Cerebral oxygenation changes in response to post-hemodialysis standing
Cerebral oxygenation changes in response to post-hemodialysis standing
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DOI：
10.1007/s10047-022-01343-2
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发表时间：
2022-07-01
影响因子：
1.3
通讯作者：
Morishita, Yoshiyuki
中科院分区：
文献类型：
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作者：
Imai, Sojiro;Ookawara, Susumu;Morishita, Yoshiyuki
很少有报道研究血液透析（HD）后站立时脑氧合变化与临床因素（包括血压）之间的关系。本研究旨在阐明影响HD后站立时脑区域氧饱和度（rSO(2)）变化的因素，并监测合并和非糖尿病（DM）患者HD后站立时脑区域氧饱和度（rSO(2)）变化的差异。使用INVOS 5100c血氧饱和度监测仪跟踪43例HD患者在HD后站立120 s期间的平均血压和脑rSO(2)的变化。静止时hd后脑rSO(2)为55.8 +/- 10.2%，站立120 s时下降至51.9 +/- 9.6%；因此，站立120 s时脑rSO(2)变化百分比为- 6.8 +/- 6.4%，显著低于HD前（p < 0.001）。这一变化与糖尿病的存在、HD持续时间、站立时120 s的平均血压和站立时120 s的平均血压变化百分比显著相关。多变量线性回归分析显示，站立120 s时脑rSO(2)变化百分比与站立120 s时平均BP变化百分比独立相关（标准化系数：0.432;p = 0.004）。此外，与不存在糖尿病的HD患者相比，合并糖尿病的HD患者在站立期间的大脑rSO(2)变化百分比显著降低。因此，HD患者站立后的脑氧合恶化应引起重视，尤其是合并糖尿病的HD患者。
Few reports have examined the association between changes in cerebral oxygenation and clinical factors, including blood pressure (BP), upon standing after hemodialysis (HD). This study aimed to clarify the factors affecting the changes in cerebral regional oxygen saturation (rSO(2)) upon standing after HD and monitor the differences in cerebral rSO(2) changes that occur upon standing after HD in patients with and without diabetes mellitus (DM). Changes in mean BP and cerebral rSO(2) were tracked in 43 HD patients during 120 s of standing after HD using an INVOS 5100c oxygen saturation monitor. The post-HD cerebral rSO(2) at rest was 55.8 +/- 10.2%, while that at 120 s of standing decreased to 51.9 +/- 9.6%; therefore, the percentage change in cerebral rSO(2) at 120 s of standing was - 6.8 +/- 6.4%, which was significantly lower than before HD (p < 0.001). This change was significantly correlated with the presence of DM, HD duration, mean BP at 120 s of standing, and percentage change in mean BP at 120 s of standing. A multivariable linear regression analysis showed that percentage change in cerebral rSO(2) at 120 s of standing was independently associated with the percentage change in mean BP at 120 s of standing (standardized coefficient: 0.432; p = 0.004). Furthermore, there were significant decreases in percentage changes in cerebral rSO(2) throughout the standing period in HD patients with versus without DM. Therefore, cerebral oxygenation deterioration upon standing after HD should receive attention, particularly in HD patients with DM.