Mathematical Modeling of Thermal and Circulatory Effects During Hemodialysis
| Autor: | Nathan W. Levin, Brm Boris Kingma, van Wd Wouter Marken Lichtenbelt, Rpj Droog, Jeroen P. Kooman, van Aa Anton Steenhoven, van der Fm Sande, Ajh Arjan Frijns |
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| Rok vydání: | 2012 |
| Předmět: |
Mean arterial pressure
medicine.medical_specialty Chemistry medicine.medical_treatment Biomedical Engineering Ultrafiltration Medicine (miscellaneous) Bioengineering Blood volume General Medicine Thermoregulation Biomaterials Anesthesia Hypovolemia Internal medicine Circulatory system medicine Cardiology Hemodialysis medicine.symptom Vasoconstriction |
| Zdroj: | Artificial Organs. 36:797-811 |
| ISSN: | 0160-564X |
| DOI: | 10.1111/j.1525-1594.2012.01464.x |
| Popis: | Intradialytic hypotension (IDH) is one of the most common complications of hemodialysis (HD) treatment. The initiating factor of IDH is a decrease in blood volume, which is related to an imbalance between ultrafiltration (UF) and refilling rate. Impaired reactivity of resistance and capacitance vessels in reaction to hypovolemia plays possibly a major role in the occurrence of IDH. These vessels also fulfill an important function in body temperature regulation. UF-induced cutaneous vasoconstriction would result in a reduced surface heat loss and an increase in core temperature. To release body heat, skin blood flow is increased at a later stage of the HD treatment, whereby possibly IDH can occur. The aim of the study is to develop a mathematical model that can provide insight into the impact of thermoregulatory processes on the cardiovascular (CV) system during HD treatment. The mathematical procedure has been created by coupling a thermo-physiological model with a CV model to study regulation mechanisms in the human body during HD + UF. Model simulations for isothermal versus thermoneutral HD + UF were compared with measurement data of patients on chronic intermittent HD (n = 13). Core temperature during simulated HD + UF sessions increased within the range of measurement data (0.23 degrees C vs. 0.32 +/- 0.41 degrees C). The model showed a decline in mean arterial pressure of -7% for thermoneutral HD + UF versus -4% for isothermal HD + UF after 200 min during which relative blood volume changed by -13%. In conclusion, simulation results of the combined model show possibilities for predicting circulatory and thermal responses during HD + UF. |
| Databáze: | OpenAIRE |
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