What is the easiest CRRT machine to use?

[gest1971]

Hi all! I am currently looking for reviews from critical care bedside nurses on which CRRT machine they use and if they like it. We are currentl using the Nx Stage machine and are finding it to be extremely challenging, even for my best nurses. It is not intuitive at all and is very frustrating to use. I want to find the machine out there that is easiest to use. We are all busy and shouldn't have to be forced to work with a machine that makes life harder!

Thank you!

I love you, you awesome nerds!

gina (Massachusetts)

[Bluebolt]

Gambro Prismaflex

[Chisca, RN]

We are currently using the Nx Stage machine and are finding it to be extremely challenging, even for my best nurses.

You mean being a dialysis nurse isn't the easiest job in the world? :)

[jamisaurus]

Prismaflex ! It's idiot (me) proof, everything is explained both in text and little drawings, it guides you along every bit of the procedure, and everything is color coded.

And no, I haven't noticed that it interferes with cardiac monitors... how so ?

We monitor continuously in leads III&V. If prisma in running, sometimes it messes up one of the leads so bad (usually V) and creates so much interference that you can't distinguish ST segment measurements or even QRS complexes. We've tried changing patches, cords, everything and it continues until CRRT treatment is stopped! Didn't know if anyone else noticed this.

[/username, BSN, RN]

We use the Fresenius 4008 and 5008. It's nurse proof and really easy to use.. just have to remember it primes backwards unlike the Aquarius which we also use. I do have to say I prefer the Fresenius on ecmo to the aquarius. The problem is the size of it. When you have ecmo, nitric, a balloon pump, dialysis as well as a VAD all going on at once it gets a bit crowded in the bays

If you have ECMO, why the balloon pump and VAD?

[Lennonninja, MSN, APRN, NP]

We use NxStage, and while that's the only machine I've ever used, I found learning it to be pretty easy.

[Wolf at the Door, BSN]

If you have ECMO, why the balloon pump and VAD?

If On ECMO can cause increased left ventricular load, the opening of the aortic valve gets restricted and IABP may be needed

IABP can be used first but if unable to maintain adequate circulation then ECMO along with that can help.

Please correct if wrong.

[Dodongo, APRN, NP]

The prisma machine I have experience with was scale/weight dependent and every time you bumped the darn thing it stopped and alarmed so with the vent, IV pumps, etc, it was not fun. I thought NxStage was pretty easy to use. The machine walks you through setup.

[Wolf at the Door, BSN]

Having been trained on both machines. The Next Stage is easier and less involved. Prismaflex is way more manual labor due to the lack of waste line. Who wants to dump a heavy bag every hour or whenever it fills up. That sucks royally. Prismaflex is used more in CVICU's.

[dread_pirate_roberts]

I loved doing CRRT, and used prismaflex. I agree with the previous assessment that the scales can be pretty annoying (literally, if access or return line is barely touching it, it alarms). You get good at it though, learn where to drape the lines so they're not touching. I also agree about emptying the effluent bag issue, but again, once you get used to it and remember to check the "time until next intervention" on it, you develop a system/schedule. I don't know about your units, our CRRTs were always 1:1 patients, so the workload of changing/emptying bags was never an issue. The screen on the prismaflex is very informational, and troubleshooting is usually pretty easy.

[EllaBella1, BSN]

We use the NxStage and it's generally pretty simple, but with patients who have complicated access sites (positional, clot frequently, etc) it can get pretty frustrating. I find that it loves to alarm venous air or arterial air all of the time, even when no air is present and there is another issue. After doing it for a few years I'm getting pretty good at determining what is causing an 'air' alarm, but I do wish that it had the capability to alarm other things that were more specific.