Tour of Automated Peritoneal Dialysis (APD) Machines

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April 13, 2021 0 Comments

It was not too way back that automated peritoneal dialysis (APD) was launched as a house dialysis remedy possibility for individuals with persistent kidney illness (CKD). In 1970, the APD machine (also referred to as a cycler) was launched to a choose few CKD sufferers who might carry out peritoneal dialysis (PD) utilizing a machine at dwelling. Peritoneal dialysis confirmed excessive demand within the Nineteen Eighties and the APD machine allowed many PD sufferers to free themselves from performing guide PD exchanges throughout the day.

You probably have thought of peritoneal dialysis utilizing a cycler however wish to know extra about the way it works, this tour could enable you higher perceive as a way to discuss together with your physician about this dwelling dialysis remedy.

Automated peritoneal dialysis (APD) – how the machine works

Slightly than performing guide peritoneal dialysis exchanges a number of instances all through the day, a affected person can do automated peritoneal dialysis whereas they sleep. Automated peritoneal dialysis is completed utilizing a machine that fills your peritoneal cavity with contemporary dialysis answer, additionally known as PD fluid or PD answer, and after a specified dwell time, drains the answer with waste out of your physique after which fills your peritoneal cavity with new dialysis answer. The common remedy time for automated peritoneal dialysis is 9 hours at night time when you sleep, however your physician will prescribe what’s finest for you.

APD gear and provides

Except for the APD machine, there’s required gear and provides that enable you carry out peritoneal dialysis remedies:

  • Masks – You might be required to put on a masks if you arrange the APD machine and if you join and disconnect from the dialysis machine. The masks needs to be over your mouth and nostril. Wash your arms after you set your masks on so you don’t contaminate your tube connections. At all times sporting your masks accurately and washing your arms are vital for fulfillment. It will restrict the alternatives for micro organism to enter your physique.
  • Massive baggage of PD fluid (PD answer) – Every PD fluid bag is full of about 6 liters of PD fluid. Two or three baggage are usually used by way of the night time. The PD fluid baggage are hooked as much as a cassette in entrance of the cycler machine, which has a tube that’s linked to the particular person’s peritoneal catheter. The catheter leads into the stomach (peritoneal cavity), and through every alternate a few of the fluid will circulation from the luggage into the stomach after which later be drained out of the physique. The PD answer dwells contained in the peritoneal cavity, gathering the wastes and additional fluid from the physique which is then drained out after every cycle is accomplished.
  •  Drain bag – The drain bag is one among two choices used to take away the PD fluid from the peritoneal cavity. The drain bag is hooked up to a cassette that warms the fluid, sending it by way of tubes linked to the cassette into an individual’s peritoneal cavity. The bag is obvious in order that the particular person could look at the waste and fluid that has been drained from the physique. The used PD fluid needs to be clear, like urine. Whether it is cloudy, that may be an early signal of an infection. Peritoneal dialysis sufferers who see this are beneficial to name their PD nurse to allow them to obtain remedy straight away.
  • Drain line – The second possibility for draining PD answer is a drain line. The drain line could be from 12 to 24 ft lengthy to be able to attain the toilet for disposal in both the bathroom, sink or bathe space.
  • Cassette and tubing – The varied tubes used to carry out APD are gathered into one space of the cycler that retains all the things organized known as the cassette or organizer. There are tubes that lead from the cassette to every dialysis answer bag (there could be from one to 4 baggage used for every remedy relying on the affected person’s prescription). The PD catheter is hooked up to a tube on the cassette as nicely. There’s one other tube that attaches from the cassette to the drain bag or drain line.

    The APD machine is programmed to empty the answer by way of the PD catheter to the drain tube (or drain line). As soon as the draining is completed, new dialysis answer is launched from a dialysis answer bag to the peritoneal catheter that results in the peritoneal cavity the place the answer will dwell for a sure time primarily based on the affected person’s prescription. This course of will repeat till the APD remedy is accomplished for the night time.

  • Documenting your APD remedy – Documenting your remedy can also be vital. This permits your physician and nurse to see how you’re doing at dwelling and assist alter your remedy to be simply best for you. There are alternative ways to do that relying on the dialysis system you employ. Your coaching nurse will enable you perceive what must be documented.

Automated peritoneal dialysis (APD) machines available on the market

The peritoneal dialysis machines have been designed to be user-friendly and usually use comparable gear and provides to carry out APD. Earlier than you obtain a cycler, you’ll undergo peritoneal dialysis coaching with a PD nurse. Here’s a description of two automated peritoneal dialysis cyclers.

