Aquapheresis

So here I am a couple years later to talk about aquapheresis. Myself, I have had 3 experiences with it & only 1 has really worked. What I mean by worked is the IV access. In 1, the extended length catheter worked, but failed in the other 2. We did a triple lumen CVC and it still wouldn't work... The withdrawal & infusion pressures were too high. I like the concept of aquapheresis, but we are seeing so many problems with the functionality of it. We are using the aquadex machine by chf solutions & the IV provided by them. We recently received a new double lumen IV to use with it but haven't tried it out yet. It is a pretty expensive therapy, especially when the equipment doesn't work & I seem to be the only nurse in our hospital that knows how to set up the machine & troubleshooting it. Since my original post I have moved to our CCU & the floor I used to work on doesn't have nurses competent with the machine, requiring the patients to come to CCU. There are definitely alot of issues to work out with this before it will be successful... IV access & competentcy of staff.
We have a nephrologist & cardiologist who would really like to get it up and going. We even have it added to our Heart Failure order sets to get physicians to consider it when we don't see at least a 250 ml diuresis in 2 hours after receiving the first dose of diuretic. I consult with the nephrologist quite often regarding the problems we have with IV access with it. I thought for sure a central line would fix the problem, but not in this case. Not sure how to get around this problem so that we aren't wasting such expensive equipment & supplies. This nephrologist likes to utilize it when we have people come in who have a large amount of fluid to remove (i.e. 50 lbs.)

Does anyone have any comments about IV access issues?