Our unit will soon be performing aquapheresis for treatment of Heart Failure. It was trialed in our CCU and will be coming to the floor. I was wondering if any other non-critical care units are doing this and how it is going.
Dec 11, '06
I'll be interested to hear, too. I've seen it at some conferences, and it seems pretty cool. The UNLOAD trial results were impressive!
Dec 13, '06
ok so im a new grad any links to the procedure?
Dec 16, '06
It doesn't look very cumbersome; I'd love to see it in action.
Jan 7, '07
We use ultrafiltration at my hospital but not very often. Forget about peripheral access, beeps way too much. In fact it beeps a lot when hooked up to a central line as well. All the ultrafiltration central line caths are inserted at the bedside and I have seen one too many get infected. Does an excellent job of fluid removal but can be cumbersome, and it's one o those things you dread having a pt with.
The set-up is a PIA too. I'm no expert and don't see it very often but My limited experience has not given me a good opinion. Needs a little bit more tweaking.
p.s. also very expensive..........
Last edit by xokelly2 on Jan 7, '07
: Reason: one more thing........
Nov 6, '07
hi, my name is terry and i live in las vegas nv. we are trying to start the aquapheresis procedure here. i am certified for the aquadex equipment. if anybody has a way to get the md's interested let me know. we are having a terrible time convincing the dr's that the procedure works. they are having a difficult time getting away from the usual treatment. leave me a message here
Last edit by sirI on Feb 6, '08
: Reason: TOS
Feb 6, '08
[FONT=Lucida Console]I work on a Cardiac Stepdown unit and we have all just gone through the training to use the aquadex Flexflow machine to do Aquapheresis. However, so far it's been a week and no Cardiologist has been talked into it. Which scares me. If its so wonderful why aren't they jumping at the chance to use it. A Nephrologist told me it will just make patients Uremic and therefore not a good idea. I work nights so I havn't had a chance to ask the cardiologists why they don't want to use it. If anyone hears anything please post it.
Feb 29, '08
Still havn't had a patient get Aquapheresis and I am really wondering why? Does anyone know why doctors aren't using this?
Mar 4, '08
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?
Mar 4, '08
i am glad you let us know about the iv access issues. we are going to start the procedure soon and we will be using the same equipment from the same company. i will talk to my nephrologist and find a answer to your question. we will be doing the procedure on an outpatient basis. our center is in a venous access building, so the interventional nephrologists may have an answer. i will get back to you if i get a solution to the iv access problem:angryfire
Mar 4, '08
Thank you CardiacNurse05 and tbrnbsn for posting on this. They trained all our nurses in Cardiac stepdown back in January 2008. We have the Aquadex machine and the equipment even special easy to use order sheets but so far no doctor will order it. I wondering about that IV access, when you do dialysis you use huge av grafts, fistulas or Udalls, etc. all with huge lumens. But you can do aquapheresis with what is it, an 18g??- now I even forgot what gauge it is.
Last edit by Miami NightNurse on Mar 5, '08
Mar 5, '08
i have not done the procedure yet, but the company i work for uses pheresis needles. i think that they are 18 gauge. i have a meeting with some interventional nephrologists and the md who has done alot of aquapheresis this month. i will find out about iv access and get back to you all.