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SHR Neuro Cancer Cardio Lipid Metab Microb
Wimmer, J; Batzel, JJ; Haditsch, B; Schneditz, D.
Evolution of volume sensitivity during hemodialysis and ultrafiltration.
Clin Auton Res. 2011; 21(5):353-360
Doi: 10.1007/s10286-011-0122-x
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Schneditz Daniel
- Wimmer Jürgen
- Co-authors Med Uni Graz
- Batzel Jerry
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- Abstract:
- OBJECTIVE: This study aimed at assessing the evolution of cardiovascular characteristics during hemodialysis and ultrafiltration by a perturbation accurately defined in its magnitude and directly relevant to the problem of volume adjustment in stable hemodialysis patients. METHODS: Excess fluid volume was removed by constant ultrafiltration-rate as prescribed. Hemodynamic variables were continuously measured throughout treatments using non-invasive finger plethysmography. In addition to ongoing volume reduction by ultrafiltration (long-term perturbation), well-defined magnitudes of intravascular volume were transiently and reversibly sequestered (short-term perturbation) into the extracorporeal circulation at hourly intervals. Sensitivities of hemodynamic variables and of the baroreflex to the acute change in intravascular volume (volume sensitivities) were analyzed. RESULTS: Eight stable patients were assessed during two subsequent treatments. Treatments were accompanied by a decrease in cardiac output (p<0.05) and stroke volume (p<0.01), and by an increase in peripheral resistance (p<0.05) and diastolic pressure (p<0.05). Mean arterial pressure remained unchanged for the whole group but correlated with the change in total peripheral resistance in individual treatments (p<0.01). The average volume sensitivity of mean arterial pressure was 11.9±9.9 mmHg/L and increased (p<0.01) during treatments, while the average volume sensitivity of heart rate remained unchanged at -7.9±8.58 1/(min L). The corresponding volume sensitivity of the baroreflex was -0.81±1.5 1/(min mmHg) and remained unchanged for the whole group, but the change correlated with the change in mean arterial pressure in individual treatments (p<0.05). INTERPRETATION: The changes in arterial pressures during hemodialysis appear to relate to an unbalanced response of barocontrol mechanisms characterized by a compromised chronotropy and vascular over-reactivity.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Baroreflex - physiology
- Blood Pressure -
- Female -
- Heart Rate -
- Hemodynamics -
- Hemofiltration -
- Humans -
- Male -
- Middle Aged -
- Renal Dialysis -
- Time Factors -
- Find related publications in this database (Keywords)
- Ultrafiltration
- Blood volume
- Blood pressure
- Baroreflex
- Renal replacement therapy