Compared to conventional bloodlines, Streamline® provided significantly lower costs per
`treatment and reductions in heparin usage and medical waste1
`
`Streamline™ Airless System Optimizes Dialysis Adequacy with Reduced Costs
`Poster presented at American Society of Nephrology Conference, 2007.
`
`Cooke JD, Moran J. – In this cross-over study of 117 patients at Satellite Healthcare in Mountain View, California, Streamline
`maintained or improved patient Kt/Vs while reducing per-treatment costs in dialysate, heparin, biohazard waste, and transducer
`protectors as compared to conventional bloodlines.
`
`With Streamline, average blood flow
`rate (BFR) significantly increased
`by 62 mL/min (p<0.0002)
`
`With Streamline, average dialysate flow rate (DFR)
`significantly decreased by 203 mL/min (p<0.0001)
`
`800
`
`597
`
`■ Conventional
`
`■ Streamline
`
`900
`
`800
`
`700
`
`600
`
`500
`
`DFR (mL/min)
`
` Increased blood flow rates enabled more efficient dialysate usage
`while maintaining or improving Kt/V. The study reported per-
`treatment dialysate savings of $1.39 with Streamline.
`
`With Streamline, average heparin dose significantly
`decreased by 28.1% (p<0.0001)
`
`5,667
`
`4,076
`
`■ Conventional
`
`■ Streamline
`
`6,000
`
`5,500
`
`5,000
`
`4,500
`
`4,000
`
`3,500
`
`Heparin Dose (units)
`
`409
`
`347
`
`■ Conventional
`
`■ Streamline
`
`425
`
`400
`
`375
`
`350
`
`325
`
`300
`
`BFR (mL/min)
`
`Streamline enabled higher blood flow rates in
`comparison to conventional bloodlines.
`
`With Streamline, % of patients with
`treatment time > 4 hours reduced by 56%
`
`16%
`
`7%
`
`■ Conventional
`
`■ Streamline
`
`20%
`
`15%
`
`10%
`
`5%
`
`0%
`
`% Patients with treatment
`
`time > 4 hours
`
`Increased blood flow rates enabled shorter
`treatment times for some patients while maintaining
`or improving Kt/V.
`
` Heparin dose was reduced in 85% of patients. The study reported
`per-treatment heparin savings of $0.07.
`
`Clinical Evidence
`
`NxSTAGE Ex 2008-1
`Nipro v NxStage
`IPR2016-00744
`
`

`
`Cost Reductions
`
`The study reported savings in dialysate usage and staff overtime of $1.39 and $1.32 respectively per treatment.
`In addition, savings of $0.19, $0.07, and $0.03 per treatment were seen for biohazardous waste, heparin, and
`transducer protectors respectively. In total, the study showed cost savings of $3.00 per treatment when using
`Streamline compared to conventional bloodlines.
`
`Reduction in Treatment Alarms
`
`The study reported a 53% reduction (p=0.002) in alarms per treatment. On average, 0.72 and 0.34 alarms per
`treatment were seen for conventional bloodlines and Streamline respectively. Most of the difference was attributable
`to fewer pressure alarms.
`
`Study Design: Cross-over study of 117 patients to determine the clinical and economic benefits of Streamline bloodlines in the
`outpatient setting. Outcomes and measurements include: average blood flow rate, average arterial pressure, average venous
`pressure, average Kt/V, average URR, total machine alarms, saline usage, acid/bicarb concentrate usage, potable and RO water
`usage, TP/syringe/needle usage, heparin usage, storage, waste removal, treatment time, and nursing hours.
`
`Study Limitations: This was a cross-over study. Limitations of cross-over studies may include confounding due to issues of
`order, carry-over and learning.
`
`Important Information: The Streamline blood tubing sets are prescription devices and, like all medical devices, involve
`some risks. Failure to observe all warnings and precautions noted in the Streamline Instructions for Use may result in serious
`complications, including blood loss due to clotting or air entering the bloodstream. Each patient’s care plan should be determined
`by the physician, based on the individual facts and circumstances of the patient. The use of anticoagulation is at the discretion
`of the prescribing physician.
`
`References:
`1. Cooke JD, Moran J. StreamlineTM airless system optimizes dialysis adequacy with reduced costs. Poster presented at
`American Society of Nephrology Conference, 2007.
`
`350 Merrimack St. • Lawrence, MA 01843 USA • www.medisystems.com • 1.800.369.MEDI
`
`© 2016 NxStage Medical, Inc. Medisystems and Streamline are registered trademarks of NxStage Medical, Inc.
`CAUTION: Federal law restricts this device to sale by or on the order of a physician. APM1714 Rev. A
`
`NxSTAGE Ex 2008-2
`Nipro v NxStage
`IPR2016-00744