Haemo Pump Speeds

[Bruno]

"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."
I could not agree more. I did not mean that high pump speeds and short dialysis times are any sort of answer. From what I've seen on this site and my experience at my own centre I believe that longer and slower is the way to go. My plan is 3x7 hour sessions per week. Blood pump Speed? Not sure yet, but probably 250.
Still, there are many who believe the less time on dialysis the better. I see them in my centre and wonder.

[Hazmat35]

"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."
I could not agree more. I did not mean that high pump speeds and short dialysis times are any sort of answer. From what I've seen on this site and my experience at my own centre I believe that longer and slower is the way to go. My plan is 3x7 hour sessions per week. Blood pump Speed? Not sure yet, but probably 250.
Still, there are many who believe the less time on dialysis the better. I see them in my centre and wonder.

HOLY COW, Bruno!  7 hours!  There is no way in the world, that I could do that much.  I'm doing 3 X / 4 hours right now, and after the 3rd hour, I'm about ready to pull them needles out myself.  I'm not a person, that can sit still for that long! 

God Bless you!  Keep up the good work. 

[Bruno]

Reverting to blood pump speed, I maybe did not mention that one way of reacting to low blood pressure is to slow the blood pump speed. Currently, I go 250 for the first 30 minutes the 300 for the next 4 and a half.
I also going to stick to my view that 20 hours per week is the way to go. I'm already doing that. When I went on dialysis I reckoned that the key to success lay not in overcoming my aversion to needles or my loss of control over my life...I thought that what I really had to learn to do was use my hours under dialysis productively and enjoyably...(not sure about that last word). I think I have managed that.
Part of my optimistic outlook is driven by this site and the people I've met.

[Hazmat35]

I am trying to use my time efficiently.  I try to bring work with me, but it is hard with one arm.  I am not a person who can sit still for too long. 

Best of luck to you!

[Zach]

"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."
I could not agree more. I did not mean that high pump speeds and short dialysis times are any sort of answer. From what I've seen on this site and my experience at my own centre I believe that longer and slower is the way to go. My plan is 3x7 hour sessions per week. Blood pump Speed? Not sure yet, but probably 250.
Still, there are many who believe the less time on dialysis the better. I see them in my centre and wonder.

Are you doing in-center nocturnal hemodialysis?
 
 

More hemodialysis = longer, healthier life.

[lillinny]

Hubby just came home in July and they have him at 350.  We were told that the fistula has to 'mature' before going any higher. . .

[Bruno]

"Are you doing in-center nocturnal hemodialysis?"
Zach, I'm doing 4 x 5 hours weekly and in a fortnight I'll be at home doing my own HD. I've looked very carefully at this site and at what happens in my centre which I believe is a world leader in kidney dialysis treatment. I've firmed in my views that pump speed and length of dialysis are important.
So at home I plan to do 3 x 7 hour sessions with a pump speed of 250. This will take place on a Monday, Wednesday and Friday and will give me Tuesday, Thursday and Saturday/Sunday off. At present the sessions will take place in daylight hours but I have the option of doing nocturnal and having 7 days free.
Before I go home we are going to 'road test' a 7 hour session with blood work before and after to make sure I travel OK.
I've had to set up my house so that I am able to do this, and rather than set up in our living room...I've set up in our bedroom so that I have the nocturnal option up my sleeve. I have to take time on considering nocturnal because I have my beloved to think of (we've been together 51 years) and I need to make absolutely sure she's OK with it before I proceed.
The big hurdle for HD is that you have to be prepared to shove two bloody great needles in your arm before each session.
I can't pretend that has not been incredibly difficult for me to overcome. However, for those prepared to go on home HD an excellent on call support service is available.

[thegrammalady]

"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."
I could not agree more. I did not mean that high pump speeds and short dialysis times are any sort of answer. From what I've seen on this site and my experience at my own centre I believe that longer and slower is the way to go. My plan is 3x7 hour sessions per week. Blood pump Speed? Not sure yet, but probably 250.
Still, there are many who believe the less time on dialysis the better. I see them in my centre and wonder.

HOLY COW, Bruno!  7 hours!  There is no way in the world, that I could do that much.  I'm doing 3 X / 4 hours right now, and after the 3rd hour, I'm about ready to pull them needles out myself.  I'm not a person, that can sit still for that long! 

