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Poiesis Duette Catheter - Balloons Fluid Loss

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  • Poiesis Duette Catheter - Balloons Fluid Loss

    A while ago, "Scaper1" posted about losing a lot of fluid out of the balloons of the Poiesis Duette Catheters, 10cc and 5cc ports. I decided to experiment with a used catheter and compare 7 days of balloon inflation.

    My Experiment:
    I filled the "non black" (orange in my case-16Fr) port with 10cc of sterile water and the "black" port with 5cc of sterile water, per the instructions for balloon inflation. I placed the catheter on a paper towel which I had labeled with the day of inflation. I took a picture of the inflated balloons. I waited 7 days and took another picture of the same catheter.

    My Results:
    Yes the balloons did lose fluid by a significant amount as you can see in the picture. The fully inflated balloons are clear and stretched out. The balloons, 7 days later are not at clear and visibly smaller. The pictures are taken from the same distance away, or very close to the same distance. I placed the catheter on a paper towel to absorb any liquid. The paper towel was never visibly or to the touch wet. What's more, there was no water mark on the paper towel as there would be if it had been wet and then dried. I presume the fluid slowly evaporated through the silicone membrane of the balloon. After taking the photos, I deflated the balloons. There were a little more than 2cc left in the black port balloon and 7cc left in the non black port balloon. Whether this is the same amount of liquid that would be lost if the catheter was inside the bladder is hard to say.

    Seems like it would be good practice to check the balloons about every 10 days by withdrawing liquid from the balloons and refilling them. I think I would test the black port (cushioning balloon) first. If the balloon had lost 1cc (20%), I think I would just re-inflate the 5cc balloon with 5cc of sterile water, and stop, then possibly repeat the inflation test in a few days. If I found the 5cc balloon had lost more than 20%, I would re-inflate it with 5cc of sterile water and then test the 10cc balloon for water loss.

    I will send my results to Poiesis for their take on this water loss.
    Attached Files
    Last edited by gjnl; 04-06-2017, 06:32 PM.

  • #2
    Interesting - good experiment !

    Comment


    • #3
      Originally posted by gjnl View Post
      A while ago, "Scaper1" posted about losing a lot of fluid out of the balloons of the Poiesis Duette Catheters, 10cc and 5cc ports. I decided to experiment with a used catheter and compare 7 days of balloon inflation.

      My Experiment:
      I filled the "non black" (orange in my case-16Fr) port with 10cc of sterile water and the "black" port with 5cc of sterile water, per the instructions for balloon inflation. I placed the catheter on a paper towel which I had labeled with the day of inflation. I took a picture of the inflated balloons. I waited 7 days and took another picture of the same catheter.

      My Results:
      Yes the balloons did lose fluid by a significant amount as you can see in the picture. The fully inflated balloons are clear and stretched out. The balloons, 7 days later are not at clear and visibly smaller. The pictures are taken from the same distance away, or very close to the same distance. I placed the catheter on a paper towel to absorb any liquid. The paper towel was never visibly or to the touch wet. What's more, there was no water mark on the paper towel as there would be if it had been wet and then dried. I presume the fluid slowly evaporated through the silicone membrane of the balloon. After taking the photos, I deflated the balloons. There were a little more than 2cc left in the black port balloon and 7cc left in the non black port balloon. Whether this is the same amount of liquid that would be lost if the catheter was inside the bladder is hard to say.

      Seems like it would be good practice to check the balloons about every 10 days by withdrawing liquid from the balloons and refilling them. I think I would test the black port (cushioning balloon) first. If the balloon had lost 1cc (20%), I think I would just re-inflate the 5cc balloon with 5cc of sterile water, and stop, then possibly repeat the inflation test in a few days. If I found the 5cc balloon had lost more than 20%, I would re-inflate it with 5cc of sterile water and then test the 10cc balloon for water loss.

      I will send my results to Poiesis for their take on this water loss.
      I check my Duette catheter balloons once a week and usually have to put around 1cc in both balloons.

      Comment


      • #4
        My normal foley loses about 5-10cc within a month. I fill it to almost 30cc.
        Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

        T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

        Comment


        • #5
          This is important to know as I plan on using these catheters next time I need a Foley. If one checks how much fluid is in the balloon and it is insufficient does one use additional prefilled syringes? I believe the Foley syringes are prefilled, correct? Or can one use an empty prefilled to draw in sterile saline from another container to use? Otherwise, one needs a pretty good supply of prefilled syringes on hand.

          Comment


          • #6
            You don't need to fill the balloons from prefilled syringes either initially or when you need to add more sterile water.

            Comment


            • #7
              I received an email from Poiesis regarding this loss of liquid in the balloons.
              "Osmosis is common with all 100% silicone catheters, it also appears the amount of osmosis occurring varies depending on length of indwelling time as well as the individuals hydration. We conduct tests with each new lot number but usually have the catheters submerged in water since when indwelling they are in a moist to wet environment, having them sitting on a paper towel may have accelerated the loss of fluid. In our testing we have not seen loss of fluid, but have heard from patients with longer indwelling periods."

