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Related Experiment Videos

Variable blood pump flow rates and the effect on recirculation

J A Hasbargen1, R J Bergstrom

  • 1Nephrology Service, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana 46202.

Clinical Nephrology
|November 1, 1994
PubMed
Summary
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Higher blood flow rates (QB) in dialysis increase recirculation, potentially reducing treatment effectiveness. Studies show significant increases in recirculation and venous pressures with higher QB, impacting clearance beyond 300 cc/min.

Area of Science:

  • Nephrology
  • Cardiovascular Physiology
  • Dialysis Technology

Background:

  • Increasing blood pump flow rates (QB) is a trend in dialysis.
  • The impact of elevated QB on recirculation and dialysis clearance is not well understood.

Purpose of the Study:

  • To quantify the effect of varying blood pump flow rates (QB) on recirculation during hemodialysis.
  • To assess the subsequent impact of recirculation on dialysis clearance and patient safety.

Main Methods:

  • Prospective study involving 16 patients undergoing hemodialysis.
  • Blood pump flow rates (QB) from 200 to 500 cc/min were tested in a randomized order.
  • Recirculation measured using the three-needle technique; angiograms and clearance calculations performed.

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Main Results:

  • Recirculation rates significantly increased with higher QB (r = 0.43), from 12.1% at 200 cc/min to 23.8% at 500 cc/min (p < 0.05).
  • Venous pressures rose substantially with increasing QB, from 120.0 mmHg to 204.2 mmHg.
  • Effective dialyzer clearances showed diminishing returns beyond a QB of 300 cc/min.

Conclusions:

  • Elevated blood pump flow rates in dialysis lead to increased recirculation and venous pressures.
  • Higher QB beyond 300 cc/min offers limited improvement in effective clearance and may pose risks.
  • Careful consideration of QB is necessary to balance treatment efficiency and patient safety.