Having problems with clotting machine? Heperin not working? Intermittent Saline pushes causing negative symptoms?
There is a "new" CSI Continuous Saline Infusion method of of thinning the blood outside of your body by infusing saline into the lines before it goes into machine. My sweet spot is 800ml infused throughout the treatment. They add 800 to the amount of fluid removed. Heparin was either making my Chest catheter ooze blood or the machine would still clog.Saline pushes every 20 minutes was causing shortness of breath and flushing. Had to stop fluid removal and wear o² after treatment started. The stopping early makes for a 2 day hangover.
ICS is becoming more and more common instead of heperin. One less drug and seems to work flawlessly. It was as simple as explaining what was happening with the heperin to Gemini and it pointed me towards several peer reviewed studies on ICS and I was sold. I presented studies to the clinic nurse and demanded we use. I have wonderful relationship with the staff and they put up with my demands. lol
here is what the Gemini search has to say about CSI.
Continuous saline infusion (CSI) is a technique used in heparin-free hemodialysis to prevent blood from clotting in the extracorporeal circuit (ECC) by continuously administering 0.9% NaCl, often at rates around 200 mL/hour. CSI is more effective than intermittent saline flushes (ISF) in maintaining circuit patency, reducing clotting, and lowering the need for blood transfusions or increased erythropoietin.
Key Aspects of Continuous Saline Infusion (CSI) Dialysis:
Purpose: Primarily used when heparin is contraindicated (e.g., high bleeding risk), CSI prevents the clotting of the dialyzer and bloodlines, ensuring uninterrupted, efficient treatment.
Methodology: Saline is administered continuously throughout the session, often via an infusion pump, rather than in bolus "flushes".
Advantages over Intermittent Flushing (ISF):
Reduced Clotting: Studies show CSI is more effective at preventing extracorporeal circuit (ECC) clots compared to ISF.
Better Dialysis Dose: Regular interruptions for flushes in ISF can reduce the overall dialysis dose delivered.
Hemodynamic Stability: Constant infusion rate aids in maintaining a stable cardiovascular load, beneficial for patients with heart conditions.
Nursing Efficiency: Less labor-intensive for staff than manual intermittent flushes.
Clinical Efficacy: While superior to ISF, both methods (CSI and ISF) still have high rates of clotting in some studies, requiring diligent monitoring.
Catheter Use: CSI has also been shown to help maintain patency (prevent occlusion) of central venous catheters (CVC) during dialysis.
Side Effects and Considerations:
Fluid Management: Because large volumes of saline are infused, close monitoring of the patient's fluid status is necessary, particularly for those with limited capacity for fluid overload.
Costs: Reduces costs associated with clotted circuits.