Title: Central venous oxygen saturation and thoracic admittance during dialysis: New approaches to hemodynamic monitoring
Abstract: 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 (ScO 2 ) 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. ScO 2 , TA, finger blood pressure (BP), and relative change in blood volume (ΔBV) were measured and sampled continuously. The relative TA decrease and ΔBV were both largest in the HP group (p<0.05 for both), whereas ScO 2 decreased only in HP patients (p<0.001). Baseline TA was lower in the HP group (p<0.01). Changes in ScO 2 and TA correlated much closer than did changes in ScO 2 and ΔBV (r=0.43 and 0.18, respectively). Our results suggest that an intradialytic decrease in cardiac output, as reflected by a fall in ScO 2 , is a common feature to HD patients prone to IDH. In patients using a central vascular access, ScO 2 and TA measurements may be more specific to the pathophysiologic events preceding IDH than ΔBV—the current standard monitoring method.
Publication Year: 2008
Publication Date: 2008-07-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
Access and Citation
Cited By Count: 22
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