God Bless you!  Keep up the good work.

durations longer than 4 maybe 5 hours is usually done at night. it's called nocturnal. i run 7 hours starting at 7pm. we have one lady running 6 hours starting somewhere between 6 and 6:30.  longer run times at slower speeds = better results. i'm off all blood pressure meds and at present take no biners. my last phos level was 2.9. i haven't cramped in years, yes i said years. i also don't go home, throw up and sleep all day. nocturnal is not muc different than spending an evening at home. watch a little tv and fall asleep. some nocturnal units even have beds.

[Zach]

Way to go, thegrammalady!!

In-center nocturnal hemodialysis,  for 7 or 8 hours, three-times-a-week is a great alternative to doing hemodialysis at home.

Let's hear it for optimal hemodialysis!

[Bruno]

"In-center nocturnal hemodialysis,  for 7 or 8 hours, three-times-a-week is a great alternative to doing hemodialysis at home."

Surely home HD is not confined to daylight hours. The major benefit is its flexibility. The difference between home HD and centre based HD is that at home you have to do the dialysis yourself including cannulation and fluid removal goals.
Perhaps we are talking about two different systems. I'm based in Sydney.

[Zach]

Perhaps we are talking about two different systems. I'm based in Sydney.

Same system, just another option.

At home or in-center.  Day or night.

[carson]

At home I do 300 pump speed, 300 dialysate flow but the odd time I've had to go in-centre they've set it up with 300 pump and 800 dialysate over 4 hours. No needles thus far!!

[Bajanne]

My pump speeds used to be between 300 and 400.  Haven't checked them recently

[RenalSurvivorDotCA]

I run 350-400 depending on the needle stick. Some pokes aren't as optimal as other times. When I get it perfectly centered in the graft i can get a full 400 blood flow from 15guage steel needles. Dialysate flow is 800.

[Ken Shelmerdine]

Nocturnal Dialysis sounds great but you have to keep your needled arm still  so that means having to sleep just lying in one position all night which would be impossible for me. Also I think the constant hum and glugging and sloshing sound of a Haemo Machine would keep me awake.

[Bruno]

Well, I've changed all my ideas now I'm home. I run on a pump speed of 300 and I try and keep my UF rate under 400...my ideal would be 300 to 350 which I usually get. I'm dialysing every second day for 6 hours. Over a fortnight that gives me 7 days on 7 days off. Of course the dialysis doesn't take a day if I get an early start.
My BP is great going on and coming off and I've had no low BP experiences and am hitting my IW every session. I think this is because I generally hit each session with 1.5 litres/kg or less to lose.
When I think about all that I said I was 'gonna do' I realise all I did was shoot my mouth off. Sorry people.

[Desert Dancer]

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.

ChickenLittle56, do you mean they insert the needles upside-down, with the backeye on top?

I'm currently running at a blood flow rate of 250 and a dialysate rate of 300; I run 8 hours every other night (24 hours one week, 32 hours the next).  My pressures are usually about -110 on the arterial and 90 on the venous, but I can only keep my arm in one of two positions, neither of them particularly comfortable. The instant I move my arm my arterial pressure shoots up and I've been trying to visualize how I could insert the needle differently to avoid this. I'm using blunts, of course, so I don't think gouging the side of the vein would be an issue.

Has anyone else done this?

[tyefly]

 I was running 430 at home....as my clinic requested.....when I was incenter I was running 350 for three hours.... now I am running 370   and running 4.5 hours......  pressures are much better.... 

[thegrammalady]

Nocturnal Dialysis sounds great but you have to keep your needled arm still  so that means having to sleep just lying in one position all night which would be impossible for me. Also I think the constant hum and glugging and sloshing sound of a Haemo Machine would keep me awake.

on top of the esrd i have asthma. hasn't been too much of a problem recently but for years i slept in a recliner because i couldn't lay down and continue to breath. i haven't found it to be too much of a problem to keep my arm mostly straight. i use a small pillow and stay pretty comfy. you don't have to remain all that still. when i first started dialysis i used to crochet to pass the time.  for the most part i've gotten used to the noise of the machines. our techs and nurses keep pretty much on top of the alarms.

[Bruno]

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.

I'm not too sure I'm getting this right, but I've been taught to 'flip' the needle because it helps you get better pressures, especially on the arterial access. I am using blunts and after shoving the needle in (black dot up) you twist it so that the red dot is up. The needle ends up with the hole in the end facing downwards, if you get what I mean. I can assure you that this trick works from personal experience.