A question about something called a CRIT-line ?

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KevN:
Quote from: coping on  August 30, 2007, 07:37:16 PM  PDT

I don't know anything about this since my dialysis unit doesn't use it but I have heard about it through many kidney forums. Seems only some brands of Hemo Dialysis machines use it. I think I heard that Fresenius uses it. Probably NxStage as well but I am not sure. I would like to hear more about it as well!

This is what I found on it:

Quote

Crit-Line III is a fluid management and access monitoring tool incorporating the latest photo-optical technology to non-invasively measure absolute hematocrit, percent blood volume change, continuous oxygen saturation and access recirculation. The addition of TQA (transcutaneous) Access Blood Flow capability to the Crit-Line III provides the hemodialysis clinician with a state-of-the-art access management tool. Fluid management using hematocrit-based blood volume monitoring has been shown to be effective in optimizing dry weights, reducing hospitalizations, minimizing hypovolemic symptoms. Crit-Line simply provides the optimal patient care.

A disposable cuvette connected to the arterial side of the dialyzer and in-line with the blood tubing set allows the Crit-Line to non-invasively monitor whole blood parameters. Patented optical technology shines near-infrared light through the blood, specifically measuring the scattering and absorption characteristics of the red blood cell. The proprietary ratio metric formula provides real-time hematocrit and oxygen saturation.

LINK*

Is that the same as Access Flow that is done every other month on the Fresenius 2008K machines in clinic?



I know that if we are put on oxygen assistance during crit-line monitoring, our numbers look better as well.  It was recommended.  I've been on it 4-5 times.  Unexpected for me, but a very cool thing indeed.

Mishy89:
Quote from: getlife on  September 10, 2007, 09:35:13 PM  PDT

Yes, I have heard of crit-line, I think Ozfan might be 'detailed' help on this one.  I have talked to the rep for the crit-line in my state, but my dialysis unit won't accept or try it.


My dad has worn my dialysis unit down on this subject! lol When I was in rehab after getting compartment syndrome They used crit-lines..it was great I didnt even get sick! But my dialysis said "no" they dont like it..I dont know why though...

coping:
Wish I knew why ... they seem like the nurses would LOVE them ...

OZfan:
Crit-Line is a valuable tool to use when you are on hemodialysis.  It measures HCT non-invasively.  The two reasons why I don't think clinics use it is the Cost or the clinicians do not understand how to interpret the technology.  The machine is about 3,000 and the little disposable blood chamber is about $2.00. You need a new blood chamber every treatment.   Adding a couple dollars to a dialysis treatment when the reimbursemnt is fixed is not always attractive to a dialysis provider.     

Last december I spoke to the CMS Medical Director reimbursing for it.  I am still advocating for it on a National Level.  Please e-mail me any letters or thoughts on this machine. 

A few years back I wrote an educatioanl booklet about the Crit-Line.     
http://www.crit-line.com/Patient_Booklet.pdf

Blood Volume Monitoring should be a standard of care.  It is a window into your intravascular structure to see how fast the fluid is being removed.  It can help let you know if you are at a correct dry weight. The number one reason people on dialysis die is because of heart disease.  Fluif overload causes high blood pressure and is very hard on your heart. 

A doctor in Thousand Oaks (Dr. Kant Tucker) bought Crit-Lines for all of his eleven facilites.  One on every chair. 
The Crit-Line is used throughout the Country, although it is very sporadic.

Most pediaric facilites use it. The machine needs reimbursemnt to have wide acceptance.  Patients and family memers need to keep demanding it. 

 





jolie3:
I have never even heard of it.  I am going to have to ask about it.  Being little, its always a problem getting off the weight.  My dialysis unit gives back 500ccs of fluid to give you back all the blood.  I find that annoying!  In order to get off the machine at your dry weight you have to be 1lbs. under weight!!  Makes the last hour really hard!

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