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Proposing an algorithm for the use of Cathflo
2
"A patient has a prescribed BFR of 300ml/minute, but you are only able to run the patient at a BFR of 290ml/minute.
"If each session is 3.5 hours, this calculates to a decrease of 6300ml processed over the course of 3 dialysis sessions (10ml/minute x 210 minutes x3), which translates to 327,600ml (6300 x 52 weeks), or two weeks of missed dialysis per year." (Dutka & Brickel, 2010)
Specific clinical recommendations?
e.g. contact MD/NP, administer ___, etc.
"It was determined that the blood flow and achieved dialysis adequacy demonstrated no difference in adequacy achieved when HD catheter blood flows were 250ml/min, 275ml/min, or 300ml/min (Moist et al., 2006)
Questions / comments?
Proposing an algorithm to address catheter dysfunction
References
Dinwiddie, L.C., & Bhola, C. (2010). Hemodialysis catheter care: current recommendations for nursing practice in north america. Nephrology Nursing Journal, 37(5), 507-20, 528; quiz 521.
Dutka, P., & Brickel, H. (2010). A practical review of the kidney dialysis outcomes quality initiative (KDOQI) guidelines for hemodialysis catheters and their potential impact on patient care. Nephrology Nursing Journal, 37(5), 531-5; quiz 536.
Moist, L.M., Hemmelgarn, B.R., & Lok, C.E. (2006). Relationship between blood flow in central venous catheters and hemodialysis adequacy. Clinical Journal of the American Society of Nephrology, 1, 965-971.