Events diary Here are some of the renal care and intensive care events coming up. You’ll find a Gambro stand at all of them, so come and say hello if you attend. ERA-EDTA Congress 10-13 May, Stockholm, Sweden The European Renal Association and European Dialysis and Transplant Association will have a busy scientific programme to address the latest advances in basic and clinical research. For further information visit www.eraedta2008.org and see the article on page 8. The BRS/RA Conference 13-16 May, Scottish Exhibition and Conference Centre, Glasgow The British Renal Society and the Renal Association, in association with the Scottish Renal Association, are offering a comprehensive forum to discuss kidney care and research. Visit us at stand 15. For further information visit www.britishrenal.org and see page 8. The Intensive Care Society - Spring Meeting 19-21 May, Manchester Central Conference Centre International and UK experts will deliver a stimulating scientific programme, with parallel sessions addressing issues of interest to a multi-professional audience. For further information visit www.ics.ac/uk British Association of Critical Care Nurses - the 23rd National Conference 15-17 September, York Racecourse This year’s conference, ‘Caring, Competence & Collaboration’, comprises plenary sessions with leading opinion formers and decision makers. For further information visit www.baccnconference.org.uk The 5th International Symposium on Clinical Applications of Serum Free Light Chain Analysis 18-19 September, Assembly Rooms, Bath Gambro is co-sponsoring this event, which has a full scientific programme focusing on a number of recent trials. For more information visit www.biennial2008.org Contact 01480 444006 marketing.uk@gambro.com The latest contribution to the dialysis fluid ‘hygienic chain’ 3 The unit is designed for use with a single patient, whether in-centre or at home. When used with our latest monitors, it enables end-to-end heat disinfection of the water unit, the connection loop to the dialysis monitor and the monitor itself. Disinfection includes the part of the monitor found before its own heat clean unit, ensuing that the hygienic chain remains unbroken. All of this is achieved through low flow heat disinfection of the dialysis machine internal tubing. The WRO 300 H is just the latest Gambro product development to address the need for superb hygiene in dialysis fluid. This follows other initiatives such as CleanCart and Ultrafilters, which also reinforced our commitment to maintaining the integrity of the hygienic chain to reduce the risk of inflammatory episodes, anaemia and cardio-vascular complications. Our approach now ensures disinfection of the total loop, especially the ‘no man’s line’ distribution loop between water plant and HD machine. Another contribution to effective disinfection is made by our central water plant heat capabilities. No chemicals are used, eliminating the need of residual test strips and providing one simple procedure. It is also automated so that the activity can be performed during the night, leaving the machine ready to operate in the morning. Contact Brian May 01480 444016 brian.may@gambro.com Nowhere is Gambro DNA better embodied than in our developments in water purification and machine cleanliness to deliver the purest dialysis fluid possible. This is encompassed within our ‘hygienic chain’ concept and our latest development: the WRO 300 H water purification unit, which uses hot water purification to disinfect efficiently without using chemicals. Visit www.gambroDNA.co.uk for more details about our programme of innovation. CATHcarry has been developed following extensive research amoung nurses and patients

Bloodlines set for upgrade with double membrane technology Gambro continues to put patient safety at the forefront of our priorities with the introduction of double membrane technology, 2M-PROTECT TP®, to our bloodlines. The new double membrane bloodlines will: • Increase patient safety by avoiding potential leakage and cross contamination. • Improve handling with easy grip of the new square shaped membrane casing. • Prevent disconnection or cracking by shortening and softening the extension line. Sam Ford, Marketing Manager, explains what lies behind this development: “The pressure transducer protector is a vital connection point to the haemodialysis machine and its pressure measuring devices. It’s really the last line of defence to prevent blood contamination. “There is concern in the dialysis community about reported cases of blood contamination through single membrane pressure transducer protectors. Although there is no evidence that this is an issue with Gambro’s bloodlines, we are constantly striving to innovate and improve patient safety and therapy experience. That’s why we are introducing the double membrane across our range over the coming months.” Contact Samantha Ford 01480 440006 samantha.ford@gambro.com Prismaflex provides a safer way to deliver citrate anticoagulation How citrate works Citrate anticoagulants work by chelating (binding) calcium in the patient’s plasma, reducing ionised calcium levels in the blood whilst it is in the circuit. This disrupts the clotting cascade in several places. Then, as the blood returns to the patient (via the return line), it mixes with the systemic blood flow to restore the Ionized calcium levels reactivating the clotting process. This results in only the blood in the circuit being anticoagulated - and not the patient. There are numerous benefits involved in using citrate. It can increase the circuit life considerably (1, 2), reducing nursing work load and increasing the time the patient is filtered and potentially reducing cost. Citrate anticoagulation has also been shown to reduce the risk of patients bleeding, and subsequent transfusion requirements (2). This can give the opportunity to anticoagulate patients who are at high risk of bleeding or HIT-positive patients. Citrate and patient safety Patient safety has always been an issue when delivering citrate. Many studies have reported potentially dangerous side effects such as metabolic alkalosis and hypernatremia (3, 4). These side effects have mostly been associated with the use of concentrated (hypertonic) citrate solution. These hypertonic forms of citrate have forced the users to use non-physiological replacement and/or dialysate fluid which can significantly increase the risk to the patient. Gambro has reduced the risks of these side effects by developing both a citrate and a dialysate/replacement fluid that are isotonic. Both the Prismocitrate 10/2 and the Prism0cal contain physiological levels of buffers and sodium. Consequently, the risks of potentially dangerous side effects are greatly reduced. Adding a second membrane to Gambro’s bloodlines will make a positive contribution to patient safety 4 Intensive care units in Europe and the US have long been using citrate to anticoagulate the circuits during continuous renal replacement therapy (CRRT). In this article, Lloyd Buck, Gambro’s Acute Care Product Manager, looks at the most important issues around citrate anticoagulation - and at the contribution Prismaflex makes to its safe application.