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Central venous oxygen saturation and thoracic admittance during dialysis: New approaches to hemodynamic monitoring

Cordtz, Joakim; Olde, Bo; Solem, Kristian LU and Ladefoged, Soeren D. (2008) In Hemodialysis International 12(3). p.369-377
Abstract
Intradialytic hypotension (IDH) is one of the most important short-term complications to hemodialysis (HD). Inadequate cardiac filling due to a reduction in the central blood volume is believed to be a major etiological factor. The aim of this study was to evaluate whether these pathophysiologic events are reflected in the central venous oxygen saturation (ScO2) and thoracic admittance (TA) during dialysis. Twenty ambulatory HD patients, 11 hypotension prone (HP) and 9 hypotension resistant, with central vascular access, were monitored during 3 HD sessions each. ScO2, TA, finger blood pressure (BP), and relative change in blood volume (Delta BV) were measured and sampled continuously. The relative TA decrease and Delta BV were both largest... (More)
Intradialytic hypotension (IDH) is one of the most important short-term complications to hemodialysis (HD). Inadequate cardiac filling due to a reduction in the central blood volume is believed to be a major etiological factor. The aim of this study was to evaluate whether these pathophysiologic events are reflected in the central venous oxygen saturation (ScO2) and thoracic admittance (TA) during dialysis. Twenty ambulatory HD patients, 11 hypotension prone (HP) and 9 hypotension resistant, with central vascular access, were monitored during 3 HD sessions each. ScO2, TA, finger blood pressure (BP), and relative change in blood volume (Delta BV) were measured and sampled continuously. The relative TA decrease and Delta BV were both largest in the HP group (p < 0.05 for both), whereas ScO2 decreased only in HP patients (p < 0.001). Baseline TA was lower in the HP group (p < 0.01). Changes in ScO2 and TA correlated much closer than did changes in ScO2 and Delta BV (r=0.43 and 0.18, respectively). Our results suggest that an intradialytic decrease in cardiac output, as reflected by a fall in ScO2, is a common feature to HD patients prone to IDH. In patients using a central vascular access, ScO2 and TA measurements may be more specific to the pathophysiologic events preceding IDH than Delta BV-the current standard monitoring method. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
hemodialysis, blood volume sensoring, central venous oxygen saturation, intradialytic hypotension, thoracic impedance
in
Hemodialysis International
volume
12
issue
3
pages
369 - 377
publisher
Wiley-Blackwell
external identifiers
  • wos:000257710600016
  • scopus:55949137882
ISSN
1542-4758
DOI
10.1111/j.1542-4758.2008.00283.x
language
English
LU publication?
yes
id
aa5042d7-c271-4739-a85a-431fce9088e4 (old id 1254974)
date added to LUP
2008-10-17 14:31:07
date last changed
2017-08-27 04:21:32
@article{aa5042d7-c271-4739-a85a-431fce9088e4,
  abstract     = {Intradialytic hypotension (IDH) is one of the most important short-term complications to hemodialysis (HD). Inadequate cardiac filling due to a reduction in the central blood volume is believed to be a major etiological factor. The aim of this study was to evaluate whether these pathophysiologic events are reflected in the central venous oxygen saturation (ScO2) and thoracic admittance (TA) during dialysis. Twenty ambulatory HD patients, 11 hypotension prone (HP) and 9 hypotension resistant, with central vascular access, were monitored during 3 HD sessions each. ScO2, TA, finger blood pressure (BP), and relative change in blood volume (Delta BV) were measured and sampled continuously. The relative TA decrease and Delta BV were both largest in the HP group (p &lt; 0.05 for both), whereas ScO2 decreased only in HP patients (p &lt; 0.001). Baseline TA was lower in the HP group (p &lt; 0.01). Changes in ScO2 and TA correlated much closer than did changes in ScO2 and Delta BV (r=0.43 and 0.18, respectively). Our results suggest that an intradialytic decrease in cardiac output, as reflected by a fall in ScO2, is a common feature to HD patients prone to IDH. In patients using a central vascular access, ScO2 and TA measurements may be more specific to the pathophysiologic events preceding IDH than Delta BV-the current standard monitoring method.},
  author       = {Cordtz, Joakim and Olde, Bo and Solem, Kristian and Ladefoged, Soeren D.},
  issn         = {1542-4758},
  keyword      = {hemodialysis,blood volume sensoring,central venous oxygen saturation,intradialytic hypotension,thoracic impedance},
  language     = {eng},
  number       = {3},
  pages        = {369--377},
  publisher    = {Wiley-Blackwell},
  series       = {Hemodialysis International},
  title        = {Central venous oxygen saturation and thoracic admittance during dialysis: New approaches to hemodynamic monitoring},
  url          = {http://dx.doi.org/10.1111/j.1542-4758.2008.00283.x},
  volume       = {12},
  year         = {2008},
}