Abstract: FR-PO491
Experience with a Novel Hemodialysis System: User Satisfaction and Clearance
Session Information
- Hemodialysis and Frequent Dialysis - IV
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Rahman, Mohammed Faisal, Baylor University Medical Center, Dallas, Texas, United States
- Albaugh, Belinda, Baylor University Medical Center, Dallas, Texas, United States
- Szerlip, Harold M., Baylor University Medical Center, Dallas, Texas, United States
Background
The need for IHD in hospitalized patients with AKI and ESRD has been increasing. Delivery of this care has a significant cost. An inpatient hemodialysis unit requires a large financial outlay for water treatment and performing IHD in an ICU room involves transporting heavy equipment and often ties up a dialysis nurse. Outset Medical's Tablo is an easily transportable, all-in- one system with a user-friendly touch screen interface that requires minimal training. This pilot project was designed to assess whether the Tablo system was both easy to use and provided adequate urea clearance.
Methods
25 hospitalized patients with AKI or ESRD requiring IHD were treated using the Tablo system. 15 of these patients were in the ICU and 10 patients were in the inpatient dialysis unit. Tablo was set up and run by a hemodialysis nurse or technician using a Revaclear 300 dialyzer. Blood flow was between 300-400 ml/min and dialysate flow rate was 300 ml/min. Dialysis prescription, duration and ultrafiltration rate were left to the discretion of the attending nephrologist. Nursing satisfaction was assessed by a Likert scale questionnaire. Dialysis adequacy was estimated by KT/V (Daugirdas) and Urea reduction ratio (URR).
Results
The majority of nurses/technicians found Tablo easier to use than a conventional dialysis machine (average score 5/5), most nurses felt comfortable providing treatment with this system after a short training session (average score 4.9/5) and they were also satisfied with Tablo as a treatment option (average score 4.9/5). Several participants also reported that the system was easy to transport and took up less space in an ICU room. Mean Kt/V was 1.18 (0.68 - 2.37), mean URR was 62.39 (44.44 - 87.04), mean patient weight was 81.98 kg (53.50 - 187.60), mean time and blood flow were 3.6 hours (3.5 – 4.5) and 366 ml/min (300 - 400) respectively.
Conclusion
Most of the operators found the Tablo system easy to use and transport. Although urea clearance was less than goal, we attribute this both to the shorter treatment time used in our center and the fact that treatment time was not adjusted for patient weight. Previous small studies have confirmed this system can deliver adequate clearance despite lower dialysate flow; larger randomized controlled trials are needed to validate this.
Funding
- Commercial Support –