  1. Baxter’s HOMECHOICE™ Automated PD System

    Like many family digital gear, the Baxter HOMECHOICE™ plugs into a daily electrical outlet. The system will inform you on the show display screen to “Press Go to Begin.” When you program your prescription numbers into the machine, the HOMECHOICE will bear in mind the knowledge for every time you employ it. You could be prompted to kind in your complete fluid quantity, remedy time and fill quantity, amongst different issues. A affected person can have one to 4 baggage of dialysis answer hooked up to the machine for the remedy in a single night time, relying in your prescription.

    Baxter’s HOMECHOICE is 20 inches lengthy, 13 inches excessive and 24 inches broad. It weighs 25 kilos.

  2. Fresenius Medical Care NA – Newton IQ cycler – The Fresenius Newton IQ™ can also be plugged into {an electrical} outlet. The machine requires the affected person or nurse to enter the affected person’s total prescription into the cycler for the primary time. This machine stays programmed for future use, till the prescription is modified and must be re-entered. A affected person could manually enter numbers corresponding to variety of fills, dwell time and drain time, amongst different info. After the numbers are entered, the Newton IQ will ask about different info, together with if the PD answer baggage should be pre-warmed or should you would like the directions in English, Spanish or French.

    Newton IQ sits 10 inches excessive and the machine is 22.5 inches lengthy and 20 inches broad. This cycler additionally weighs 25 kilos.

Each the Baxter HOMECHOICE and Fresenius Newton IQ cyclers have colourful buttons subsequent to a transparent show display screen that walks you thru every step of preparation. Every machine comes with a booklet or handout to assist information you thru arrange in case there’s something you’re unfamiliar with on the show display screen. It’s endorsed to name the producer first, Baxter or Fresenius, in case of main machine points. It’s best to name the producer when the issue happens in order that they will higher help you with trouble-shooting the issue. Each producers have 24-hour per day hotlines to assist help you with any cycler issues. Your PD healthcare group can also be available that can assist you with any questions.

Adjusting to the APD machine

Each APD machines are meant for nighttime use or throughout the day for individuals who work at night time. While you’re asleep, the cycler helps you dialyze safely and effectively. It might take time to regulate to utilizing the automated peritoneal dialysis machine.

  • Noise – APD machines don’t make a lot noise. In the event that they do, it’s only a slight buzzing sound. You could possibly hear it whereas it’s plugged in and turned on. Sufferers have mentioned the noise is minimal and never disruptive to falling asleep.

  • Alarms – Hardly ever do the alarms go off on the machine, however once they do, it is actually because it’s possible you’ll be sleeping able that’s blocking the circulation of dialysate. Many instances, shifting to a distinct place will alleviate this drawback. The show display screen signifies why the alarms are sounding so you possibly can right the matter, flip off the alarms and resume dialyzing.

  • Emergencies – Emergencies can occur, which is why the APD machines are designed to provide you with a warning if there’s a drawback. For instance, if the electrical energy had been to exit, the cycler routinely goes right into a shut down mode for as much as two hours. If the electrical energy goes on earlier than two hours are up, the cycler will proceed to dialyze from the place it left off. You should have been skilled on how one can do guide peritoneal dialysis exchanges within the occasion the electrical energy is off indefinitely or for an prolonged interval. Emergency situations shall be mentioned together with your PD nurse in your PD coaching classes.

  • Care associate non-obligatory – An individual on automated peritoneal dialysis could choose to have a care associate, however it isn’t normally obligatory. The cycler is straightforward sufficient to arrange and use so {that a} PD affected person doesn’t want help from a care associate.

  • Getting up throughout the night time – If there’s a have to stand up in the course of the night time throughout APD, you possibly can normally keep hooked up and dialyze, because the tube is comparatively lengthy. You can even detach from the cycler and if you come again the APD machine will bear in mind the place you left off. Your PD coaching nurse provides you with instruction on how one can carry out this process safely.

APD affected person advantages

Many sufferers recognize that utilizing the automated peritoneal dialysis machine throughout the night time helps release their day. The APD cycler possibility has given many sufferers the power to journey, since it’s transportable. Many individuals are in a position to work exterior their dwelling with out having to carry out guide peritoneal dialysis a number of instances a day, though it’s attainable to do guide peritoneal exchanges at work. Some sufferers performing automated peritoneal dialysis additionally report feeling higher and get higher outcomes on their lab exams.


You could have a alternative in relation to dwelling dialysis and it’s good to discover your choices. Speak to your physician if you’re focused on studying extra about automated peritoneal dialysis or different dwelling dialysis remedies.

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