UF Profiling

NephroBSN, BSN, RN · Mar 12, 2006

I'm new to dialysis and work in a clinic w/Fresenius K's that have Na Modelling & UF Profiling available. I've not been able to find much info on the UF profiling, especially which profiles work best for which pts, etc. Is there any good info out there to read? Any advice?
Thanks!

Can't really give you any formal info. I've been in hemo since 1987. I've seen alot of changes. Remember hemo is a relatively new field compared to OB or surgery. All of us are still learning the craft.

Profile 2 is a gradually reducing profile. Start out high and drops down low at the end of the treatment. You can see each of the profiles in that screen as graphs. Many nephrologists limit the hourly take off of fluid and Profile 2 may exceed that amount early in it's use. I use profile 2 for big weight gainers who have high B/P's at the beginning of treatment and tend to drop very low at the end. Say a patient has 7K on and a B/P of 210/120 coming in and I know if I don't profile him and take 2500 off every hour he will drop like a rocket I will use #2. It takes off lots of weight early on and then drops off as the B/P drops off. It might start at like 2800 and go all the way down to 300 by the end of treatment.

Another Profile I use often is #4. It is supposedly for severe cardiac patients. Takes off alot of weight for like half and hour and then drops right down low to rest the heart. It might start at 1200 for a half hour and then drop off to 400 for a half hour and then back up to 1200 and follow a pattern like that.

Sometimes you just have to experiment with them.. But don't go by just one treatment. Try one for several treatments and see if it helps.

The unit I am in now uses all Profile 2 and we don't give hypertonic or Mannitol. Don't even have any in stock that I know of. We just give NS or turn down goal.

2 and 4 are the only one's I've ever used.

worldnurse · Mar 13, 2006

UF modeling is used at my unit.

I do it only for some patients who have problems with "plain" dialysis without any interventions and I don't like seeing old unique orders for it unless it is actually used. There were plenty when I started but I have since removed all but one or two.

I have one patient off who you simply can't pull much fluid the last 1 1/2 hours of the run or the pt will just crash. The first 2 1/2 hours however you can pull as much as you want to, even extreme amounts. So for that patient, UF profile # 1 is a good choice, since that will allow the patient to cruise at a very low rate for the last couple of hours.

Another patient has severe cardiac problems that seems to go in cycles so for that patient we will sometimes try profile 4, although it seems that that pt will simply have a poor run anyway if that is the case.

If a patient comes in with a lot of extra fluid we might also try profile #3 to see if it can help remove some of the fluid overload fast, especially if there is shortness of breath.

I approach UF modeling very much as a team effort, and I always confer with my techs so that they can make suggestions and the treament will be evaluated even if I'm doing something elsewhere. Especially since we do have a couple of patients who does not tolerate UF modeling. UF modeling means raising their rate at some time during their run, either intermittently like profile #4 or at the beginning like 1 or 3 and some pts simply run bettter on an even rate. And if it ain't broke, don't fix it, as they say.

NephroBSN, BSN, RN · Mar 13, 2006

UF modeling is used at my unit.
I do it only for some patients who have problems with "plain" dialysis without any interventions and I don't like seeing old unique orders for it unless it is actually used. There were plenty when I started but I have since removed all but one or two.
I have one patient off who you simply can't pull much fluid the last 1 1/2 hours of the run or the pt will just crash. The first 2 1/2 hours however you can pull as much as you want to, even extreme amounts. So for that patient, UF profile # 1 is a good choice, since that will allow the patient to cruise at a very low rate for the last couple of hours.
Another patient has severe cardiac problems that seems to go in cycles so for that patient we will sometimes try profile 4, although it seems that that pt will simply have a poor run anyway if that is the case.
If a patient comes in with a lot of extra fluid we might also try profile #3 to see if it can help remove some of the fluid overload fast, especially if there is shortness of breath.
I approach UF modeling very much as a team effort, and I always confer with my techs so that they can make suggestions and the treament will be evaluated even if I'm doing something elsewhere. Especially since we do have a couple of patients who does not tolerate UF modeling. UF modeling means raising their rate at some time during their run, either intermittently like profile #4 or at the beginning like 1 or 3 and some pts simply run bettter on an even rate. And if it ain't broke, don't fix it, as they say.

Excuse me but not to confuse newbie's to dialysis let's keep the vernacular consistent.

