|
The hospital reported that allergic-like reactions appeared in 5 patients at about 5-55 min after hdf began between the dates of september 12 and september 15, 2022.Same product code and same lot number.Patient 1: hdf, patient was in cold sweat, pallor, cracked voice, with laryngeal edema at about 30 min.Patient 2: hdf, patient was in sweat, bp decreased more than 30mmhg at about 20 min.Patient 3: hdf, patient vomited, sweat profusely, limbs endings cyanosis at about 5 min.Patient 4: hdf, patient vomited, pruritus was seen at 10 min.Patient 5: hdf, patient was abdominal pain, vomited, sweat profusely at about 55 min.All the 5 patient haven't used 17h and hdf for over 1 month.The dialyzer of patient no.5 patient was kept.The hospital applied a self-inspection on the priming operation, dialysate quality, ro water quality, evaluate of the qb and qf, no abnormalities was reported, our local clinical specialist 're still concentrate on the actual operation.The priming volume is about 1000ml, the priming uses a flow at 80-100ml/min (500ml), then self circulation is applied, a faster flow (200ml/min) priming was after the self circulation (500ml).The hospital used ns for priming, the brand of ns is shimen, and the brand of the tube is cgst-003-e.Dialysate a is from huayue medical, dialysate b is from taishikang.Avf needle is jms.Dexamethasone was applied after the incidents happened, the nurse changed new tube and dialyzers(fb-17u) fot the patient, following treatment is hf-hd, the effects was meliorated after a instant treatment.In the incidents, hdf qb and qd was not available.We suggested the hospital use a lower qf flow and a lower hco3- concentration at the beginning of treatment while rising the qf flow up to target volume gradually.No side effects was found in the patient who restarted hdf.
|
