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Metry, G; Spittle, M; Rahmati, S; Giller, C; Giller, A; Kaufman, A; Schneditz, D; Manno, E; Brener, Z; Boniece, I; Ronco, F; Ronco, C; Levin, NW.
Online monitoring of cerebral hemodynamics during hemodialysis.
Am J Kidney Dis. 2002; 40(5):996-1004 Doi: 10.1053/ajkd.2002.36333
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Schneditz Daniel
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Abstract:
BACKGROUND: Several factors, including anemia, diabetes, and hypertension, potentially could disturb the cerebral autoregulation mechanism in hemodialysis (HD) patients. This study examined the effect of hemodynamic and rheological changes on mean cerebral blood flow (CBF) velocity (MV) during HD. METHODS: Continuous online monitoring of MV and pulsatility index in the middle cerebral artery were performed in 18 HD patients by transcranial Doppler ultrasound during the entire HD period (range, 3 to 4 hours). In addition, blood pressure, hematocrit (Hct), and relative decrease in blood volume were continuously monitored. Blood samples were obtained at the beginning and end of HD to measure hemorheological variables. RESULTS: After HD, Hct increased significantly from 33.6% +/- 5.9% to 41.4% +/- 5.7% (P < 0.001). Blood and plasma viscosity increased significantly from 3.33 +/- 0.77 to 4.36 +/- 1.3 mPa.s (P < 0.001) and from 1.35 +/- 0.29 to 1.54 +/- 0.38 mPa.s (P < 0.001), respectively. The change in MV (DeltaMV) was not significantly different from zero and correlated significantly with change in Hct. During HD, mean arterial pressure (MAP) in 15 patients changed within the normal range (group I), whereas 3 patients developed hypotension (group II) and their MAP decreased from 99 +/- 5 to 60 +/- 8 mm Hg (P < 0.05). In both groups, DeltaMV were not significant. CONCLUSION: Results of this study suggest that CBF does not appear to be diminished significantly during HD.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Aged, 80 and over -
Cerebral Cortex - blood supply
Diabetes Mellitus, Type 2 - blood
Female - blood
Hemodynamic Processes - physiology
Hemorheology - instrumentation
Humans - instrumentation
Male - instrumentation
Middle Aged - instrumentation
Monitoring, Physiologic - instrumentation
Online Systems - instrumentation
Regional Blood Flow - physiology
Renal Dialysis - instrumentation
Ultrasonography, Doppler, Transcranial - instrumentation

Find related publications in this database (Keywords)
hemodialysis (HD)
transcranial Doppler (TCD)
cerebral hemodynamics
blood pressure (BP)
hemorheology
blood volume
hernatocrit (Hct)
fibrinogen
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