Individualised Dialysate Temperature Improves Intradialytic Haemodynamics and Abrogates Haemodialysis-Induced Myocardial Stunning, without Compromising Tolerability.

Autor: Jefferies, Helen J., Burton, James O., McIntyre, Christopher W.
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Zdroj: Blood Purification; 2011, Vol. 32 Issue 1, p63-68, 6p
Abstrakt: Background/Aims: Haemodialysis-induced myocardial stunning is associated with intradialytic hypotension, increased likelihood of cardiovascular events and death. Dialysis at 35°C reduces stunning, but adverse thermal symptoms limit technique adoption. This study investigated whether individualised body temperature dialysis improves haemodynamic stability and abrogates stunning. Methods: Randomised crossover study of 11 patients compared LV regional wall motion abnormalities (RWMAs) at 37°C (HD37) and body temperature ('individualised', HDind). Regional systolic function was quantitatively assessed by echocardiography. Haemodynamics were assessed using continuous pulse wave analysis. Thermal symptoms were scored by questionnaire. Results: Mean predialysis body temperature was 36.0 ± 0.1°C. Mean number of peak stress RWMAs per patient was lower with HDind (3.9 ± 1.4 vs. 5.3 ± 1.5, p = 0.03). Intradialytic systolic BP was higher during HDind versus HD37 (p < 0.001). Individualised body temperature dialysis demonstrated symptomatic tolerability comparable to HD37. Conclusions: Individualised-temperature haemodialysis abrogates stunning, providing effective haemodynamic stabilisation at no additional therapy cost. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index