck!

[alrightstill]

Just an update for those following along at home.. (uhhh.. haha). 

Turns out it WAS a faulty machine.  The new (new) machine worked great and my pressures are back to normal.   

[Earlinda]

I had that very same problem with a faulty new machine.  I was throwing 38 alarms and the NxStage tech and I were trying to work thorugh alarms and problems.  One night Eric the tech was on the phone with me and could hear the alarms and said I will have you a new machine tommorrow.  Well that was New Years eve and so far there have been zero alarms with the new new machine.

Earlinda

I think the NxStage Tech Eric is wonderful and owe him for all the help!!!!