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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Kron, S; Schneditz, D; Leimbach, T; Czerny, J; Aign, S; Kron, J.
Determination of the critical absolute blood volume for intradialytic morbid events.
Hemodial Int. 2016; 20(2):321-326
Doi: 10.1111/hdi.12375
Web of Science
PubMed
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FullText_MUG
- Co-authors Med Uni Graz
- Schneditz Daniel
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- Abstract:
- The reduction of blood volume below a critical threshold is assumed to trigger intradialytic morbid events (IME). Recently, we presented a simple method to determine the absolute blood volume during routine hemodialysis (HD) carried out without blood sampling and without injection of dyes or radiolabeled markers. Such information could be used to detect excessive volume reduction during HD and to prevent IME. Therefore, we performed a pilot study in IME-prone patients to identify the absolute blood volume at which they developed clinical symptoms. A volume of 240 mL of ultrapure dialysate was automatically infused into the extracorporeal circulation using the bolus function of a commercial online hemodiafiltration machine incorporating a blood volume monitor (BVM). The increase in relative blood volume (RBV) caused by the infusion was measured and used to determine the absolute blood volume at that time. The blood volume per kilogram body mass at the time of symptomatic IME was also determined. All IME-prone patients of a single-dialysis center were included in the study. Ten out of 12 patients became symptomatic at a specific blood volume between 65 and 56 mL/kg (mean 62 mL/kg) whereas RBV showed a wide scatter (82-97%). A specific blood volume of 65 mL/kg seems to represent the threshold for IME by this method. The technique could be completely automated without altering the hardware of the dialysis device. Present feedback systems for automated blood volume-controlled ultrafiltration could be adapted to maintain absolute blood volume above this critical volume to safely prevent volume-dependent IME. © 2015 International Society for Hemodialysis.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Blood Volume - physiology
- Dialysis Solutions - adverse effects
- Female -
- Hemodiafiltration - methods
- Humans -
- Hypotension - etiology
- Male -
- Renal Dialysis - adverse effects
- Renal Dialysis - methods
- Find related publications in this database (Keywords)
- Absolute blood volume
- blood volume monitoring
- hemodialysis
- intradialytic morbid events
- volume management