Thought my day started with luck because I was only TECH-ing (worked as tech instead of a nurse) this day when suddenly a venous pressure alarm gave me an eerie feeling.

High venous pressure with no signs of clot! I tried detaching the venous lines to check the patency of the venous access—100% patent; I turned on the pump and let the venous line drain on the bucket to note any obstruction or clot—good flow; I flushed the system but this time around, venous pressure even skyrocketed. Finally, I returned the blood to fully see the chambers for any clots—na-da!

But there’s more, the blood in the arterial line was lighter than that from the venous line which already gave me a hunch of dialysis access recirculation but the high venous pressure was a first for me!

So I asked the crystal ball (google),

“Does dialysis access recirculation cause high venous pressure alarm?”

Then, the great AI immediately answered,

“Yes, dialysis access recirculation can indeed cause a high venous pressure alarm on a dialysis machine because when blood is recirculating back into the venous line, it creates a resistance to blood flow, leading to an elevated pressure reading at the venous needle site.”

Explanation:

Blood Flow Dynamics:
When a significant amount of blood is recirculating within the access, it means the blood is not efficiently exiting the access through the venous needle, causing a buildup of pressure in the vein.

Stenosis as a Cause:
The most common reason for recirculation is a narrowing (stenosis) in the vein near the access site, which impedes the normal flow of blood.

When dialysis access recirculation happens, a portion of the already partially dialyzed blood flows back into the dialyzer, reducing the overall efficiency of the dialysis process and potentially leading to inadequate waste removal from the body.

Dialysis was not efficient anymore so, treatment was cut early, patient referred to the access center and discussed with the techs to cannulate a new venous spot next treatment, farther away from the stenosis (pt was on buttonhole).

And that was my kind of Friday the 13th. Definitely one for the books!