Technical training dates With the upgrade of our facilities complete, there’s never been a better time to attend a course. Here’s what’s available over the next few months: Prismaflex Technical course 23-24 April and 24-25 June This two-day course is for technicians and engineers responsible for maintaining and servicing Prismaflex machines. It provides a firm understanding of the Prismaflex’s role in continuous renal replacement therapy and enables them to perform basic calibration, fault finding and simple maintenance. AK 95 S Extended course 13-16 May This four-day course is aimed at service engineers who have participated in the Basic course and then had at least six months’ practical experience with the AK 95 S. It provides engineers with a deeper knowledge of the system, enabling them to carry out advanced trouble shooting and maintenance. WRO 300 H course 22-23 May This two-day course gives service engineers a deeper knowledge of the WRO 300 H system, enabling them to perform advanced trouble shooting and maintenance. AK 200 S Basic course 2-5 June Any service engineer working with the AK 200 S should attend this four-day course as it provides a thorough grounding in relevant systems. After the course, engineers should be able to handle simple maintenance and trouble shooting. Prisma Technical course 8-9 July This two-day course is for technicians and engineers responsible for maintaining and servicing Prisma machines. It covers how the machine works, basic calibration, fault finding and simple maintenance. Prismaflex Study Days Monthly during April-July These provide further knowledge on the principles of CRRT therapies and give delegates a firm overall understanding of using and trouble shooting the Prismaflex machine more effectively. The schedule is: • 29 April - Manchester. • 13 May - Glasgow. • 17 June - London. • 16 July - Huntingdon. To book a place on a course, or for further information and a full list of all our training course dates, please contact Louise Young 01480 444033 louise.young@gambro.com Cardiovascular death rate is less in patients treated with on-line HDF A positive assessment of the effects of on-line HDF is an outcome of a prospective observational study of all chronic HD patients in the northwest part of the Tuscany region, Italy. During a 30-month follow-up, all patients on on-line HDF treatment (17% of all) were compared to those on HD (56%) or low-volume HDF with bagged reinfusion fluid (27%). Both HDF groups showed better survival rates than the regular HD group. Inflammatory markers (CRP, IL-6) also correlated significantly with mortality rates. Patients on on-line HDF showed significantly lower IL-6 levels than the other groups. [Panichi V et al, Nephrol Dial Transplant. 2008; Advance Access Feb 27, 2008] American researchers investigate allergic reactions in haemodialysis patients An outbreak of acute allergic-type reactions in US haemodialysis patients is being investigated by the US Centers for Disease Control and Prevention (CDC). In a report on their ongoing investigation, CDC states, 65 confirmed or probable cases from mid November 2007 to mid January 2008. The following signs and symptoms are reported: • Generalised or localised sensations of warmth, numbness or tingling of the extremities. • Difficulty in swallowing. • Shortness of breath/audible wheezing/chest tightness. • Low blood pressure/tachycardia. • Nausea/vomiting. One factor being investigated is receipt of a certain batch of heparin, but other exposures have not been ruled out as potential causes of the reactions. [Centers for Disease Control and Prevention (CDC), MMWR Morb Mortal Wkly Rep. 2008 Feb 8;57(5):124-5] 7 As Home Care Operations Coordinator David Lyons explains, the team’s responsibilities extend beyond liaison with patients: “Although the delivery of consumables to patients is an important aspect of our work, we are just as committed to clinical support. We make a point of keeping renal units fully informed about any issues that crop up. “Whenever we talk to a patient who raises anything about their treatment we tend to contact their renal unit. We understand the critical relationship that hospitals have with patients and we want to support clinical staff as much as possible.” Like other areas of service at Gambro, Home Care will see some specific new investment and service developments over the next year or so. We will keep you informed through future editions of Highlights and our other communication channels. Contact David Lyons 01480 444025 david.lyons@gambro.com Support for patients from members of the Home Care team including, from left, Lynne Kemp, David Lyons and Tina Hanibal, often means a friendly voice at the other end of the line There have been a number of interesting dialysis-related papers published recently. As always, our clinical specialists have been monitoring the publications and here is our summary of the papers we have found to be especially relevant.

