recirculation studies

[Sharon Niemi]

I am writing procedures for Recirculation Studies for patients with fistuals and grafts. Does anyone have these procedures already written and if so could you pass on to me the particulars of how to and any references you might have. My current research shows two different methods on how to do this. The peripheral stick in conjuntion with the A & V lab draws and the other is utilizing the A & V draws only. I have found conflicting data on when to draw the labs as well as the need to slow the dialysis flow rate down. Any additional information concerning these issues would be particulary helpful to me as well. Thank-you for your help!

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[LPN2RN]

When in doubt, check with DOQI! Here's the link!

http://www.kidney.org/professionals/doqi/doqi/vag12.html

We went with the non-peripheral stick method after years of using it. You will find that your patients appreciate not having to stuck. Also, our clientel, as you have noticed, doesn't have such great venous access! So they are difficult draws! We also use Transonic technology to monitor access issues. Good luck!

[NephRN]

Sharon,

Do you use Crit-lines (In-Line Diagnostics) where you work? They are extremely valuable pieces of equipment when you need to establish a new dry weight or challenge an existing dry weight. They are also invaluable when treating acute or trauma patients. Anyway, they also are invaluable for doing recirc studies very quickly without having to stick the patient, waste any blood, or even send any blood to the lab. The out patient centers in my area don't use them but in the hospital setting, our docs love them and so do our patients! In the past, we followed the recirc protocol that can be found in the ANNA Core Cirriculum. Good Luck!