Here at our unit in NY, we've seen this a handful of times. The machine(a Fresenius T) is set up for a patient, hansens are connected to the dialyzer and new saline bag is hooked up, all clamps are open. Going back to the machine, the first time I saw it the saline bag was HUGE, another time I hadn't swapped the new saline bag on and it went form near empty to full, today it happened again but I hadn't put the patient on, someone else did...I looked at the bag an hour after he went on and noticed it was inflated. It's not air but fluid, and the blood pump was ran correctly, no blood in the bag...just clear fluid that looked like saline. I have seen it 3 times and each time the machine is removed from service to see why this happened. Fresenius has no answers, the biomed guys have no answers, they keep blaming the lines. If the lines are a problem, it would happen on more than one machine, no?
When you are running a machine and the saline bag isnt clamped The dialyzer will send fluid back into the blood lines since the pressure is lower. Its like a simulated dehydrated patient. Clamp the lines, problem will be gone.
my nurses said they dont clamp or it stops. But it has to do with the pressure. I cant remember exactly how it was explained hence why I suggested looking it up. But it is the water difusing from the dialysate to the lines.
First of all, if you are recirculating, all clamps should be open and there should be no dialysate going into the saline bag. I agree with NYHQCTech that you have the same issue many of us have had in the past. We started using a hemostat on the saline bag after complete set up to denote where the saline was at the time the hanson's were put on the dialyzer. If the saline was above the clamp, the set up would be discarded due to having non sterile dialysate in the sterile dialysis lines. Before we knew the real issue, the machine would be pulled and another machine put in its place. Get the upgrade - don't subject your patients to non-sterile fluid.
I have contacted the biomed manager and tech on site to see what they know about the issue. Of the 3 times I've seen the big bag, only one time there was a patient hooked up, the other 2 were set up waiting for someone who never showed. It seems odd that this has been known about since 2014 and it's happened here 3 times that I know of and the biomed guys never said anything about a recall and parts to "fix" it...the machine I have seen this twice on is under warranty so maybe they'll do the upgrade to prevent it.
After a few months of back and forth with Fresenius, having them say it couldn't be the machine and it doesn't make sense...they finally found the problem. The machine was on the floor to be used 3 times recently and the bag inflated so the machine was pulled, Fresenius showed up and could not replicate the issue and told us to put it back on the treatment floor to see if it would happen for us and our tech manager said no. They tried for a few hours yesterday and swapped a board inside the machine in question to another T machine and the problem followed, they finally had an answer and are replacing the problem parts since the machines are under warranty.
This is not possible once patient is connected and dialyzing. Depending on the UF rate the bag would fill with blood if saline clamp was open or it would drain completely. During recirculation pre tx, the bag will fill with dialysate which the upgrade addresses.