High Arterial Pressure.

[vcarmody]

My husband and I are still new to this whole Nxstage thing.  We had a problem today they I could not seem to fix and I am hoping someone here can help me if it happens again.  We just stated using new cartridges lot #0047707 and so far we have had a problem every treatment. The first one we used we got alarm code 86 after following all the instruction in the book we got it again and had to replace the cartridge.  Every other one so far we have had high arterial pressure, not to high but high enough to alarm and make us lower our blood flow which we normally do at 450, we have had to stay at 440. Today we were able to get to 450 no problem and his arterial pressure was under 200, then about 45 minutes into treatment it went up to about 230. I repositioned the needle a few times even flipped it but we still were getting high pressure.  Then I reset the pressure pod (my first time doing this)  his pressure was still high, but I realized I did it wrong and attached to monitoring line before I hit treatment, so I did it again, this time correctly.  then his pressure was only like 30 and the access pressure pod was full of saline and not blood, I am not sure what I did wrong, but I knew something was not right so I reset it again.  Pressure pod was full of blood but his pressure was still high so I just did a manual rinse back.  I'm hoping someone here can tell me if there was anything else I could have done, or if you have any suggestions?  Any input would be appreciated.   

[silverhead]

I would definitely talk to the NxStage techs about this cartridge lot problem, they may be aware of this and can send you a new different lot, I've never run into a 86 code, but looked it up and it sounds like  a cart problem, not something you are doing wrong.  Slowing down to 440 is really insignificant if it cures the pressure problem, heck going down to 400 is fine if it means you can finish the session......
Tom

[vcarmody]

We got an answer to the high pressure.  It seems that my husbands vein has either decided to bend or narrow per the vascular surgeon, he is going to have a fistula gram next week.   I have started a new button hole and so far no more pressure problems.  It was so weird because we would run at say 400 for a while then get and alarm for high pressure, then I would lower it and we would be good for a little while and then the pressure would skyrocket again and again I would lower the pressure and so it went for a whole treatment,  It was almost like his  vein was saying get this damn needle out of here.. LOL
I did call NxStage, the second day I had the problem and they told me it sounded like an access problem to them (the tech from NxStage was shocked that we have been home for 6 months and have never called them for any problems).  The Tech was very helpful which is big relief sense I am still not all that confident when we have a problem.   

[M3Riddler]

My husband and I are still new to this whole Nxstage thing.  We had a problem today they I could not seem to fix and I am hoping someone here can help me if it happens again.  We just stated using new cartridges lot #0047707 and so far we have had a problem every treatment. The first one we used we got alarm code 86 after following all the instruction in the book we got it again and had to replace the cartridge.  Every other one so far we have had high arterial pressure, not to high but high enough to alarm and make us lower our blood flow which we normally do at 450, we have had to stay at 440. Today we were able to get to 450 no problem and his arterial pressure was under 200, then about 45 minutes into treatment it went up to about 230. I repositioned the needle a few times even flipped it but we still were getting high pressure.  Then I reset the pressure pod (my first time doing this)  his pressure was still high, but I realized I did it wrong and attached to monitoring line before I hit treatment, so I did it again, this time correctly.  then his pressure was only like 30 and the access pressure pod was full of saline and not blood, I am not sure what I did wrong, but I knew something was not right so I reset it again.  Pressure pod was full of blood but his pressure was still high so I just did a manual rinse back.  I'm hoping someone here can tell me if there was anything else I could have done, or if you have any suggestions?  Any input would be appreciated.

VCarmody,

We have recieved the 86 alarm a few times. If you receive this alarm at the beginning of prime, just power cycler off and back on.
Also, the cartridge may not be seated correctly in the cycler. Usually the power off/back on works. If you still get alarm, then replace with new cartridge.

[Zog]

Hope the fistulagram went well.  We had those issues and my wife ended up with 4 stents in that kinked cephalic vein before it scarred shut.  She had a basilic vein transposition in June (which is about as rough as fistula surgeries get) and it is working well now.  Hope your fix is simple.

[looneytunes]

VC...we also had arterial pressure problems with lot 47707.  I actually returned a couple of used cartridges to NxStage for them to look at.