1. Intradialytic non-invasive hemodynamic monitoring: usefulness of cardiac preload values in predicting hemodynamic instability
- Author
-
María Ángeles Fernández Rojo, Rafael Díaz-Tejeiro Izquierdo, Mario Vaquero Alonso, Dabaiba Regidor Rodríguez, Laura Cueto Bravo, Iván Carmena Rodríguez, David Carro Herrero, Carlos Jesús Cabeza Reina, and Francisco Javier Ahijado Hormigos
- Subjects
Hipotensión arterial intradiálisis ,Monitorización hemodinámica ,Precarga cardiaca ,Peso seco ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Introduction: Adequate control of patient blood volume in hemodialysis (HD) is essential as a modifiable risk factor for morbidity and mortality. In this study, we propose continuous non-invasive hemodynamic monitoring using bioreactance (Starling SV.Baxter) and real-time characterization of cardiac preload data to aid in the accurate assessment of volume status and improvement of tolerance in HD. Methodology: Observational and prospective study on the relationship between cardiac preload data and intradialytic hemodynamic instability. Forty-six stable HD patients were recruited. Clinical, analytical, and dialysis data were collected from all participants. The protocol included bioimpedance (BIVA), pre- and post-dialysis echocardiography and tissue Doppler, and monitoring of hemodynamic parameters during the session. Results: According to the Fall20 definition, 24 patients (51.19%) experienced intradialytic hypotension (IDH). We found no relationship between IDH and analytical, echocardiographic, BIVA parameters, or relative blood volume measurement (BVM) values. Regarding hemodynamic monitoring, indexed systolic volume (ISV) was lower in patients with IDH (38.2 ± 0.9 vs. 39.2 ± 1.9; p
- Published
- 2024
- Full Text
- View/download PDF