New machine for home heamo in the making, not NXstage, not Quanta...

[JW77]

New kid on the block, or is that kidney..  Oh well


http://outsetmedical.com/tablo/


It looks good.. A few years ago I tested a prototype, which might have been the quanta in the making, I think MORE needs to be put into making heamo portable, compatible and affordable, especially in countries where resources are stretched (UK) and space for housing is short (UK)..

[justagirl2325]

That looks slick.  And the quote "dramatically reduces the time involved in setting up and managing dialysis" well if they could do that, that would be awesome. 

You don't realize until you do home hemo that it's not a 4 hour session, it's 45 minutes to set it up and prime it, 4 hours on, 15 minutes clean up, then you start the disinfection (an hour minimum depending on the type - one type is 6.5 hours) it really adds up.  And that's not even counting the managing of the supplies.

[Simon Dog]

disinfection (an hour minimum depending on the type - one type is 6.5 hours)

Disenfection on the NxStage consists of removing the cartridge/line set (1 minute if you are slow) and wiping down the exterior (takes me one minute because by bleach solution is in another room and I have to go get it).  I find that 5 weekly treatments on NxStage takes me no more time than the 3.5 I was doing on the BabyK because of the reduced setup/teardown time.

Several interesting things about the tablo -

- They are using the buzzwords "high dose dialysis".  I take this to mean you get in-center type URR (>=65%) rather that the lower NxStage URR (goal can be as low as 38% or so; I got 49% on my last labs).

- Real time dialysate preparation using HP inkjet cartridge technology (yes, they licensed it from HP).   Hopefully, it not an RO system that throws away as much waste water as pure water generated.  No need to make a batch in advance, and no option to "revert to bags".

- Fancy setup - you don't unclamp the saline bag to give yourself a bolus of saline, but you type it in on the console.

- Internet integration by default.  This could throw a monkey wrench in the NxStage strategy of charging a monthly fee to use internet connectivity (asking price is $99/month per patient for the Nx2Me software)

- Single patient machine with re-use.  I think you only change the filter and line set every few treatments.  This could dramatically reduce the patient time spent on setup/takedown tasks.

[Vt Big Rig]

Well. I agree with the added time that they do not tell you about with NxStage. Set up , then holding sites, then disinfecting, then "making a batch" for the next day all takes time. Then there is tracking and ordering supplies, and some maintenance on the machine.

But I consider that time I would have to take up driving back and forth to the center if I was not using NxStage.

This article sure does a good job at taking shots at NxStage and hitting all the "buttons" that I would guess some folks do not like about NxStage. Unless I missed it, there is no discussion about weight and portability. I do like the computerization and it seems like everything is at your fingertips better.

I much prefer my NxStage than what I believe in center would be like. Having said that .... any competition in this field HAS TO improve things. I am all for that!!!!

[justagirl2325]

NXstage machine sounds like a dream compared to the one we have (Baxter AK96) and yes, we rotate disinfections of the machine we he comes off 1) heat - 45 minutes, turn it on and let it go 2) clean cart - 120 minutes, you have to be there for the first 10 then you can let it go and 3) integrated - 1.5 hours of which you have to be there for the first half hour, then let it go for an hour, then let it sit for 3 hours minimum and then turn on the rinse for 2 hours. 

[Michael Murphy]

Since this system has been cleared only for in center or hospital use, the big impact is going to be no need for large ro systems to drive dialysis machines.  Hospitals will be able to have dialysis systems that can be rolled to patients rooms, thus eliminating patient transport and the need to ship,semi ambulatory patients to centers with large ro machines.

[kristina]

New kid on the block, or is that kidney..  Oh well


http://outsetmedical.com/tablo/


It looks good.. A few years ago I tested a prototype, which might have been the quanta in the making, I think MORE needs to be put into making heamo portable, compatible and affordable, especially in countries where resources are stretched (UK) and space for housing is short (UK)..

Hello JW77 and many thanks for this useful information, it is very much appreciated.
I do hope very much that your housing-problem has been sorted out ?
Best wishes and kind regards from Kristina.

[JW77]

I'm quite excited about any progress.  I use a Gambro AK96 (company now owned by baxter)

My biggest problem in my life is NOT being able to move from my parents house due to lack of space in the area I wish to visit.  My partner is willing to assist me, BUT I'd need some time training on a new machine, and in the meantime I cannot spend more than a weekend with her at her current place.  Her tendency agreement withholds co habitation or I'd have moved in many moons ago..

So anything in the way of progress in smaller, transportable, that works for me.

I'm a bit gutted a missed a recent home dialysis conference in Manchester (UK) but looking forward to listening to the transcripts.. AND the NKF conference is due soon next month (thats National Kidney Federation, UK).

The NXstage to me, doesn't seem truly portable without a car/van... 

On with the quest.