Role of short-term regulatory mechanisms on pressure response to hemo dialysis-induced hypovolemia
Role of short-term regulatory mechanisms on pressure response to hemo dialysis-induced hypovolemia
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DOI：
10.1046/j.1523-1755.2002.00095.x
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发表时间：
2002-01-01
影响因子：
19.6
通讯作者：
Santoro, A
中科院分区：
文献类型：
--
作者：
Cavalcanti, S;Cavani, S;Santoro, A
Background. A large inter-subject variability exists in the arterial pressure response to hemodialysis-induced blood volume (BV) withdrawal. We investigated the hypothesis that this variability is due to the inter-subject differences in the shortterm reflex capacity to compensate for hypovolemia.Methods. Mean arterial pressure (MAP), heart rate (HR) and the percentage reduction in BV (%R-BV) were recorded in 32 subjects during their regular hemodialysis sessions. On the basis of absolute MAP changes between the beginning and the end of the session with respect to %R-BV at the end of the session. three distinct pressure responses were identified: (1) hypotension-prone response (2) unstable response with delayed hypotension and (3) hypotension-resistant response. For each kind of response, one patient was selected and a computer model of the cardiovascular system including the main short-term reflex compensatory mechanisms was used to analyze data collected over live consecutive sessions. The %R-BV and HR were used as model inputs. while simulated arterial pressure was fitted to the measured MAP by the tuning model parameters representing the efficiency in the control of venous capacity, microvascular resistance and heart inotropism.Results. The model-based analysis related the hypotension-prone response to a lack of efficacy in capacity and resistance regulation. In the unstable response with delayed hypotension. the control of venous capacity was not effective an resistance control alone kept the pressure stable only for a limited %R-BV reduction (
