Key result
Continuous SVV monitoring shows increases during intradialytic hypotension while remaining stable in unaffected hemodialysis patients.
Why the study?
Monitoring intravascular volume is crucial for predicting and preventing intradialytic hypotension during hemodialysis, and stroke volume variation is a sensitive indicator of plasma volume changes.
Does continuous monitoring of stroke volume variation using the ClearSight system detect intravascular volume changes and predict intradialytic hypotension in hemodialysis patients?
Case-Control (n=9)
No
Does continuous monitoring of stroke volume variation using the ClearSight system detect intravascular volume changes and predict intradialytic hypotension in hemodialysis patients?
Continuous monitoring of stroke volume variation using the ClearSight system may be a useful non-invasive tool to monitor intravascular volume and guide targeted interventions for intradialytic hypotension.
SVV monitoring may aid IDH prediction in diabetic HD patients; hypothesis-generating and requires larger prospective validation.
Background Monitoring intravascular volume is crucial for predicting and preventing intradialytic hypotension (IDH). Stroke volume variation (SVV) is a highly sensitive indicator of changes in plasma volume. Methods The ClearSight system was used to continuously monitor SVV in nine hemodialysis (HD) patients with diabetes mellitus, six of whom experienced intradialytic hypotension (IDH) during HD sessions. This study aimed to investigate changes in SVV over time and the response of SVV to intravenous fluid bolus administration. Results SVV increased in all patients with IDH but was stable in patients without IDH. Two cases of IDH exhibited a slow increase in SVV and decrease in systolic blood pressure (SBP) following the initiation of HD sessions. In three cases of IDH with SVV elevation, a rapid decrease in SVV and an increase in SBP were observed soon after intravenous fluid loading. In patients with IDH who did not receive intravenous fluid replacement and were treated only with vasoconstrictors, the SVV did not decrease and remained elevated. Conclusions Continuous monitoring of the SVV during HD sessions using the ClearSight system may be useful for intravascular volume monitoring, providing invaluable insights into the pathophysiology of IDH and direct targeted therapeutic interventions.
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Miyamoto et al. (2025) conducted a case-control in Intradialytic hypotension during hemodialysis (n=9). Stroke volume variation (SVV) monitoring vs. Patients without intradialytic hypotension was evaluated on Changes in stroke volume variation (SVV) over time. Continuous monitoring of stroke volume variation during hemodialysis sessions showed an increase in all patients with intradialytic hypotension, while remaining stable in patients without it.
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