Residual Red Blood Cell Volume in Extracorporeal Blood Circuit after Hemodialysis: A Single-Center Study.

IF 2.2 3区 医学 Q3 HEMATOLOGY
Sae-Yong Hong, Nam-Seon Beck, Jong-Ran Lee, Eun-Kyoung Jeon, So-Min Kim, Sol-Rim Park, Ok-Ju Park, Jungrak Hong, Joung-Il Im
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Abstract

Introduction: The factors contributing to blood loss during hemodialysis (HD) procedures remain underexplored. This study aimed to quantify blood loss during HD and identify the potential factors associated with it.

Methods: The study included 70 ESRD patients undergoing HD. After dialysis, the extracorporeal blood circuits were rinsed with 1,000 mL of 0.05% NH3 solution in distilled water, and hemoglobin levels were measured. Univariate regression was used to assess the linear relationship between residual red blood cell (RBC) volume and various parameters, including HD mode, dialyzer surface area, ultrafiltration goal, hypotension during HD, blood flow rate, activated partial thromboplastin time, and C-reactive protein. Multivariate regression was also conducted to explore the relationships among these parameters.

Results: The mean RBC volume remaining in the extracorporeal blood circuit after HD was 1.6 ± 0.9 mL (mode: 1.0, range: 0.3-6.5 mL). When converted to whole blood volume per patient, the mean blood volume was 5.3 ± 3.0 mL (median: 4.1 mL, mode: 4.0 mL, range: 1.0-19.0 mL). Multivariate analysis identified the dialyzer surface area as the only significant determinant of residual RBC volume.

Conclusion: After HD, the remaining RBC volume in the extracorporeal blood circuit varies from 1.6 to 6.5 mL. When the RBC volume was converted to whole blood volume for each case, the blood loss ranged from 1.0 to 19.0 mL. Dialyzer surface area was the only significant determinant of residual RBC volume.

血液透析后体外循环中的残余红细胞容量:单中心研究
导言:导致血液透析过程中失血的因素仍未得到充分探究。本研究旨在量化血液透析过程中的失血量,并确定与之相关的潜在因素:研究纳入了 70 名接受血液透析的 ESRD 患者。透析后,用 1,000 mL 0.05% NH3蒸馏水溶液冲洗体外血液回路,并测量血红蛋白(Hb)水平。采用单变量回归评估残余红细胞(RBC)体积与各种参数之间的线性关系,包括血液透析模式、透析器表面积、超滤目标(UFG)、血液透析过程中的低血压、血流速度、活化部分凝血活酶时间(aPTT)和 C 反应蛋白(CRP)。此外,还进行了多变量回归,以探讨这些参数之间的关系:结果:血液透析后体外血路中剩余的平均红细胞体积为 1.6 ± 0.9 毫升(模式:1.0,范围:0.3-6.5 毫升)。如果换算成每位患者的全血量,平均血量为 5.3 ± 3.0 毫升(中位数:4.1 毫升,模式:4.0 毫升,范围:1.0-19.0 毫升)。多变量分析表明,透析器表面积是决定剩余红细胞体积的唯一重要因素:结论:血液透析后,体外血路中剩余的 RBC 容量从 1.6 毫升到 6.5 毫升不等。将每个病例的 RBC 容量换算成全血容量后,失血量在 1.0 至 19.0 毫升之间。透析器表面积是决定残余 RBC 容量的唯一重要因素。
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来源期刊
Blood Purification
Blood Purification 医学-泌尿学与肾脏学
CiteScore
5.80
自引率
3.30%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.
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