Continuous monitoring of changes in cerebral oxygenation during hemodialysis in a patient with acute congestive heart failure

Autor: Mitsutoshi Shindo, Taro Hoshino, Kiyonori Ito, Hideyuki Hayasaka, Yoshiyuki Morishita, Hirofumi Shimoyama, Susumu Ookawara, Saori Minato, Takayuki Uchida, Masaya Kofuji, Haruhisa Miyazawa
Rok vydání: 2019
Předmět:
Zdroj: Journal of Artificial Organs. 23:292-295
ISSN: 1619-0904
1434-7229
Popis: A 71-year-old man undergoing hemodialysis (HD) was admitted to our hospital with congestive heart failure (CHF) and pneumonia. After admission, ultrafiltration with HD was urgently performed because of a lack of respiratory improvement despite the use of noninvasive positive pressure ventilation. During HD, cerebral regional saturation of oxygen (rSO2) was monitored by INVOS 5100c oxygen saturation monitor (Covidien Japan, Japan) to evaluate changes in tissue oxygenation. At HD initiation, cerebral rSO2 was very low at 34% under the fraction of inspiratory oxygen (FiO2) of 0.4. Ultrafiltration was performed at the rate of 0.5 L/h thereafter, cerebral rSO2 gradually improved even as inhaling oxygen concentration decreased. At the end of HD, cerebral rSO2 improved at 40% under a FiO2 of 0.28 as excess body fluid was removed. After pneumonia and CHF improved, he was discharged. Reports of the association between cerebral oxygenation and acute CHF status in patients undergoing HD are limited; therefore, in our experience with this case, cerebral oxygenation deteriorated with the CHF status but was improved by adequate body-fluid management during HD.
Databáze: OpenAIRE