Hemodialysis Machine Air Detectors Need Not Detect Microbubbles

Polaschegg, Hans‐Dietrich

doi:10.1111/j.1525-1594.2007.00510.x

Cited by 17 publications

(34 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Besides this, creation of micro-bubbles is also possible during a hemodialysis therapy. The contemporary hemodialysis machines cannot detect any doses of air infusions less than 0,1 ml/k/minutes in bolus infusions and 0,03 ml/kg/minutes in continuous infusions and thus fail to activate the alarm system (Polaschegg, 2007). Therefore, the hemodialysis machines today remain ineffective in preventing microbubbles to enter the venous system.…”

Section: Air Embolismmentioning

confidence: 99%

Acute Complications of Hemodialysis

Özkan¹,

Ulusoy²

2011

Technical Problems in Patients on Hemodialysis

View full text Add to dashboard Cite

Section: Air Embolismmentioning

confidence: 99%

Acute Complications of Hemodialysis

Özkan¹,

Ulusoy²

2011

Technical Problems in Patients on Hemodialysis

View full text Add to dashboard Cite

“…Moreover, an overly sensitive detector could be annoying and time-consuming as a result of numerous alarms during the treatment. Should the severity of this hazard be revised, probably the best way would be the prevention of microbubble injection, through some kind of filter or the use of an airless extracorporeal circuit, as proposed by Barak and Katz (22) or Polaschegg (21), respectively.…”

Section: Air Embolismmentioning

confidence: 99%

Multidisciplinary Evaluation for Severity of Hazards Applied to Hemodialysis Devices

Lodi¹,

Vasta²,

Hegbrant³

et al. 2010

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives: Risk analysis for medical devices is a crucial process to grant adequate levels of safety. Identification of device exposure-related hazards is one of the main objectives.Design, setting, participants, & measurements: Hazard analysis for hemodialysis devices has been performed by a multidisciplinary team involving engineers and clinical experts. A potential harm list was identified from clinical and technical experience, postproduction information, and literature. Various hazardous situations (circumstances when the use of the dialysis device may lead to described harms) were described. Such hazardous situations were correlated to the extent of the deviation of a specific device parameter from expected ranges. The clinical severity that was relevant to any specific harm was categorized for each hazardous situation using a descriptive and numerical scale with five levels (from negligible [i.e., discomfort only] to catastrophic [i.e., potentially lethal]).Results: Harms in which the deviation of a parameter strictly coincides with the clinically measured effect on the patient are defined as "direct." Otherwise, when another clinical parameter must be involved to quantify severity, the related harm is considered "indirect." Two complete examples of multidisciplinary evaluation for severity of hazards (MESH) are given for a direct harm (air embolism) and for an indirect harm (hypothermia). For other harms, the maximum value of severity involved is provided.Conclusions: MESH represents a possible example of risk management for dialysis equipment in which, although the manufacturer is directly responsible, a multidisciplinary task force may contribute to a better link between engineering and clinical perspectives.

show abstract

“…Exposure to smaller amounts of air have not been considered a risk for the hemodialysis patient . If the air is formed as small microbubbles, they are thought to collapse and be absorbed into the blood relatively fast …”

mentioning

confidence: 99%

Air contamination during hemodialysis should be minimized

Stegmayr

2016

Hemodialysis International

View full text Add to dashboard Cite

During preparation of the hemodialysis (HD) extracorporeal circuit (ECC) a priming solution is used to remove air from the tubes and dialyzer. Ultra sound techniques have verified micro embolic signals (MES) in the ECC that may derive from clots or gas embolies. In vitro studies could clarify that embolies of air develop within the ECC and also pass the safety systems such as air traps and enter the venous line that goes into the patient. Clinical studies have confirmed the presence of MES within the ECC that pass into the return-venous-line during conventional HD without inducing an alarm. In addition, studies confirmed that such MES were present within the AV fistula and subclavian vein, but also detected within the carotid artery. Autopsy studies revealed the presence of gas embolies surrounded by clots within the lung but also brain and myocardial tissue. This review will focus on how the MES develop and measures of how the exposure can be limited.

show abstract

Hemodialysis Machine Air Detectors Need Not Detect Microbubbles

Cited by 17 publications

References 9 publications

Acute Complications of Hemodialysis

Acute Complications of Hemodialysis

Multidisciplinary Evaluation for Severity of Hazards Applied to Hemodialysis Devices

Air contamination during hemodialysis should be minimized

Contact Info

Product

Resources

About