Acute Intradialytic Hypotension Clinical Trial
Official title:
Italian Group of Study on the Role of Oxygen Saturation as a Potential Surrogate Marker of Intradialytic Cardiovascular Instability
The aim of the present work was to analyze the short-term variability of SO2 during hemodialysis in sessions with and without hypotension to correlate the SO2 variability to hemodynamic instability.
During the last 40 years a lot has been achieved in dialysis regarding both monitors safety
and membranes overall performances Anyway, intradialytic symptoms still remain a major
concern for nephrologists: in particular, hypotension is the most frequent [1].
Intradialytic hemodynamic monitoring systems have been developed to have continuous
surveillance of the main hemodynamic variables (heart rate, body temperature, blood pressure
itself, cardiac output, ecc…).
In a second moment, the further evolution was towards the retroactive control systems, to
force some of the variables involved in the genesis of the hemodynamic stability, along a
pre-determined, ideal, trend. In this view, various bio-feedback mechanisms have been
proposes along the years, for example, to tackle hypovolemia-related hypotension. Their
scientific rationale is the control of either blood volume or directly natremia, in order to
pilot plasma refilling towards the vascular compartment [2].
Despite the great achievements obtained, the forecasting of acute hypotension during
hemodialysis still remains a complex problem, likely involving more than one variable.
SO2 can be considered an indirect expression of the hemodynamic stability. Moreover, in
dialysis, it has always been regarded as a bio-compatibility marker for membranes [3].
Nowadays, SO2 changes during dialysis are easy to measure with a fully, non-invasive sensor
assembled on the arterial line.
We planned this study to analyze on a large number of sessions the short-term variability of
SO2 during hemodialysis in relationship with hemodynamic tolerance.
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Observational Model: Case-Only, Time Perspective: Prospective