I am an RN certified nephrology nurse in Nashville, TN.
I work in the hemodialysis unit at St Thomas Hospital. We are an acute, inpatient dialysis unit. We dialyze patients in our 8 bed unit as well as remote dialysis in critical care areas.
Our medical director is having his patients (in the critical care areas) dialyze for extended hours. We dialyze for six to eight hours on a low blood flow (200) and a low dialysate flow. He believes this more gentle dialysis is more beneficial to the patients who are very unstable hemodynamically. CVVH has also been tried at our hospital with more unfavorable outcomes.
An impasse has developed because the critical care nurses do not want the responsibility of the equipment, even though it has been explained that the dialysis nurses would monitor the machines (hands on) once hourly. Our unit needs some literature on this type of treatment, so it can be formally presented. I have been delegated to acquire this information.
Up to this point, my retrieval of information has been dismal. Do you have any information you can share, or can you point me to another site that might have some information on this extended dialysis. I would really appreciate any help you might be able to give me. Up to this point I am batting zero.
Thanks,
Peggy Evans

I have a article on CAVH using the frencius H machine Dialysis nurses set up machine critical care nurses monitor machine it has a 200 blood flow and 100 dialsate flow in this paper it talks about the hospitals using it now and the Dr's who set up the procedure.A local hospital in my area is trying to start this but critical care nurses are reluctant.The acute dialysis nurses at the hospital do not know the machine and are hesitating too.I used to work there and I am now nurse manager of a dialysis center in the area that uses these machines.I have invited the ICU nurses to come observe the machines at my unit.But without their dialysis nurses taking part I do not know if its going to work.People tell me because the BF and Dialysate flow are so low is why the critical care nurses can monitor it?? I'll send you what I have it might help its long send fax number

Have you ever tried blood volume monitoring at your unit? The Crit-Line monitor will allow you to see how well the patient is plasma refilling, and you can adjust your UFR accordingly.
This might be a good comprise for everyone.

You should be able to find all the info you need on this type of treatment. The Lynchburg nephrology web site has an area devoted to this type of treatment as they have a slow nocturnal program.

I do this type of treatment with my father at home. We are in a slow nocturnal program and dialyze on the Fresenius H machine 6 nights a week for 8 1/2 hrs at home while we sleep.

Also if you go to www.multimed.com/homehemotoday you will find
numerous articles by reknown nephrologist regarding this type of treatment.

The results of patients doing this type of treatment have been so significant this is getting a lot of attention today.

I don't understand the nurses having a problem with this patients are doing it at home across the USA.

If you have specific questions about this you can e-mail me at Marty1@infoblvd.net

I apologize if I have responded in a way that is different than what your post meant. I took your post to mean you wanted more info on this type of treatment and there was a problem with nurses on the responsibility of the machines?

Hello, i newbie, anybody can help me?

In our ICU we are using a 4008s with an online module for SLED 6 - 10 hrs. Can't find the information for it, but will return if i can.