Today we had a septic patient on high doses of pressors with AKI requiring SLED. SLED could not be continued as the dialysis machine started triggering the blood leak alarm, which persisted despite changing the dialysis machines multiple times.
It happened after the patient received hydroxocobalamin infusion to reduce the pressors requirements( it has been shown to be a NO scavenger) and it worked in our patient. Chromogenic substances such as hydroxocobalamin can lead to discoloration of dialysate fluid,
That can activate the blood leak detector and causing the dialysis machine to shut down. Gambro Phoenix X36, NxStage, and Prisma Flex dialysis machines are reported to be not affected by this dialysate discoloration due to hydroxocobalamin and can be safely used.
There is no definite time limit for transition back to using hemodialysis machine as serum hydroxocobalamin level is noticeable up to 30 days following its administration, in some reported cases a successful transition was made in few days .
You can follow @MunerMohamed1.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled:
Those who think consciousness raising & movement building are disconnected, or even a distraction from electoral politics have not paid attention to the history of social change.In this thread, we
Read more
The 2020s will be known as the Remote Work decadeA few predictions of what is likely to emerge[ a thread ] Third Space: Office and Working from Home will
Read more
1/29: Have you ever had a concept explained to you that helps frame complex issues you’ve been wrestling with and opens your eyes to new possibilities? A concept that I
Read more
By continuing to use the site, you are consenting to the use of cookies as explained in our Cookie Policy to improve your experience.