Improving detection of symptomatic, asymptomatic intradialytic hypotension (AIDH), during hemodialysis (HD) with guided automated blood pressure (BP)
Zasuwa G, Frinak S, and Yee J. Improving detection of symptomatic, asymptomatic intradialytic hypotension (AIDH), during hemodialysis (HD) with guided automated blood pressure (BP). American Journal of Kidney Diseases 2020; 75(4):661-661.
Am J Kidney Dis
IDH is an HD complication associated with patient morbidity and mortality. IDH detection enables early intervention that may reduce complications. We explored the hypothesis that the continuous intra-access pressure (IAP) measurements using the Vas-Alert algorithm (VA) can detect IDH during HD and initiate a blood pressure (BP) measurement. Undetected A/IDH was defined as a systolic BP (SBP) decline of 40 mmHg from the predialysis SBP and an intradialytic SBP <100 mmHg. Fresenius T2 dialysis machines (n=24) with CLiC devices that asses blood volume changes had software (LabVIEW) installed to calculate IAP at 20psec intervals from DM data. IAP was determined by hematocrit (default value, 0.34) and venous pressure (VP) by VA from 3470 treatments among 291 patients over 36 days. Electronic health records and dialysis machine data were merged. IAP curves and slopes were correlated with A/IDH.