Abstract

FERNANDEZ MARTINEZ, Ana Vanessa et al. Comparison of automatic versus manual infusion in post-dilutional online haemodiafiltration. Rev Soc Esp Enferm Nefrol [online]. 2010, vol.13, n.1, pp.17-22. ISSN 1139-1375.

Post-dilutional online haemodiafiltration is the most efficacious infusion method for the elimination of molecules with different molecular weights; it has also been associated to a better control of anaemia and of the nutritional condition of the patient, presenting lower morbility for patients undergoing haemodialysis. Recently, major advances have been made in the technology enabling the automatic prescription of the infusion flow, which could reduce the nursing workloads. The aim of this study is to evaluate the efficacy of automatic infusion compared to manual infusion in post-dilutional online HDF, by measuring the final convective volume and the rinsing volume of small molecules using Kt. The nursing workloads were also evaluated, measured by the number of interventions related to the technique, an evaluation of the convenience and efficacy perceived by nursing staff and whether there were differences in the patient's comfort during the session. A prospective study was designed of 86 patients; after three sessions with each of the reinfusion modes, significant differences were observed both in the replacement volume (1.5 litres) and in the dialysis dose administered, measured using Kt (1.02 litres), which are higher in the automatic form. Furthermore, the subjective evaluation of nursing staff is much higher in the automatic mode compared to manual, both in perceived efficacy and in convenience. Patients also expressed greater comfort in sessions with automatic reinfusion as the number of acoustic alarms was reduced, favouring rest. Although the clinical effects were slight, automatic reinfusion is shown to be a good alternative especially in relation to the adaptation to the technique by nursing staff and by patients.

Keywords : Haemodiafiltration; Quality of life; Infusion.

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