“Any access recirculation is abnormal. Recirculation … should have prompt investigation of its cause. … If access recirculation values exceed 20%, correct placement of needles should be confirmed before conducting further studies.” http://www.kidney.org/professional/KDOQI/guidelineñupHDñVA/index.htm

The Transonic Hemodialysis Monitor helps to optimize efficient dialysis delivery through measurement of delivered pump blood flow and recirculation. Use of these measurements guarantee efficient and effective hemodialysis (dialysis adequacy) by:

1. Testing calibration of the blood pump;
2. Verifying true delivered blood flow and compares delivered blood flow
3. Comparing delivered blood flow to pump setting to identify flow disparity and avoid underdialysis. If disparity is significant, Flow-QC® assists in determining cause (blood pump calibration versus inflow restriction/excessive pre-pump negative arterial pressure);
4. Detecting and quantifying access recirculation in AV access and catheters;
5. Identifying inadvertent reversal of dialysis lines to prevent recirculation and/or underdialysis;
6. Confirming proper needle placement;
7. Identifying sources of large negative arterial blood line pressure

(and its resulting underdialysis);

1. Determining the most appropriate blood pump setting for a low flow access when it is not feasible to increase access flow;
2. Measuring delivered flow and recirculation to help maximize catheter function.

Reference:

Spergel LM, “Transonic Flow Surveillance: The Cornerstone of My Vascular Access Management Program (VAMP©)î or Clinical Applications of the Transonic Flow Monitor in the Hemodialysis Facility. (Transonic Focus Note # HD58)