Management of dialyser blood leak during haemodialysis part 1

Rupture of a dialyser membrane can occur due to :

• Dialyser being dropped
• Application of excessive trans-membrane pressure during isolation ultrafiltration of excessive fluid removal
• Clotting of the blood circuit
• Clotting of the dialyse

Careful observation of the blood circuit for colour, clots and monitoring of the trans-membrane pressure by ensuring the maximum pressure according to the manufacturer is not exceed, should ensure any leak is prevented. In addition, dialysis machines use an optical sensor to detect any passing of blood into the dialysate compartement by looking for a colour change in what should be clear fluid.
False alarms (which activate the machine alarm system as if it were a true blood leak), can be caused by tiny air bubbles passing through the intact membrane. This is generally caused by inadequate priming before dialysis has commenced on air which has entered the blood circuit during the treatment requiring "recirculating" until all air is removed and the alarm cleared