Laura E A Harrison, Nicholas M Selby, Christopher W McIntyre
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引用次数: 27
摘要
背景/目的:血液透析引起复发性血流动力学应激，并伴随缺血性终末器官功能障碍。由于可以修改透析处方/时间表以减轻这种循环压力，因此迫切需要一种易于应用的测试，以便对弱势患者进行有针对性的干预。方法:对18例常见于血液透析的患者进行透析时中心静脉血氧饱和度(ScvO2)及临床指标(包括超滤、血压)测定。结果:透析前ScvO2为63.5±13%，透析结束时ScvO2为56.4±8% (p = 0.046)。超滤体积是透析引起心肌缺血的关键驱动因素，与ScvO2呈负相关(r = -0.680, p = 0.015)。结论:这项初步研究表明ScvO2取样是可行的，具有潜在的临床应用价值，可作为透析期间循环应激的指标。
Central venous oxygen saturation: a potential new marker for circulatory stress in haemodialysis patients?
Background/aims: Haemodialysis causes recurrent haemodynamic stress with subsequent ischaemic end-organ dysfunction. As dialysis prescriptions/schedules can be modified to lessen this circulatory stress, an easily applicable test to allow targeted interventions in vulnerable patients is urgently required.
Methods: Intra-dialytic central venous oxygen saturation (ScvO2) and clinical markers (including ultrafiltration, blood pressure) were measured in 18 prevalent haemodialysis patients.
Results: Pre-dialysis ScvO2 was 63.5 ± 13% and fell significantly to 56.4 ± 8% at end dialysis (p = 0.046). Ultrafiltration volume, a key driver of dialysis-induced myocardial ischaemia, inversely correlated to ScvO2 (r = -0.680, p = 0.015).
Conclusions: This initial study demonstrates ScvO2 sampling is practical, with a potential clinical utility as an indicator of circulatory stress during dialysis.
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