Key result
Continuous computerized hemodynamic monitoring is linked to fewer intradialytic symptoms during acetate dialysis.
Why the study?
The effects of continuous computerized non-invasive hemodynamic monitoring on intradialytic symptoms and differing hemodynamic behaviors during various dialysis modalities were evaluated in critically ill patients.
Does continuous computerized hemodynamic monitoring reduce intradialytic symptoms in critically ill patients undergoing regular acetate dialysis?
Observational (n=30)
Does continuous computerized hemodynamic monitoring reduce intradialytic symptoms in critically ill patients undergoing regular acetate dialysis?
Continuous non-invasive hemodynamic monitoring can reduce intradialytic symptoms, and bicarbonate dialysis or acetate-free biofiltration offer better hemodynamic stability than acetate dialysis in critically ill patients.
Continuous hemodynamic monitoring was associated with fewer intradialytic symptoms; hypothesis-generating and requires randomized confirmation before practice change.
The effects of continuous, computerized, non-invasive hemodynamic monitoring on the appearance of intradialytic symptoms, aided by preventive therapeutic maneuvers, were evaluated in 30 critically ill patients undergoing regular acetate dialysis. The hemodynamic behavior was assessed by a system that interfaces a personal computer with a blood pressure monitor and to a transthoracic electrical impedance-measuring instrument. Monitoring allowed us to reduce significantly the frequency of some important intradialytic symptoms such as nausea, vomiting, and hypotension. The same monitoring system was used acutely to characterize differing hemodynamic behaviors during acetate dialysis (AD), bicarbonate dialysis (BD), and acetate-free biofiltration (AFBF). AD showed a prevalent vasodilation effect with a compensatory increase in heart rate and higher cardiac output values, which were not sufficient to maintain blood pressure stability. BD and AFBF were characterized by a more efficient vasoconstrictor effect and good hemodynamic stability. AFBF, despite a 1 h reduction in session length compared to BD, did not present significant differences in hemodynamic response resulting from session shortness or other technical changes.
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Spongano et al. (1988) conducted an observational in Critically ill patients undergoing regular acetate dialysis (n=30). Continuous computerized hemodynamic monitoring vs. Different dialysis modalities (Acetate dialysis, Bicarbonate dialysis, Acetate-free biofiltration) was evaluated on Intradialytic symptoms (nausea, vomiting, hypotension) and hemodynamic behavior. Continuous computerized hemodynamic monitoring significantly reduced intradialytic symptoms such as nausea, vomiting, and hypotension in 30 critically ill patients undergoing acetate dialysis.
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