Aquapheresis: Troubleshooting
Aquapheresis: Troubleshooting
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Hematocrit sensor is reading unreliable numbers or has stopped reading altogether
Hematocrit sensor is reading unreliable numbers or has stopped reading altogether
There may be some clot build up in the sensor.
There may be some clot build up in the sensor.
Troubleshooting steps:
Optimize anticoagulation: If the ACTs are subtherapeutic, consider increasing the heparin drip (***bolus?).
If all else fails:
The sensor cannot be changed while the circuit is running.
Filter pressure (Pu) is very high (>*** mmHg)
Filter pressure (Pu) is very high (>*** mmHg)
There is likely clot build up in the filter. There is a high risk of sudden failure of the circuit, even in if the pressures temporarily stabilize.
There is likely clot build up in the filter. There is a high risk of sudden failure of the circuit, even in if the pressures temporarily stabilize.
Troubleshooting steps:
Optimize anticoagulation: ***
Blood flow rate ***
If filter pressures continue to rise:
If primed with albumin, consider returning the prime volume vs letting the circuit run as long as possible.
This is a judgment call that will differ for each patient depending on hemoglobin, time on circuit (whether another run will be needed today), and other idiosyncratic factors.
If primed with blood, there is no need to return the prime volume. Let the circuit run as long as possible, and depending on time on circuit, consider setting up for another run.
The circuit has failed
The circuit has failed
Evaluate why the circuit failed and any identify any remediable issues.
Evaluate why the circuit failed and any identify any remediable issues.
Consider:
If the patient was very active, this may have interrupted flows long enough to cause some stasis and clotting.
FAQs
FAQs
Q: Can we administer blood transfusions via the lines?
A: If already accessed for Aquapheresis, then administering a blood transfusion is acceptable.
Note: the hematocrit sensor will need to be recalibrated after a transfusion.
References
References
[AMA formatted citations]
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