Air bubbles pass the security system of the dialysis device without alarming

被引:33
作者
Jonsson, Per [1 ]
Karlsson, Lars
Forsberg, Ulf
Gref, Margareta
Stegmayr, Christofer
Stegmayr, Bernd
机构
[1] Umea Univ, Dept Biomed Engn & Informat, Umea Univ Hosp, SE-90185 Umea, Sweden
[2] Umea Univ, Dept Internal Med, Umea Univ Hosp, SE-90185 Umea, Sweden
[3] Umea Univ, Dept Clin Physiol, Umea Univ Hosp, SE-90185 Umea, Sweden
[4] Umea Univ, Inst Phys, Umea Univ Hosp, SE-90185 Umea, Sweden
[5] Gen Hosp, Skelleftea, Sweden
关键词
hemodialysis; microbubbles; safety risk; air trap; air chamber; safety; regulations;
D O I
10.1111/j.1525-1594.2007.00352.x
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
During hemodialysis microembolic findings have been noted after the venous chamber (subclavian vein). The aim of this study was to evaluate if air could pass the venous chamber and, if so, if it passes the safety-system detector for air-infusion without triggering an alarm.Various in vitro dialysis settings were performed using regular dialysis devices. A dextran fluid was used instead of blood to avoid the risk of development of emboli. Optical visualization as well as recirculation and collection of eventual air into an intermediate bag were investigated. In addition, a specifically designed ultrasound monitor was placed after the venous air trap to measure the presence of eventual microbubbles. Speed of dialysis fluid was changed, as was the level of the fluid in the air trap. Thereby a fluid level was considered "high" if it was close to the top of the air trap and "low" if it was around the mid part of the air trap. By optical vision microbubbles were seen at the bottom of the air trap and could pass the air trap towards the venous line without alarming. During recirculation several mL of air were collected in an intermediate bag after the venous line. Ultrasound monitoring exhibited the presence of microbubbles of the size of approximately 5 mu m upwards passing to the venous line in all runs performed. Amount of bubbles differed between devices and in general an increased fluid speed correlated significantly with the increased counts of microbubbles/min. No alarming of the detector occurred. A more concentrated fluid allowed higher counts/min when flow was increased to 600 mL/min. Data revealed that air passes the safety-sensor in the air trap without alarming. The presence of air increased in general with fluid speed and a lower fluid level in the air trap. Differences were present between devices. If this affects the patients has to be elucidated.
引用
收藏
页码:132 / 139
页数:8
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