Haemo Pump Speeds

[Ken Shelmerdine]

I'm just curious to know what average the pump speeds are for patients with fistulas. Mine is about 310. If I go any higher the pressure builds and the machine alarms.

[Phil]

In my center the machines are set to never go higher than 300. I usually go at about 250.

[Des]

mine is 300, my pulse rate goes up when it is higher.

[RightSide]

I go between 400 and 450, depending on how well the needles have been placed into my fistula.

But according to the Handbook of Dialysis, the pump speed has only a moderate effect on the effectiveness of dialysis.  Increasing pump speed from 300 to 350 will have little effect.

The size of the dialyzer (artificial kidney), and the length of time of dialysis, are more important.

[YLGuy]

400

[chiefsfan301]

pump speed 450 with flow greater than 2000

[BigSky]

Anywhere between 450-500.

Arterial is around 130  (arterial actually will not even register a pressure until pump is around 220)
Venus is around 200-220

[KICKSTART]

Ken i think its standard practise to run at 300 in the UK .

[Poppylicious]

Ken i think its standard practise to run at 300 in the UK .

I was at dialysis with Blokey last night

(as an aside, it's only the third time I've been and I really admire you all for having to do that three times a week)

and his line was tugging so they decreased the pump speed from 375 to 350 and told him that only those with fistulas (he's still on a chest line) could have pump speeds over 400 (he spent the whole session on a pump speed of 400 on Monday with no problems.)  I know the chap opposite him (with fistula) was on a pump speed of 400+ and he didn't alarm once.

 

[cookie2008]

We run mine between 400 and 450.

[KICKSTART]

Ken i think its standard practise to run at 300 in the UK .

I was at dialysis with Blokey last night

(as an aside, it's only the third time I've been and I really admire you all for having to do that three times a week)

and his line was tugging so they decreased the pump speed from 375 to 350 and told him that only those with fistulas (he's still on a chest line) could have pump speeds over 400 (he spent the whole session on a pump speed of 400 on Monday with no problems.)  I know the chap opposite him (with fistula) was on a pump speed of 400+ and he didn't alarm once.

 

How strange ..no one in our unit goes over 300 , i also have a tunnel line in ! but even fistula's run at 300 ..some less !

[ChickenLittle56]

I normally run at 450 with most PCTs and 500+ with one pct who knows how to tweak the needle so the machine can faster.

[Zach]

With some filters, using a blood pump speed of 500 ml/min is beyond their ability to remove additional toxins.
You may be just spinning your wheels.

Also for best efficiency, the dialysate flow speed should be twice the speed of the blood pump.
Not too many patients are on 1,000 dialysate flows.

 

[ChickenLittle56]

You may have something there Zach, how can someone tell if there is a difference between higher and lower speeds. I was wondering if I can tell from comparing kt/v at different speeds.

[Stoday]

My pump speed is 250, but that's because I'm a beginner and I'm on 17 gauge needles.

I asked my tech about it (Why is my pump speed only 250?) and she said that from next week they'd increase the size of the needles. 

And my duration from 3 hours to 3½.   

Then they'd see about increasing thr rate.

Maybe I should have kept quiet. That Shelmerdine fellow has a lot to answer for.   

 

[cloud393]

I use NxStage and am running at 450.

[Riki]

I run between 380 and 400.. any higher and my hand goes to sleep

[flipperfun]

In my unit in the UK average pump speeds are 400.  I am very small and my pump speed is 350.  I get tingling if it is set higher. 
Have a good bank holiday - Flipper fun

[looneytunes]

Using a fistula and 15g needles, hubby is running at 450 to 500 on the NxStage

[Ken Shelmerdine]

Maybe I should have kept quiet. That Shelmerdine fellow has a lot to answer for.   

 

  Sorry

[Stoday]

Update:

I'm now on 300 using 16g needles for 3½ hours. And I got cramps for the first time for the last hour.

Even so, I forgive Ken. 

[Bruno]

Does depend on your needle gauge but I usually run on 300. Less if my BP is low. My expert adviser (Nurse Liz) says that the idea of Dialysis is to wash your blood as many times as possible in a session and blood pump speed is how this is achieved. That said, there is a limit to what you can tolerate and here at RPA Sydney, that seems to be 300.
I guess, too, that would depend on how many hours you are dialysing. I'm on 20 per week but I'd imagine the less you do the more you might want to speed it up.

[M3Riddler]

Does depend on your needle gauge but I usually run on 300. Less if my BP is low. My expert adviser (Nurse Liz) says that the idea of Dialysis is to wash your blood as many times as possible in a session and blood pump speed is how this is achieved. That said, there is a limit to what you can tolerate and here at RPA Sydney, that seems to be 300.
I guess, too, that would depend on how many hours you are dialysing. I'm on 20 per week but I'd imagine the less you do the more you might want to speed it up.

Bruno,
This is not 100% acurate. running as many cycles of blood through the filter does not necessarily help. Some molecules/toxins such as phosphorus require time to be removed as it takes time to transfer from different compartments of the body So it does not matter how many cycles of blood you process, its also the time on treatment.
Many in-center staff want to cycle as much blood because they have to turn the chair around for another patient. They are not able to let you dialyze  the time needed to remove these molecules.
Also, they try to pull of too much fluid too fast. The boday can only handle a certain amount per hour as also, fluid has to move between compartments to get to the bloodstream. When you pull too much off, it stresses the heart and fistula etc.
Lower blood flowes and longer treatment time is much better for the body than higher blood flows and shorter tratments.

Higher blood flows and shorter treatments is much better for the pocket book of the center as they can turn the chair over to another person waiting.

Also, you may notice that they try to pull as much fluid off as and then the person may feel washed out...what do they do.?  They give them a few hundred cc's of saline thus defeating the purpose of taking the fluid off in the first place.  This is why slow and gentle dialysis is much better. Take the fluid off over a longer period of time and you should not have the washed out feeling.

[Hazmat35]

They just started using 14 gauge needles on my Fistula and increased the flow to 500. 

[ChickenLittle56]

At some clinics they 'flip' the needles. When they do that I can reach speeds of 500>.
They don;t do that at the clinic that I am now because they say the needle tip gauges the side of the vein.