Nikkiso Aquarius blood pump rotor occlusion - pediatric vs adult
I'm new to Nikkiso Aquarius, but something feels off.
When servicing we only have tools to set one occlusion setting for each rotor, and I'm told these are the only tools that are available.
When calibrating for the adult lines the pump segment fits as expected, but the pediatric line feels loose to me (the segment is a different physical size / smaller wall thickness), and I'm concerned that we have a risk of haemolysis in pediatric patients.
(We don't generally treat children here, but there's always a first time!)
Any experience or insight welcome
Royal Papworth Hospital, Cambridge
I haven't worked on Nikkiso Aquarius at all. However form experience of other machines, I would say if there is not a different blood pump rotor used is there a different software version/setting to use paediatric lines? This would at a guess change the speed of the blood pump rotor to account for the different volume.
Have you measured the flow from the different segments to see if there is difference?
I have to admit I wasn't aware of any machines other than the AK98 that were suitable for paediatric patients (Under a certain weight)
Senior Renal Tech
Royal Free London
Don't use the machines myself but, haemolysis occurs when the blood pump is to tight to the wall of the pump housing, resulting in crushed cells. if the pedi lines are loose this won't happen, the volume of blood being moved will be reduced and the blood pump speed measurement will be inaccurate but no crushed red cells.
This issue has raised its head when demonstrating our new Redsense venous line clamp on an in vitro sham dialysis ( using just saline rather than bovine blood ) and despite the clamp working I suspect there was back leakage from the bubble trap through the blood pump which reduced the trapped high venous pressure low enough for the venous clamp to re-open and the blood pump to restart with a much wider venous pressure window ,has anyone else experienced this ?
Does anyone actually calibrate the blood pump rotor gap using a manometer and a stopwatch anymore to eliminate red cell damage and resulting hemolysis ?
(The result may have been exagerated due to the low viscocity saline rather than actual blood )