Hemodialysis Delivery Systems and Machine Components

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Conductivity range

12.6-15.9

Dialysate Temp

35-39 C set by MD machine is set to alarms when temp rises or falls 2 degrees beyond set point

Acceptable range for dialysis

6.9-7.6

5 characteristics of the dialyzer that can influence dialysis effectiveness, treatment comfort and patient

Biocompatibility molecular weight cutoff surface area ultrafiltration coefficient clearance

Purpose of Dialysate

Carries away waste products and excess fluid removed form the patient's blood during the dialysis process Prevents excess removal of essential electrolytes during the dialysis process

How do we know if the Dialysate is properly mixed

Conductivity and PH check

Dialysate formula

Na (sodium) Ca calcium K potassium HCO3 bicarbonate baking soda

What must be tested before each treatment

PH and Conductivity

Transmembrane Pressure TMP

Pressure that exist in the dialyzer want the transmembrane pressure to be greater on the blood side than the dialysate side TMP determines how much water is forced across the dialyzer membrane

What is Dialysate

a solution of purified water and electrolytes in concentration similar to blood consist of the following chemicals which we use to clean a pt blood acidified salt solution referred to as acid bicarbonate purified water also contains essential electrolytes to assure theses are not depleted during dialysis

Dialysate

acid concentration electrolytes and is tailored to the pt needs

Clearance has 6 factors

adequate heparinization dialysate flow proper circuit priming procedure blood flow vascular access length of treatment

Clearance

amount of a specific solute that is removed form a patient's blood during dialysis reflects the efficiency of the dialyzer

bicarbonate solution

buffer the acid - preserving the acid base balance of the blood

Blood leak detector

checks for blood in the effluent spent dialysate due to broken dialyzer fiber detector can sense very small amounts of blood machine will alarm, blood pump will stop, clamp woll activate

Extracorporeal Circuit

circuit carries the blood from the patients access to the dialyzer and back to the access needles blood tubing blood pump dialyzer venous line clamp blood flow monitors pressure monitors air detector

Conductivity

ease with which an electric current is carried or conducted through something. to assure that the dialysate is at the proper conductivity to prevent hemolysis or crenation of the patient's blood

Auto flow

flow option allowing for automatic optimal dialysate flow proportionate to the blood flow rate. automatically adjust flow to 1.5 to 2.0 times the the QB

Calcium

helps correct balance in the blood and slows the development of bone disease

Pressure monitoring

is needed to accurately calculate transmembrane pressure TMP and ensure patient safety

crenation

make blood cells look like raisins

conductivity

measure of the ion concentration of a solution

dalton

molecular weight amount of membrane in contact with blood & dialysate permeability

Countercurrent flow

preferred flow geometry for optimal dialysis

hemolysis

red blood cell break

Dialysate isn't

sterile

Biocompatibility

substance does not cause a reaction by the body's immune system dialyzer not compatible, allergic reaction or clotting may occur

purified water

tap water treated to use in dialysate

Disafe Filter testing

testing required every 2 weeks

ph

the scale used to measure the hydrogen ion concentration of a substance


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