2008K machine

jnette, ASN, EMT-I · Apr 17, 2005

You mean if the GOAL is set for 500 ?

If I don't want to pull ANY fluid off the patient for whatever reason, I would turn the UF off and simply allow the machine to clean the patient's blood.

But even if you didn't want to do that, you could just set the goal for the amount you want to pull off.. which in this case would be your rinseback amount.

If the patient weighs less post tx. this way, it could be any number of things.. the scales might be off just a tad (did they reweigh her again to be sure?) and/or they may have been off just a bit when she weighed in.

O.7 is certainly nothing to be concerned about either way.

It could also be that some fluid is still being removed in the blood cleaning process, or with the use of sodium modeling, etc., not really sure, but I will inquire and see what I can find out.

We allow for a I kilo above/below range post tx.

I don't think you can really hit the weight right on target each time... too many variables.

Did you ask the nurses or Clinical Manager THERE ? What did they tell you?

imperial · Apr 18, 2005

You mean if the GOAL is set for 500 ?
If I don't want to pull ANY fluid off the patient for whatever reason, I would turn the UF off and simply allow the machine to clean the patient's blood.
But even if you didn't want to do that, you could just set the goal for the amount you want to pull off.. which in this case would be your rinseback amount.
If the patient weighs less post tx. this way, it could be any number of things.. the scales might be off just a tad (did they reweigh her again to be sure?) and/or they may have been off just a bit when she weighed in.
O.7 is certainly nothing to be concerned about either way.
It could also be that some fluid is still being removed in the blood cleaning process, or with the use of sodium modeling, etc., not really sure, but I will inquire and see what I can find out.
We allow for a I kilo above/below range post tx.
I don't think you can really hit the weight right on target each time... too many variables.
Did you ask the nurses or Clinical Manager THERE ? What did they tell you?

J'nette: Yes, the clinical manager stated that he did not know why it was .7 less. Yes, the goal or number in the UFR was 500. I tried to find this in the manual (machine) as well as two books but can't.. Again, thx.

Three of our clients got 'ultracare' t shirts.

jnette, ASN, EMT-I · Apr 18, 2005

Imperial.. I asked today myself, as we have a few patients who also often go out a tad less than what we plug them in for.. even if you set their goal at a certain amount, some will go out a bit lower. There is no real explanation other than that some ppl seem to lose fluid more rapidly during their tx. than others, or a bit more fluid, I should say. It has nothing to do with the machines themselves, but rather with the individual and how their body responds to dialysis.

Regardless, it is to be considered a GOOD thing, as this simply means they have fluid there yet to give.. in other words, they are not yet "dry" at their ESTIMATED dry weight. They have more fluid to give up. So if they go out lower than what you set their goal at, then you are pulling fluid that still needs to come off.

Hope that helps.

imperial · Apr 19, 2005

Imperial.. I asked today myself, as we have a few patients who also often go out a tad less than what we plug them in for.. even if you set their goal at a certain amount, some will go out a bit lower. There is no real explanation other than that some ppl seem to lose fluid more rapidly during their tx. than others, or a bit more fluid, I should say. It has nothing to do with the machines themselves, but rather with the individual and how their body responds to dialysis.
Regardless, it is to be considered a GOOD thing, as this simply means they have fluid there yet to give.. in other words, they are not yet "dry" at their ESTIMATED dry weight. They have more fluid to give up. So if they go out lower than what you set their goal at, then you are pulling fluid that still needs to come off.
Hope that helps.

j'nette: thanks.. think it explains. Now, if a patient becomes dizzy and has hypotension after dialysis it could mean too much fluid taken off. So, let me make sure I am understanding this.... if the patient only has rinseback taken off.. but loses, let's say, .7.. that means that there was additional fluid to be taken off. I guess the part that is confusing to me is how the machine tells that it is not too much. I am always interested in the rationale/mechanics, etc. thks.. today.. this particular patient entered and left .1 under and 500 was goal including rinseback.. so, guess only .1 needed to be taken off... One patient told me that she was told she might continue to urinate for the remainder of treatment. She is in similar situation with fluid goal, etc.. again, thanks.

ageless · Apr 20, 2005

Hello all:
WOndering if you can answer this question. I have read all I can and can't seem to find the answer. (two books and research online)
If the UFR is set for, as example, only 500 (including rinseback) and patient does not have fluid taken off, but after dialysis is .7 under pre weight, what is cause? Also, if UFR were 500 (400 rinseback) 100 fluid removal and patient left at .7 under what would cause be.
Thanks. I

Do you know what the patient weighed before treatment?

If the patient came in .6 under their dry weight to begin with, then the -0.1 plus the -O.6 would explain the -0.7.

J.B. · Apr 26, 2005

I think that fluid removal is not exact as there are so many other factors that can influence how much is removed.

the size of the artificial kidney and its co-efficient and the patients venous pressure can alter the amount of fluid removed. this is especially noticable if you are only trying to remove small amounts but have a large 'kidney'.

if the patient is symptomatic post dialysis then they should be weighed prior to disconnecting and then more fluid can be given. if they are not symptomatic then their dry weight needs evaluating.

imperial · Apr 29, 2005

Thanks J.B. that would make sense. I believe this patient has a 180 size dialyzer, is that what you mean? How does the venous pressure actually cause change in amount removed. thanks. tried to look up in various books to find out but could not find. thx.