Question 5.3

Give two causes for this appearance of the ultrafiltrate from a CVVHDF circuit.

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College Answer

Answer:
Intravascular hemolysis
Rupture of filter membrane

Discussion

Its difficult to find a reference for this. The appearance is clearly that of blood, or at least haemoglobin. How did this happen?

Well; its one of the following possibilities:

  • The filter membrane ruptured, releasing blood into the effluent
  • There is a massive intravascular haemolysis
  • The patient has recently received a dose of hydroxycobalamin, which tends to discolour all body fluids, and which will cause the blood detector in the dialysis machine to alarm.

References

Sutter, Mark, et al. "Hemodialysis complications of hydroxocobalamin: a case report." Journal of Medical Toxicology 6.2 (2010): 165-167.