Help! Have you seen this with these machines?
We have been experiencing occasional blood chamber clotting in the Gambro Phoenix machines. The material is a lipid like protein. We have seen this on the dialysate effluent side on the Cobe C3 but not in a blood tubing set. Sometimes it is particular patients and sometimes three or four patients on a shift.

Which Chamber?? Arterial or venous??

quote:

Originally posted by Nova:
Help! Have you seen this with these machines?
We have been experiencing occasional blood chamber clotting in the Gambro Phoenix machines. The material is a lipid like protein. We have seen this on the dialysate effluent side on the Cobe C3 but not in a blood tubing set. Sometimes it is particular patients and sometimes three or four patients on a shift.

Nova,

Did you switch dialyzers from a cellulosic to polysulfone membrane? I have noticed that lipids build up in the venous header of polysulfone dialyzers much more than it does in dialyzers that are cellulosic, this material could be migrating to the venous drip chamber and being trapped by the filter.

I think the substance you were seeing in your C3's was most likely pseudomonous as lipids are too large to pass through the dialyzer membrane.

Chuck

Vonous chamber Betty

quote:

Originally posted by Chuck W:
Nova,

Did you switch dialyzers from a cellulosic to polysulfone membrane? I have noticed that lipids build up in the venous header of polysulfone dialyzers much more than it does in dialyzers that are cellulosic, this material could be migrating to the venous drip chamber and being trapped by the filter.

I think the substance you were seeing in your C3's was most likely pseudomonous as lipids are too large to pass through the dialyzer membrane.

Chuck

Hmm Very interesting -- We use polysulphone membranes and have used Gambro C3's and Phoenix machines - both having problems with clotting in the chambers. I thought it was some type of flaw in the design of the chamber/tubing set because it is not as prominent on other machines that don't use this type of cassette.(ei. generic tubing sets with the Fresenius or B.Braun.), still using same membrane. Could you please explain a little more about the lipids? Thank, Marilyn

Marilyn,

As you know, clotting in the chambers can have numerous causes. If you are having a lipid problem, it will look like small blobs of white-ish wax sticking to the end of the venous fiber bundle, you may also see it trapped by the venous drip chamber filter.

When we were using polysulfone and seeing this, I looked closely at who it was happening to and their chloresterol levels but could not find any correlation between the two. Once we switched to a modified tri-acetate membrane, the problem instantly went away.

Chuck