23 Pseudo Blood-Leak? A Hemodialysis Mystery

Ávila, José G.; Kasama, Richard; Prasad, Deepali; Weisberg, Lawrence S.

doi:10.1053/j.ajkd.2011.02.026

Cited by 1 publication

(3 citation statements)

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“…The photodetector is triggered when green light (wavelength 562–575 nm) is absorbed by blood [ 32 , 33 ]. Avila et al [ 2 , 25 ] performed dialysis treatment successfully using the NxStage machine without a problem with hydroxocobalamin-related false blood leak alarms. The blood leak detector of the NxStage machine uses a single optical emitter with an 880-nm wavelength designed to detect light scatter.…”

Section: Discussionmentioning

confidence: 99%

“…The blood leak detector of the NxStage machine uses a single optical emitter with an 880-nm wavelength designed to detect light scatter. This method does not depend on light absorption and cannot incriminate hydroxocobalamin as possibly representing blood [ 2 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Based on the existing evidence, the Gambro Phoenix X36 [ 4 ] and NxStage [ 22 , 25 ] machines would be suitable for hemodialysis, as their blood leak sensor response does not continually interrupt treatment due to hydroxocobalamin-related false blood leak alarms. In addition, depending on the availability of CRRT in each institution, providing CRRT with a Prismaflex machine [ 23 , 24 ] is also an option to overcome the hydroxocobalamin-related interference with hemodialysis.…”

Section: Discussionmentioning

confidence: 99%

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High-dose hydroxocobalamin for vasoplegic syndrome causing false blood leak alarm

Cheungpasitporn

Hui

Kashani

et al. 2017

Clinical Kidney Journal

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Blood leak alarms are important safety features in a hemodialysis machine to protect patients from loss of blood through a rupture in the dialyzer membrane (true alarms). A false blood leak alarm can be triggered by air bubbles or detector malfunction (such as deposits of grease or scale). Hydroxocobalamin is an injectable form of vitamin B12 approved by the US Food and Drug Administration for the treatment of confirmed or suspected cyanide toxicity. Due to observations of an increase in arterial pressure after high-dose hydroxocobalamin infusion for the treatment of acute cyanide poisoning, it has recently been reported as an off-label rescue treatment for post–cardiopulmonary bypass vasoplegic syndrome. We report an 83-year-old man who received hydroxocobalamin following cardiac surgery for treatment of vasoplegic syndrome. The patient developed severe acute kidney injury with volume overload. Hydroxocobalamin interference with the blood leak detector compromised his dialysis treatment. We describe the use of continuous renal replacement therapy to overcome the hydroxocobalamin-related interference with hemodialysis. As the utility of hydroxocobalamin potentially expands, physicians must be aware of its inadvertent effect on renal replacement therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%