              It was also suggested that we use pre-filled syringes with sterile water and glycerin solution. This product is sterile and presented in a sterile packet. The glycerin solution has shown to be beneficial in reducing the amount of water lost from the balloon over a length of time, most noticeably in 100% silicone catheters, due to maintaining an osmotic pressure comparable to urine. If you search the internet, you can find sources for these prefilled syringes.
              Last edited by gjnl; 04-08-2017, 07:31 PM.

              Comment


              • #8
                More information about the 10% aqueous glycerin prefilled syringes and why glycerin help to retain liquid in the balloons:
                Attached Files

                Comment


                • #9
                  They're kindly sending me a sample of the glycerine syringes, so I'll report back too. Currently we're using sterile water, and draining and refilling the balloons every week.

                  Comment


                  • #10
                    Reliable source?

                    If you search the internet, you can find sources for these prefilled syringes.
                    Has anybody found a reliable source for the prefilled syringes with glycerin?

                    Comment


                    • #11
                      Originally posted by Fragile View Post
                      Has anybody found a reliable source for the prefilled syringes with glycerin?
                      An email that I received from Poiesis Medical indicates that the European catheter manufacturer Rusch recommends and supplies with their silicone catheters (in kit form) the 10% aqueous glycerin prefilled syringes. Poiesis Medical appears to be in negotiation with Rusch to become a supplier of these syringes in the United States. After doing an internet search and not finding much, I get the impression that these syringes are not readily available in the United States at this time. I guess for now, we wait to see how Poiesis will be offering these syringes. If anyone has any better luck finding a United States source, let us know here.

                      Comment


                      • #12
                        Originally posted by gjnl View Post
                        An email that I received from Poiesis Medical indicates that the European catheter manufacturer Rusch recommends and supplies with their silicone catheters (in kit form) the 10% aqueous glycerin prefilled syringes. Poiesis Medical appears to be in negotiation with Rusch to become a supplier of these syringes in the United States. After doing an internet search and not finding much, I get the impression that these syringes are not readily available in the United States at this time. I guess for now, we wait to see how Poiesis will be offering these syringes. If anyone has any better luck finding a United States source, let us know here.
                        This catheter has been nothing but good to me. I have noticed that the balloons lose water a long time ago. I really hope that we get those syringes in US soon.
                        I ordered 50 catheters 1 hear ago just so I don't run out
                        C5/C6 Complete since 08/22/09

                        Comment


                        • #13
                          Originally posted by Mac85 View Post
                          This catheter has been nothing but good to me. I have noticed that the balloons lose water a long time ago. I really hope that we get those syringes in US soon.
                          I ordered 50 catheters 1 hear ago just so I don't run out
                          50 catheters? How often do you change your catheter? 50 would last me about 4 yrs.

                          Comment


                          • #14
                            Originally posted by gjnl View Post
                            If anyone has any better luck finding a United States source, let us know here.
                            Not a USA source, but their website says they ship worldwide, and they list a US$ (USA dollars) price:
                            http://www.medibargains.co.uk/optipure-purified-water-with-10-glycerin-x-200-syringes/



                            If you are really motivated to use this, you could consider making your own. It would require taking the sterile water or normal saline pre-filled 10ml. syringe from your catheter insertion kit, squirt out 1ml, and use it to then suck up 1ml. of 100% liquid glycerin. If you use this for the balloon filling, be sure that the glycerin is mixed well in the syringe before use (shake it well).

                            https://www.walgreens.com/store/c/af...uId=sku4117393


                            (KLD)
                            Last edited by SCI-Nurse; 04-18-2017, 12:10 PM.
                            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                            Comment


                            • #15
                              Originally posted by HACKNSACK44 View Post
                              50 catheters? How often do you change your catheter? 50 would last me about 4 yrs.
                              You're right, changing the catheter about once a month, you have a 4 year supply.

                              Originally posted by SCI-Nurse View Post
                              Not a USA source, but their website says they ship worldwide, and they list a US$ (USA dollars) price:
                              http://www.medibargains.co.uk/optipu...-200-syringes/

                              If you are really motivated to use this, you could consider making your own. It would require taking the sterile water or normal saline pre-filled 10ml. syringe from your catheter insertion kit, squirt out 1ml, and use it to then suck up 1ml. of 100% liquid glycerin. If you use this for the balloon filling, be sure that the glycerin is mixed well in the syringe before use (shake it well).

                              https://www.walgreens.com/store/c/af...uId=sku4117393


                              (KLD)
                              I'm personally not motivated enough to use the glycerin syringes for filling the balloons to go to either of the extents you've mentioned. I haven't found deflation of the silicone balloons over a month's use to be that much of a problem. I'll wait until they are available in the United States and I can bill them through my insurance as medically necessary supplies.

                              Until recently, when a member here mentioned they noticed the balloons deflating in the Duette catheters, I don't think many of us gave it much thought. I think it should be said that the Duette catheter isn't unique in this problem. With silicone foley catheters, in general, you will find the balloons will deflate some over a one month use. It is the silicone material, not a manufacturing issue.

                              Comment

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