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An Interesting Case "Trust Your Eyes"
While screening for access recirculation with the HD01 Monitor a clinician in the UK found no recirculation at a pump flow (Qb) of 231
ml/min, but noticed a small deflection in the arterial baseline. The clinician increased pump flow to 304 ml/min and repeated the recirculation test. Recirculation then
showed 4%. The HD01 may not recognize access recirculation < 2%.
If you have any doubts about recirculation, you should increase pump flow and repeat the recirculation test. Even though recirculation is
only 4% at Qb = 302 ml/min, it could be 25% at Qb = 350 ml/min, etc.
Any recirculation indicates that access flow is smaller than pump flow (except for inadvertent line reversal or close needle position [2-3
cm]). The low flow indicates that the vascular access is severely compromised and may soon clot. The recirculation test should be followed by an HD01 access flow
measurement for conclusive confirmation of the low access flow.
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