Relative blood volume changes during haemodialysis estimated from haemoconcentration markers.

Autor: Pstras L; Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Trojdena 4, 02-109, Warsaw, Poland. leszek.pstras@ibib.waw.pl., Waniewski J; Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Trojdena 4, 02-109, Warsaw, Poland., Wojcik-Zaluska A; Department of Physical Therapy and Rehabilitation, Medical University of Lublin, Lublin, Poland., Zaluska W; Department of Nephrology, Medical University of Lublin, Lublin, Poland.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2020 Sep 09; Vol. 10 (1), pp. 14809. Date of Electronic Publication: 2020 Sep 09.
DOI: 10.1038/s41598-020-71830-0
Abstrakt: Relative blood volume (RBV) monitoring is frequently used in haemodialysis patients to help guide fluid management and improve cardiovascular stability. RBV changes are typically estimated based on online measurements of certain haemoconcentration markers, such as haematocrit (HCT), haemoglobin (HGB) or total blood protein concentration (TBP). The beginning of a haemodialysis procedure, i.e. filling the extracorporeal circuit with the patient's blood (with the priming saline being infused to the patient or discarded) may be associated with relatively dynamic changes in the circulation, and hence the observed RBV changes may depend on the exact moment of starting the measurements. The aim of this study was to use a mathematical model to assess this issue quantitatively. The model-based simulations indicate that when the priming saline is not discarded but infused to the patient, a few-minute difference in the moment of starting RBV tracking through measurements of HCT, HGB or TBP may substantially affect the RBV changes observed throughout the dialysis session, especially with large priming volumes. A possible overestimation of the actual RBV changes is the highest when the measurements are started within a couple of minutes after the infusion of priming saline is completed.
Databáze: MEDLINE
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