Characteristics of hypotension-prone haemodialysis patients: is there a critical relative blood volume?
Characteristics of hypotension-prone haemodialysis patients: is there a critical relative blood volume?
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DOI：
10.1093/ndt/gfg171
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发表时间：
2003-07-01
影响因子：
6.1
通讯作者：
Passlick-Deetjen, J
中科院分区：
文献类型：
--
作者：
Barth, C;Boer, W;Passlick-Deetjen, J
背景主要由超滤诱导的低血容量引起的透析中病态事件（IME，主要是低血压）仍然是血液透析（HD）期间最常见的并发症。本研究的目的是检验在易发生IME的HD患者中存在个体临界相对血容量（RBVcrit）的假设。在这项前瞻性国际多中心研究中，来自9个透析中心的60名IME倾向患者在最多21次标准HD治疗期间接受了观察，未接受试验特定干预。通过超声方法（BVM;血容量监测器）连续监测RBV。此外，连续记录超滤率。定期测量血压，在IME期间更频繁。记录所有IME和特殊治疗干预。在585次HD治疗期间，共记录了537例IME，其中一些症状不止一种。从HD会话开始到结束，IME的发生率增加了10倍。RBVcrit显示出较宽的个体间范围，从71%到98%不等。然而，个体内RBV限值相对稳定，SD为
Background. Intradialytic morbid events (IME, mostly hypotension) mainly due to ultrafiltration-induced hypovolaemia still are the most frequent complication during haemodialysis (HD). This study was performed to test the hypothesis that there is an individual critical relative blood volume (RBVcrit) in IME-prone HD patients.Methods. In this prospective international multicentre study, 60 IME-prone patients from nine dialysis centres were observed during up to 21 standard HD sessions without trial-specific intervention. The RBV was monitored continuously by an ultrasonic method (BVM; blood volume monitor). Also, the ultrafiltration rate was registered continuously. Blood pressure was measured at regular intervals, and more frequently during IME. All IME and specific therapeutic interventions were noted.Results. In total, 537 IME, some with more than one symptom, were documented during 585 HD sessions. The occurrence of IME increased up to 10-fold from the start to the end of the HD session. RBVcrit showed a wide inter-individual range, varying from 71 to 98%. However, the intra-individual RBV limit was relatively stable, with an SD of