Vascular refilling in hemodialysis using feedback-controlled ultrafiltration profile.

IF 1.4 4区医学 Q4 ENGINEERING, BIOMEDICAL

International Journal of Artificial Organs Pub Date : 2024-10-01 Epub Date: 2024-08-03 DOI:10.1177/03913988241264709

Stefanie Broszeit, Joachim Kron, Til Leimbach, John Volkenandt, Susanne Kron

{"title":"Vascular refilling in hemodialysis using feedback-controlled ultrafiltration profile.","authors":"Stefanie Broszeit, Joachim Kron, Til Leimbach, John Volkenandt, Susanne Kron","doi":"10.1177/03913988241264709","DOIUrl":null,"url":null,"abstract":"Background: The rate and the duration of ultrafiltration (UF) are considered the most important factors to affect vascular refilling. The aim of the study was to investigate whether a UF profile could improve the vascular refilling.Methods: Dialysis was delivered by a machine providing feedback control of ultrafiltration rates. Absolute blood volume (BV) was measured by dialysate bolus method. Vascular refilling volume (Vref) was calculated as UF volume - Δ absolute BV.Results: In 40 patients, refilling fraction (Vref/UF volume) was 30.5% in the first hour. Thereafter, refilling fraction steeply increased and reached maximum values in the third and fourth hour at about 95%. The cumulative refilling fraction was 68.5 ± 9.4% at the end. In 14 patients, refilling data from the feedback-controlled UF profile were compared to dialysis sessions with constant UF rates. In 12 of 14 patients, refilling fraction was significantly (p = 0.013) higher in sessions with UF profile (71.6% vs 64.4%).There was a significant negative correlation (r = -0.606; p = 0.002) between the blood volume to extracellular volume ratio and the refilling fraction. The sum of this ratio and the refilling fraction was 1.01 ± 0.06.Conclusions: Despite significant differences, a feedback-controlled UF profile has no advantage over the previous refilling studies with regard to the refilling fraction because vascular refilling seems to depend mainly on the ratio of BV to ECV. This would explain the different results in studies using BV guided UF feedback programs.","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Artificial Organs","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1177/03913988241264709","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/3 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The rate and the duration of ultrafiltration (UF) are considered the most important factors to affect vascular refilling. The aim of the study was to investigate whether a UF profile could improve the vascular refilling.

Methods: Dialysis was delivered by a machine providing feedback control of ultrafiltration rates. Absolute blood volume (BV) was measured by dialysate bolus method. Vascular refilling volume (V_ref) was calculated as UF volume - Δ absolute BV.

Results: In 40 patients, refilling fraction (V_ref/UF volume) was 30.5% in the first hour. Thereafter, refilling fraction steeply increased and reached maximum values in the third and fourth hour at about 95%. The cumulative refilling fraction was 68.5 ± 9.4% at the end. In 14 patients, refilling data from the feedback-controlled UF profile were compared to dialysis sessions with constant UF rates. In 12 of 14 patients, refilling fraction was significantly (p = 0.013) higher in sessions with UF profile (71.6% vs 64.4%).There was a significant negative correlation (r = -0.606; p = 0.002) between the blood volume to extracellular volume ratio and the refilling fraction. The sum of this ratio and the refilling fraction was 1.01 ± 0.06.

Conclusions: Despite significant differences, a feedback-controlled UF profile has no advantage over the previous refilling studies with regard to the refilling fraction because vascular refilling seems to depend mainly on the ratio of BV to ECV. This would explain the different results in studies using BV guided UF feedback programs.

查看原文本刊更多论文

利用反馈控制超滤曲线实现血液透析中的血管再充盈。

背景：超滤（UF）的速率和持续时间被认为是影响血管再充盈的最重要因素。本研究旨在探讨超滤曲线是否能改善血管再充盈：透析由一台可对超滤率进行反馈控制的机器进行。绝对血容量（BV）通过透析液注射法测量。血管再充盈容量（Vref）的计算方法是超滤容量-Δ绝对血容量：结果：40 名患者的血管再充盈率（Vref/UF 容积）在第一小时为 30.5%。此后，再充盈率急剧上升，在第三和第四个小时达到最大值，约为 95%。最后的累积再充盈率为 68.5 ± 9.4%。在 14 名患者中，将反馈控制 UF 曲线的再充盈数据与恒定 UF 率的透析疗程进行了比较。在 14 名患者中，有 12 名患者在使用超滤曲线的透析过程中，再充盈率明显较高（71.6% vs 64.4%）（p = 0.013）。该比率与再充盈分数之和为 1.01 ± 0.06：尽管存在明显差异，但反馈控制的 UF 曲线在再充盈分数方面与之前的再充盈研究相比并无优势，因为血管再充盈似乎主要取决于血容量与细胞外体积的比率。这也解释了使用 BV 引导的 UF 反馈程序的研究中出现的不同结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Artificial Organs 医学-工程：生物医学

CiteScore

3.40

自引率

5.90%

发文量

审稿时长

3 months

期刊介绍： The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.