Tablo

I thought it was a home system. Now I'm curious

They are used in their large acute/inpatient unit.  This is Alaska Regional Hospital, part of HCA, one of the nations largest healthcare providers.  I don't know what their other hospitals in HCA are using, but I think it's a good trend.

I have heard that the blood flow only goes to 250 or 300 which is not high enough for conventional dialysis.  I guess it would be OK in a hospital setting or maybe a daily home unit though.

I just looked on their web page.  QB-400. QD 300 circuit volume 140 ml.  I have no personal experience with the system, but it seems to be gaining in popularity.

yes its true hospitals are doing like everyone else and trying to cut cost. I know they are also appearing in Florida

Here is my comparison between Tablo and Braun machines.  I am currently using Tablo, and previously used Braun.

Tabo: Hate that they do not have a heparin pump.  Can't manually fix air bubble problems. Spends a lot of time in bypass without letting you know why, so we can't fix the problem. Hate that the once weekly chemical clean takes 10hrs, so one has to plan accordingly. Hate that a quick chem which we usually run if unknow hep b status takes an hour, and we can't just set it and leave. 

Love that Tablo's are so easy to setup. Everything from setup to cultures to cleaning is automated with step by step instructions. Love that the water filtration is in this one compact machine, no need to drag around a separate water system. Love that I no longer have to mix citrix to clean machine with. Love that the machine takes care of saline, so you don't have to remember to clamp saline at start of treatment like on the Brauns so you don't give the pt the whole bag. Love that the max BFR is 400, and max DFR 300 which gives fewer alarms than when running faster.  Pt's blood gets cleaned properly on those settings d/t 85 percent saturation rate in the filter (if I remember correctly). Like the automatic saline flushes. Can set it to q 30 min etc., and 50ml Q 30, or 100 ml q 15.  Whatever is needed to avoid clotting. Drawback is that it can go into long bypass modes, up to 5 minutes.

Some things I miss about the Braun is of course the heparin pump.  If there is a problem with air in the lines, one can easily fix that through drawing air from the bubble chambers.  Felt like I had more control on fixing things on the Braun. Shorter cleaning time on the Braun.

Thank you.  Great education

I met a home pt that used tablo. Says he went through 3 machines in <1yr because of issues (he didn't cause, the machines were new, and did have mfg issues per documentation). He is now using NextStage for 8 mos and says there have been no problems. I know that doesn't relate to hospital use, but does lend to general use

We're currently using Tablo here at the VAMC (Southeast). It was introduced to us 2 years ago however we still mostly use Fresenius T machines. It has a positive side to it because it's small and we can drag it from places to places (ie ICU) without pushing another big RO machine (for Fresenius T). The convenience doesn't compensate for its many downsides. We were told that it's mostly designed for home HD use and be design it wiser for home use but not for ICHD or hospital use. To make a long story short -- we don't like it!

I know this is an older thread, but any updates on pros/cons of Tablo? Looking at a Dialysis Program Manager position at a small rehab hospital.  They are currently using Fresenius, but will be going to Tablo when the FMC contract runs out. 

Duncan6 said:

I know this is an older thread, but any updates on pros/cons of Tablo? Looking at a Dialysis Program Manager position at a small rehab hospital.  They are currently using Fresenius, but will be going to Tablo when the FMC contract runs out. 

Pros:

Using jugs for acid and bicarb

RO in same machine

Small machine - R2D2 style

Cons:

Too many to mention. 

@intergrativenurse   Thanks for the info.  The concept looks really cool, but I definitely have some concerns.