Key result
Intermittent pneumatic circulator use during hemodialysis significantly improved systolic and diastolic blood pressures (P=0.002 for both) and decreased the frequency of hypotension (P=0.028).
Why the study?
Does an intermittent pneumatic circulator improve blood pressure and reduce hypotension in subjects undergoing chronic hemodialysis?
RCT (n=16)
Randomized
Does an intermittent pneumatic circulator improve blood pressure and reduce hypotension in subjects undergoing chronic hemodialysis?
The use of an intermittent pneumatic circulator on the lower extremities during hemodialysis helps stabilize blood pressure and reduces the frequency of hypotensive episodes.
Answers are grounded in this paper and cite their sources.
Supports intermittent pneumatic circulator use in hemodialysis to stabilize blood pressure; extends RCT evidence for nonpharmacologic intradialytic hypotension prevention.
Hypotension is frequently reported during hemodialysis. This study aimed to examine the effect of the intermittent pneumatic circulator on blood pressure during hemodialysis. Sixteen subjects with chronic hemodialysis were recruited. Each subject randomly received two test conditions on separate days, hemodialysis with and without the circulator. The circulator was applied to the subject on lower extremities during 0.5-1 hr, 1.5-2 hr, 2.5-3 hr, and 3.5-4 hr of hemodialysis. Systolic and diastolic blood pressures (SBP and DBP) and heart rate (HR) were analyzed at pre-dialysis, 1 hr, 2 hr, and 3 hr of hemodialysis. Stroke volume (SV) and cardiac output (CO) were evaluated between 2.5 and 3.0 hr of hemodialysis. Blood chemicals (sodium, calcium, potassium, and phosphorous) and Kt/V before and after each hemodialysis session were analyzed. The number of episodes of hypotension was also recorded. The circulator intervention significantly improved SBP and DBP across all time points (P = 0.002 for SBP; P = 0.002 for DBP). The frequency of hypotension was significantly decreased (P = 0.028). SV and CO were significantly improved with the circulator intervention (P = 0.017 for SV; P = 0.026 for CO) and no statistical significances were found on blood chemicals or Kt/V analyses. The results suggested that the circulator intervention helps stabilize blood pressure and appears to be a practical treatment. Future studies are suggested to develop new circulator innovations with sensor feedback systems to enhance safety and maximize treatment efficiency.
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Hsu et al. (2010) conducted an RCT in Hypotension during hemodialysis (n=16). Intermittent pneumatic circulator vs. Hemodialysis without the circulator was evaluated on Systolic and diastolic blood pressures (SBP and DBP) (p=0.002). Intermittent pneumatic circulator use during hemodialysis significantly improved systolic and diastolic blood pressures (P=0.002 for both) and decreased the frequency of hypotension (P=0.028).
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