magazine highlights Clearing failure codes on Prisma machines Failure codes on machines are among the most common enquiries our Help Line receives. In many cases, clearing the codes is a relatively simple matter, so here’s a reminder of how to deal with two you might encounter when using a Prisma machine. Failure code 0002 - prime test failure This alarm can sometimes occur at a prime test. As the alarm index in the operators’ manual and laminated error code sheet shows, this code indicates a problem with the air detector. We have found the following trouble-shooting effective in dealing with this alarm: 1. Remove the return line from the air detector. 2. Give this part of the line a tap with your fingers to remove any micro bubbles that may be in that part of the line. 3. Either wet your fingers or a cloth with clean water then wipe down the part of the return line that will sit in the air detector. 4. Reseat the return line into the air detector, ensuring that the line is flush to the back. 5. Press ‘retest’. 6. The machine will retest the air detector and this usually resolves the alarm. If not, please contact the Help Line. Failure code 0040 - self test failure If this code appears when a Prisma fails its two-hourly periodic self test, it means there is a problem with the filter pressure pod. When this occurs, press ‘retest’ - but prepare to take remedial action to reposition the diaphragm in the filter pressure pod should it fail again. Instructions to do this are in the operators manual. Repeated retesting will result in an off set of the filter pressure. To support you, we offer laminated sheets with the self test failure codes listed and instructions on how to reposition the pressure pod diaphragms. Contact Technical Service department 01480 414243 Join us at May’s renal conferences As always, Gambro will be playing an active part in the main renal conferences in 2008. We will be taking these opportunities to share with you information about our latest products, and even to invite you to tour our manufacturing facilities in Sweden. BRS/RA Conference - Glasgow This year’s British Renal Society and Renal Association Conference will be held at the Scottish Exhibition and Conference Centre in Glasgow on 13-16 May. Gambro would like to welcome you to stand 15 where we will be featuring our new CathCarry PD protector, showing how our products support anticoagulation in intensive care, and holding product demonstrations of the Prismaflex and WRO 300 H machines. We will also be running private seminars at an adjacent venue, with the focus on trials of the high cut off protein permeable membrane. Dr Paul Cockwell and Dr Colin Hutchison from the University Hospital of Birmingham will be presenting the results and status of the trial to date. You can also get an exclusive preview of our new AK 96 HD machine, which is due for launch towards the end of the year, or attend one our presentations on the hygienic chain concept by Rolf Nystrand, Consultant Microbiologist. ERA-EDTA Congress - Stockholm The European Renal Association and European Dialysis and Transplant Association Congress in Stockholm on 10-13 May promises a full programme of seminars and lectures. As the event is in Sweden it presents a great opportunity for our Gambro colleagues there to welcome UK customers. Tours around our facilities will be held, so please let us know if you would like to join us for one of them. If you would like to join us at the Gambro events mentioned above, please contact 01480 444006 marketing.uk@gambro.com This paper is made from 80% Recycled Fibre content (60% post-consum de-inked pulp + 20% recycled wood). Balance 20% virgin ECF fibre from sustainable forests. 80% Highlights is a Gambro publication, produced four times a year for UK renal care and intensive care clinicians and technicians. We welcome your comments on Highlights, including ideas about the sort of information you would like us to feature. Please also let us know if you would like to subscribe to Highlights, notify us of a change of your contact details, or tell us you no longer wish to receive a copy. Contact us at marketing.uk@gambro.com Gambro, Lundia House, Ermine Business Park, Huntingdon, Cambridgeshire PE29 6XX Tel 01480 444000 Email marketing.uk@gambro.com Web www.gambro.co.uk © Copyright Gambro 2008 8