Venous pressure high and blood turn to dark

[uae808]

Hi guys :

we have a situation when started patient on hemodialysis via Braun machine , venous pressure gradually went up to 200-260mmhg , and the blood turned to dark , we just did access flow for patient recently ,950ml/ min, and machine just giving alarm when venous pressure out of range , I would be much thankful if can anyone explain it !

[Guttercat, ASN, RN]

There's really not enough information given here. Things like how long was the patient on the machine when the issues began to present, what sort of access (loop graft, fistula?), and the UFR. Does the patient have any history of hypercoagulation and clotting the circuit, and are they on intradialytic heparin?

First thing that popped into my head was that the blood lines were accidentally connected in reverse on a loop graft.

[uae808]

Sorry,it happened 45 mins into dialysis , and the patient has BCAVF , she is on 50 iu / kg fragmin 1.9 ml

[uae808]

Patient doesn't has history of hyper coagulation ,but during HD,venous pressure always on the high side 180- 210

[hstclair]

Their O2 level has likely dropped and they're not refilling the vascular space. 45 min into treatment is usually when you start to see the drop in O2. Try supplemental O2, decreasing UF rate, T-berg position or all.

Also, sleep apnea is a huge issue so if the patient sleeps during treatment, they aren't getting enough O2.

[rain888]

Thank you Hstclair