venous pressure.....

[tyefly]

Ok   for the third day in a row..... I had to quit my treatment because of very high venous pressure..... what is going on...... 400 or better.....   even when I slow the speed down the pressure reduce alittle but back up....  having alarm 30.... today it happened with in 20 min of starting treatment...yesterday I had to stop in a hour.... I called nxstage and they suggested that I put a syring on a pull out blood in my venous.... no problem....  came out easy and went in easy......   I even increased my heparin use today  up from 3000 to 4000..... 
  I am worried.....   I have had a good treatment in three days....    is there something wrong with the machine...or my fistula.....  do I need more heparin.....     do I need a angiogram.....   am I going to get one of the neck hook ups.....( I have never had one of those )     

   Ok   Yes I am a little scared......  after all     this is my life line......   I hate the unknown.....

[BigSky]

Could be a stenosis starting in your fistula with pressures that high.

Also part of the problem can be that Nx Stage seems to have a problem in measuring pressure IMO, but again with pressures that high I would be weary of stenosis


On Cobe and Phoenix machines my venous is 220-230 running at a blood flow of 450 and blood pump speed set at 500.

Nx Stage venous is 250 with a blood speed of 400. 



I might add,  you most likely will not need a neck or chest cath if they do a fistulagram unless they damage it.  Usually they can do a fistulagram in an hour or so and then one can dialyze immediately afterword.

[Rerun]

Gosh, if you called NxStage didn't they have any answers??

             

[greg10]

Gosh, if you called NxStage didn't they have any answers??
             

NxStage will give you answers to the workings of the dialysis cycler and dialysate.  They will not be able to answer too much about the state of the patient and their access.

Unfortunately, an access that is not working well will cause a venous side high pressure.  This could be due to clots or cannulation.  Have you called your local dialysis center that trained you on NxStage and ask then about your potential access problem?  I find that they are usually the ones with the answers that can help to get your access working properly. 

[tyefly]

Yes called nxstage.....   they had me unhook and place a syring and pull blood.... I did not have any problems with that.... hooked up again ....and  U 400 to 500.      I had those pressures even at Blood speed 250....  Nxstage told me to quit  and contact my center......   so thats what I did.... 

     I will call them in the morning......

[tyefly]

So I am going in for a angiogram...fistualgram..what ever its called.....    My center told me that its probably the cartridge that I am using....  which I am using the 171B.....   in prep for extended ( when ever they can find the time to get the heparin pump)....  The clinic told me that they have never used this cartridge with anyone and so they think that it may be the problem ... they told me to switch back to the reg cartridge......  and that since that cartridge causes high venous pressure that I might not be able to do the extended..... 

Hey   any of you that do extended have problems with their cartridges.....    ( I personally dont think this is the problems... but I am not the expert....  but is my clinic....)

well lets see what the fistulagram test show..... go from there.....   I HATE  Dialysis..........

[greg10]

So I am going in for a angiogram...fistualgram..what ever its called.....    My center told me that its probably the cartridge that I am using....  which I am using the 171B..... ..........

You don't have an extra 170B around that you can try for one treatment?  I doubt that is the reason because the accompanying 170B document describes the 171B as well, the only difference I could see was the extra T line for the syringe pump.

We have not tried the 171B.

[tyefly]

Had the fistulagram.....   they infiltrated me    and so they couldnt do very much testing...... Gee I havnt even sone that to my self yet.....  Doc said   that I sould be just fine..... just make sure when I dialysis next time make sure my arm does not move and keep it in a downward motion ...  just make sure I dont move it at all during the run......         oh  Yea   ...........thats what I am going to do .....sure I am ...... 
 I did run successfully with the 170 cartridge....going to try the 171 again .....   I cant believe its the cartridge...

[Bruno]

Maybe your blood pump speeds are too high.