Hi,
We are trying to implement a program to test our access flow on our dialysis pts.
We have tested the critline TQA, we find it to be time consumming and the sensor seem to loose sensitivity after about 30 uses. (they are good for 50 tests). We also have a couple of Fresenius k machines with the access flow test software. We like it but there are only two machines equiped to do the test.
We have been thinking about Transonics.
We have about 50 pts to monitor per month.
Will this amount of pts justify the expense for the equipment?
Any ideas about the cost of Transonic equipment, special lines etc..?
Thanks

Good Questions ALEX2.First and foremost lets talk about the Transonics monitor .It will cost about $22,000 dollars,very easy to use,the software is dependable and the results are very accurate .How often are you going to test your patients.If only once a quarter The Critline Monitor does a great job.The old monitors have Delta-h which takes more time but the results are accurate,in addition to the other features that it has.The Fresenius software update on all your machines is expensive.In addition to the above info remember that you do not have to purchase any special lines for the Transonics Monitor ,but you need The TQA Sensor pad for The Crit-Line monitor.And last none of these are currently reimbursed however the PATIENTS will be in their assigned dialysis chair more often because of you being pro active.In addition some VACSULAR ACCESS CENTERS are now offering Vascular Access Technicians to do these procedures for you freeing up your staff...

Old school
Thanks for your reply.
I am not familiar on how the the access flow test is done by transonics. Let me ask you a few questions and see if you can help me.
When you do the test using transonics, do you need to reverse the blood lines to perform the test?
Do you have to give a saline bolus?
The sensors coming out of the transonics monitor I imagine that they need to be attached to the blood lines, right? Can they be attached to any blood line?

Thanks

Realistically, the staff time involved is too time consuming for crit-line, the cost of transonics is too high. DHS does not require these tests be done but they do require that KT/V's be adequate. Spend the time on Kt/V's, improving those that are low, and developing a QM tool for improvement.

Our vascular access center uses the Transonics machine to test all of our pt's with permanent accesses. We employ 2 Transonics technicians who alternatingly go out to our dialysis units to test our pts. We test about every 6 weeks. We found that with the number of dialysis units we are covering, this was the most frequent we could go. Transonics is very costly, and I honestly do not see how any entity other than a vascular access center could justify the cost. We can justify the cost by the referrals that it generates. However, if you weigh in the value it provides to the patients, the cost is negligible. It's a very valuable tool.
Transonics works through a method of saline dilution. I don't fully understand the science of it.
To answer your questions:
YES, you do have to reverse the lines. Fresenius makes what is often called "twister lines" so that the lines don't have to be disconnected and reconnected after the test.
YES, you do have to instill a certain amount of saline. I believe it's around 100cc. I don't know for sure I've never actually performed the test myself.
With regards to the sensors, they are calibrated by the internal software to adjust for different HD lines. This is set when entering the patient data. As far as I know, the same set of sensors can be used on any popular dialysis line as long as the software parameters have been set.

Alex,To really understand what you need to do to start and maintain a successful Vascular Access Program.Look up NKF K/DOQI Clinical Practice guidelines for vascular access. Guideline #4 Also if you rely on KT/V results for access problems THIS IS FOR YOU AS WELL.The transonics only uses 10 ccs and WE ARE ABOUT ACCESS PATENCY AND SURVIVAL....FISTULA FIRST AND FOREMOST

Do you have to do flow monitoring? What about a derived static pressure reading with every treatment ? Vasc-Alert markets this product. It is FDA approved and is also acceptable under Guideline #4 of the K/DOQI CPG's.

If you have an electronic medical record, there is no clinical staff time involved in data collection as is required with all of the flow methods.

Website is: Vasc-Alert