Abstract: FR-PO501
Rheologic and Fill/Drain Pressure Differences Between a Novel Gravity-Based Automated Peritoneal Dialysis Cycler (APD) and Conventional Pump-Based Cyclers
Session Information
- Peritoneal Dialysis: Current Topics
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Lindo, Steve J., Simergent, LLC, Oklahoma City, Oklahoma, United States
- Pendergraft, Rick, Simergent, LLC, Oklahoma City, Oklahoma, United States
- Henderson, Jacob D., Simergent, LLC, Oklahoma City, Oklahoma, United States
- Sloand, James A., Simergent, LLC, Oklahoma City, Oklahoma, United States
Background
APD offers patients selecting Peritoneal Dialysis (PD) greater convenience, autonomy, & lifestyle flexibility than Continuous Ambulatory PD. APD is the predominant mode of PD in the US and other countries. PD fluid inflow and outflow in most contemporary APD cyclers is pump, rather than gravity-based, technology integrated into cyclers for travel portability. However, a previous study showed PD patients and RNs prefer the features of a quiet, gravity-based cycler with reduced setup time and portability within the home over current pump-driven cyclers. Data have also shown increased delivery/suction pressures generated by pump-driven PD flow can be associated with patient complaints of drain pain and tidal PD used to help address it. Tidal PD is the leading contributor to development of increased intraperitoneal volume (IIPV), a complication potentially leading to patient morbidity and mortality. This evaluation assessed pressures & fill/drain flow rates generated by a novel gravity-based APD cycler and current commercially-available pump-based APD cyclers.
Methods
Manufacturer-specified* rheologic and fill/drain pressure differences for pump-based cyclers were compared to gravity-based Archimedes cycler test results†. These fill/drain flow rate tests were conducted in vitro using 71 cm bed height, 305 cm patient line, 15 cm transfer set, and a 60 cm curled catheter placed inside a container. A 140 cm heater bag height and 30 cm drain container height were used.
Results
Comparative filling and draining pressures & flow characteristics of three cyclers are shown below.
Conclusion
The novel Archimedes gravity-based APD cycler with features previously demonstrated to be preferred by patients and PD RNs achieves comparable rheologic benchmarks using inflow (fill) and outflow (drain) pressures that are much lower than current pump-based cyclers by leveraging continuous flow vs. pulsatile flow. The former has the potential to significantly improve patient experience and reduce drain pain complaints.
| APD Cycler | Maximum Fill Pressure (cm H2O) | Maximum Drain Pressure (cm H2O) | Fill Rate (mL/min) | Drain Rate (mL/min) |
| Simergent Archimedes† | 69 | -41 | 218 | 125 |
| Baxter HomeChoice Pro* | 155 | -155 | 220 | 125 |
| Fresenius Liberty Select* | 663 | -255 | n/a | 100 |
Funding
- Commercial Support – Simergent, LLC