Is there any links or info out there about what a "safe" recirculation time is? Currently we have a 2hr time ( which starts as soon as the saline hits the tubing), about 10 years ago, it was 4 hours. A physician had us recirculate a non reuse dialyzer for 8 hours , then draw samples and send to the lab, the result was 0CFU and <0.01EU. But I cannot get a definitive answer from anyone (including corporate) as to why the 2hr recirc time is our policy. So I ask is there any research out there that I can bring to the table to get this time increased with any risk to the patient? What does your clinic practice and why? As we know some patients are not as timely to get their TX done as others.
In the March-April edition of Nephrology Nursing Journal, ANNA published results of a "Literature Search" on this topic. Basically it said that there is little or no published data on the subject to make a decision on. The only thing it really talked about was possible problems related to bacteria/endotoxin.
DISCLAIMER : My opinions and views are mine and may not be the same as my employer.
Most likely it's 2 hours for liability reasons, or because someone, somewhere went on a dialyzer that had been recirculating all day and got sick. "Back in the day" we used to put patients on dialyzers that had been recircing for five or six hours with no problems. With everyone trying to cut costs as much as possible I'm surprised no one has done a study on this to at least get it increased to four hours, which gives you plenty of time to call in a patient to take the place of a no-show.
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