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Blood pump speed for blood return
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<Guest>
posted
I am a 35 year veteran of dialysis and have always returned blood at between 150 - 200 ml/min. The rationale for this was that when we return the blood we could overload the heart at faster pump speeds. I see in some clinics they return blood at 300 - 400 ml/min and wonder if this is safe? If not, why/ or your rationale for this?

Thanks!!
 
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<Anny nomous>
posted
quote:
dialysis and have always returned blood at between 150 - 200 ml/min. The rationale for this was that when we return the blood we could overload the heart at faster pump speeds. I see in some clinics they return blood at 300 - 400 ml/min and wonder if this is safe? If not, why/ or your rationale for this?


If this is a catheter patient the answer is yes as you can return too fast and the heart would not be able to pump out as fast as your putting it back in.

as for a fistula/graft I can see it being alright because that is what is being run during a treatment so the access can keep up with that type flow.

Beyond this I have no answers
 
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quote:
Originally posted by Anny nomous:
quote:
dialysis and have always returned blood at between 150 - 200 ml/min. The rationale for this was that when we return the blood we could overload the heart at faster pump speeds. I see in some clinics they return blood at 300 - 400 ml/min and wonder if this is safe? If not, why/ or your rationale for this?

Your rational for the fistula/graft is not correct. Just picking numbers here for illustration purposes because each individual access has a different flow rate:
If normal flow rate through the access is 1000 ml/min and the BFR during dialysis is 300 ml/min you are decreasing the access flow to 700 ml/min. During rinseback you are no longer drawing blood from the access so you would be increasing the access flow to 1300 ml/min.

Chuck

If this is a catheter patient the answer is yes as you can return too fast and the heart would not be able to pump out as fast as your putting it back in.

as for a fistula/graft I can see it being alright because that is what is being run during a treatment so the access can keep up with that type flow.

Beyond this I have no answers


DISCLAIMER : My opinions and views are mine and may not be the same as my employer.
 
Posts: 2173 | Location: Baltimore, MD USA | Registered: 24 October 2001Reply With QuoteReport This Post
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our staff are only returning the blood not more than 200 for fistulas, some occasion get away with 250.
The reason is that the fistula relaxes by returning the blood on slow flow specially those who are bleeders and there is always a chance that a fistula will blow with high flow when returning.
 
Posts: 38 | Registered: 13 April 2019Reply With QuoteReport This Post
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