Key result
A visual indicator using real-time heart rate variation predicts impending IDH with ~89% accuracy.
Why the study?
Most IDH studies use baseline and ultrafiltration data but lack real-time patient condition identification during dialysis.
Does a visual indicator using heart rate variation accurately predict intradialytic hypotension in dialysis patients?
Observational (n=40)
No
Does a visual indicator using heart rate variation accurately predict intradialytic hypotension in dialysis patients?
A visual indicator combining real-time heart rate variation and a multi-layer perceptron method can predict intradialytic hypotension with up to 88.6% accuracy.
HR-based real-time IDH indicator may aid dialysis monitoring; leaves open need for prospective validation before clinical use.
BACKGROUND: To date, most intradialytic hypotension (IDH) studies have proposed technologies to comprehensively predict the occurrence of IDH using the patient's baseline information and ultrafiltration (UF) information, but it is difficult to apply the technologies while identifying the patient's condition in real time. METHODS: In this study, we propose an IDH indicator that uses heart rate (HR) change information to identify the patient's condition in real time and visually shows whether IDH has occurred. The data used were collected from 40 dialysis patients in a clinical trial conducted in the Artificial Kidney Unit at Yeungnam University Medical Center, Korea, from 18 July to 29 November 2023. RESULTS: The IDH indicator infers changes in the patient's blood pressure during dialysis by analyzing the upper and lower maximum HRs based on the real-time average HR. Medical staff can respond to IDH in real time by looking at the IDH indicator, which visually expresses changes in the patient's HR. In addition, we propose a multilayer perceptron structure that inputs upper and lower maximum HR information based on the average HR for the time interval accumulated in real time. In learning using 40 min of data up to 5 min before IDH occurred, models using two and five layers showed excellent performance, with accuracy of 88.6% and 85.2%, respectively. CONCLUSIONS: By combining IDH visual indicators and the multi-layer perceptron method, medical staff can effectively respond to IDH in real time.
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Bae et al. (2024) conducted an observational in Intradialytic hypotension (n=40). IDH visual indicator and multi-layer perceptron model was evaluated on Accuracy of predicting IDH up to 5 minutes before occurrence. A visual indicator using a two-layer perceptron model based on real-time heart rate variation predicted intradialytic hypotension up to 5 minutes before occurrence with 88.6% accuracy.
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