It's UF PROFILING

and

SODIUM MODELING

NephroBSN, BSN, RN · Mar 13, 2006

UF modeling is used at my unit.
I do it only for some patients who have problems with "plain" dialysis without any interventions and I don't like seeing old unique orders for it unless it is actually used. There were plenty when I started but I have since removed all but one or two.
I have one patient off who you simply can't pull much fluid the last 1 1/2 hours of the run or the pt will just crash. The first 2 1/2 hours however you can pull as much as you want to, even extreme amounts. So for that patient, UF profile # 1 is a good choice, since that will allow the patient to cruise at a very low rate for the last couple of hours.
Another patient has severe cardiac problems that seems to go in cycles so for that patient we will sometimes try profile 4, although it seems that that pt will simply have a poor run anyway if that is the case.
If a patient comes in with a lot of extra fluid we might also try profile #3 to see if it can help remove some of the fluid overload fast, especially if there is shortness of breath.
I approach UF modeling very much as a team effort, and I always confer with my techs so that they can make suggestions and the treament will be evaluated even if I'm doing something elsewhere. Especially since we do have a couple of patients who does not tolerate UF modeling. UF modeling means raising their rate at some time during their run, either intermittently like profile #4 or at the beginning like 1 or 3 and some pts simply run bettter on an even rate. And if it ain't broke, don't fix it, as they say.

Excuse me but not to confuse newbie's to dialysis let's keep the vernacular consistent.

It's UF PROFILING

and

SODIUM MODELING

NephroBSN, BSN, RN · Mar 13, 2006

Excuse me but not to confuse newbie's to dialysis let's keep the vernacular consistent.
It's UF PROFILING
and
SODIUM MODELING
Just so we are all on the same page.
Just my thoughts so there is no confusion.

NephroBSN, BSN, RN · Mar 13, 2006

Excuse me but not to confuse newbie's to dialysis let's keep the vernacular consistent.
It's UF PROFILING
and
SODIUM MODELING
Just so we are all on the same page.
Just my thoughts so there is no confusion.
Oh dear me, I seem to have a heavy thumb.. Didn't mean to post three times.. CSR disease...LOL

SotaRN · Mar 14, 2006

Thanks for the great info! I've been using it more and more & really paying attn to the results, then educating pct's on which pt's do best on profiling...I've been mainly using #2 with mostly good results. We have hypertonic in our clinic but I don't like to use it b/c when I started an MD was raising a huge stink over a nurse that was using it all the time...now that I've learned more, I understand the many negatives to using it. Our PCT's will generally give 200ml NS for cramps & turn UF off then give more NS if no results (policy/procedure!)...many times pts leave only 1kg under what they came in at which is frustrating. Seems much better to set the machine at the beginning & avoid cramping if possible all together. I'd also rather just reduce the goal then turn UF off completely, especially considering we're giving them fluids.

Wow, I never knew there was so much to dialysis! In school all they really teach you about it is that it exists! Maybe if they taught more about the physiology behind it which is truly amazing the field would attract more nurses! :idea:

Thanks for sharing w/a newbie!!!

NephroBSN, BSN, RN · Mar 14, 2006

Thanks for the great info! I've been using it more and more & really paying attn to the results, then educating pct's on which pt's do best on profiling...I've been mainly using #2 with mostly good results. We have hypertonic in our clinic but I don't like to use it b/c when I started an MD was raising a huge stink over a nurse that was using it all the time...now that I've learned more, I understand the many negatives to using it. Our PCT's will generally give 200ml NS for cramps & turn UF off then give more NS if no results (policy/procedure!)...many times pts leave only 1kg under what they came in at which is frustrating. Seems much better to set the machine at the beginning & avoid cramping if possible all together. I'd also rather just reduce the goal then turn UF off completely, especially considering we're giving them fluids.
Wow, I never knew there was so much to dialysis! In school all they really teach you about it is that it exists! Maybe if they taught more about the physiology behind it which is truly amazing the field would attract more nurses!
Thanks for sharing w/a newbie!!!

I'm a travel nurse.. The unit I am in now doesn't turn off UF. We just lower goals..

You might try profile 4 on some patients.

Also, this unit has had students come through for a day. Yes they can't do anything but interview a patient but most of them are very interested.

I love students.

petals · Mar 16, 2006

The Fresenius manual has all the info about why you should use the UF profiling and Sodium. Call your rep if you cant find it

chart209 · Apr 13, 2006

The unit I work in we use 3 but UF only has it's complication so the other way we do it is reduce temp and sodium profiling. We only take off a litre an hour and to be honest it does work with the patients we have.