Online monitoring of cerebral hemodynamics during hemodialysis

George Metry, Margaret Spittle, Shahriar Rahmati, Cole A. Giller, Angela Giller, Allen Kaufman, Daniel Schneditz, Edward Manno, Zohar Brener, Irene Boniece, Federico Ronco, Claudio Ronco, Nathan W. Levin

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Several factors, including anemia, diabetes, and hypertension, potentially could disturb the cerebral autoregulation mechanism in hemodialysis (HD) patients. This study examined the effect of hemodynamic and theological changes on mean cerebral blood flow (CBF) velocity (MV) during HD. Methods: Continuous online monitoring of MV and pulsatility index in the middle cerebral artery were performed in 18 HD patients by transcranial Doppler ultrasound during the entire HD period (range, 3 to 4 hours). In addition, blood pressure, hematocrit (Hct), and relative decrease in blood volume were continuously monitored. Blood samples were obtained at the beginning and end of HD to measure hemorheological variables. Results: After HD, Hct increased significantly from 33.6% ± 5.9% to 41.4% ± 5.7% (P < 0.001). Blood and plasma viscosity increased significantly from 3.33 ± 0.77 to 4.36 ± 1.3 mPa.s (P < 0.001) and from 1.35 ± 0.29 to 1.54 ± 0.38 mPa.s (P < 0.001), respectively. The change in MV (ΔMV) was not significantly different from zero and correlated significantly with change in Hct. During HD, mean arterial pressure (MAP) in 15 patients changed within the normal range (group I), whereas 3 patients developed hypotension (group II) and their MAP decreased from 99 ± 5 to 60 ± 8 mm Hg (P < 0.05). In both groups, ΔMV were not significant. Conclusion: Results of this study suggest that CBF does not appear to be diminished significantly during HD.

Original languageEnglish (US)
Pages (from-to)996-1004
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume40
Issue number5
DOIs
StatePublished - Nov 1 2002

Fingerprint

Renal Dialysis
Hemodynamics
Cerebrovascular Circulation
Hematocrit
Arterial Pressure
Doppler Ultrasonography
Blood Viscosity
Blood Flow Velocity
Middle Cerebral Artery
Blood Volume
Hypotension
Anemia
Reference Values
Homeostasis
Blood Pressure
Hypertension

Keywords

  • Blood pressure (BP)
  • Blood volume
  • Cerebral hemodynamics
  • Fibrinogen
  • Hematocrit (Hct)
  • Hemodialysis (HD)
  • Hemorheology
  • Transcranial Doppler (TCD)

ASJC Scopus subject areas

  • Nephrology

Cite this

Metry, G., Spittle, M., Rahmati, S., Giller, C. A., Giller, A., Kaufman, A., ... Levin, N. W. (2002). Online monitoring of cerebral hemodynamics during hemodialysis. American Journal of Kidney Diseases, 40(5), 996-1004. https://doi.org/10.1053/ajkd.2002.36333

Online monitoring of cerebral hemodynamics during hemodialysis. / Metry, George; Spittle, Margaret; Rahmati, Shahriar; Giller, Cole A.; Giller, Angela; Kaufman, Allen; Schneditz, Daniel; Manno, Edward; Brener, Zohar; Boniece, Irene; Ronco, Federico; Ronco, Claudio; Levin, Nathan W.

In: American Journal of Kidney Diseases, Vol. 40, No. 5, 01.11.2002, p. 996-1004.

Research output: Contribution to journalArticle

Metry, G, Spittle, M, Rahmati, S, Giller, CA, Giller, A, Kaufman, A, Schneditz, D, Manno, E, Brener, Z, Boniece, I, Ronco, F, Ronco, C & Levin, NW 2002, 'Online monitoring of cerebral hemodynamics during hemodialysis', American Journal of Kidney Diseases, vol. 40, no. 5, pp. 996-1004. https://doi.org/10.1053/ajkd.2002.36333
Metry G, Spittle M, Rahmati S, Giller CA, Giller A, Kaufman A et al. Online monitoring of cerebral hemodynamics during hemodialysis. American Journal of Kidney Diseases. 2002 Nov 1;40(5):996-1004. https://doi.org/10.1053/ajkd.2002.36333
Metry, George ; Spittle, Margaret ; Rahmati, Shahriar ; Giller, Cole A. ; Giller, Angela ; Kaufman, Allen ; Schneditz, Daniel ; Manno, Edward ; Brener, Zohar ; Boniece, Irene ; Ronco, Federico ; Ronco, Claudio ; Levin, Nathan W. / Online monitoring of cerebral hemodynamics during hemodialysis. In: American Journal of Kidney Diseases. 2002 ; Vol. 40, No. 5. pp. 996-1004.
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abstract = "Background: Several factors, including anemia, diabetes, and hypertension, potentially could disturb the cerebral autoregulation mechanism in hemodialysis (HD) patients. This study examined the effect of hemodynamic and theological changes on mean cerebral blood flow (CBF) velocity (MV) during HD. Methods: Continuous online monitoring of MV and pulsatility index in the middle cerebral artery were performed in 18 HD patients by transcranial Doppler ultrasound during the entire HD period (range, 3 to 4 hours). In addition, blood pressure, hematocrit (Hct), and relative decrease in blood volume were continuously monitored. Blood samples were obtained at the beginning and end of HD to measure hemorheological variables. Results: After HD, Hct increased significantly from 33.6{\%} ± 5.9{\%} to 41.4{\%} ± 5.7{\%} (P < 0.001). Blood and plasma viscosity increased significantly from 3.33 ± 0.77 to 4.36 ± 1.3 mPa.s (P < 0.001) and from 1.35 ± 0.29 to 1.54 ± 0.38 mPa.s (P < 0.001), respectively. The change in MV (ΔMV) was not significantly different from zero and correlated significantly with change in Hct. During HD, mean arterial pressure (MAP) in 15 patients changed within the normal range (group I), whereas 3 patients developed hypotension (group II) and their MAP decreased from 99 ± 5 to 60 ± 8 mm Hg (P < 0.05). In both groups, ΔMV were not significant. Conclusion: Results of this study suggest that CBF does not appear to be diminished significantly during HD.",
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AU - Metry, George

AU - Spittle, Margaret

AU - Rahmati, Shahriar

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AU - Giller, Angela

AU - Kaufman, Allen

AU - Schneditz, Daniel

AU - Manno, Edward

AU - Brener, Zohar

AU - Boniece, Irene

AU - Ronco, Federico

AU - Ronco, Claudio

AU - Levin, Nathan W.

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N2 - Background: Several factors, including anemia, diabetes, and hypertension, potentially could disturb the cerebral autoregulation mechanism in hemodialysis (HD) patients. This study examined the effect of hemodynamic and theological changes on mean cerebral blood flow (CBF) velocity (MV) during HD. Methods: Continuous online monitoring of MV and pulsatility index in the middle cerebral artery were performed in 18 HD patients by transcranial Doppler ultrasound during the entire HD period (range, 3 to 4 hours). In addition, blood pressure, hematocrit (Hct), and relative decrease in blood volume were continuously monitored. Blood samples were obtained at the beginning and end of HD to measure hemorheological variables. Results: After HD, Hct increased significantly from 33.6% ± 5.9% to 41.4% ± 5.7% (P < 0.001). Blood and plasma viscosity increased significantly from 3.33 ± 0.77 to 4.36 ± 1.3 mPa.s (P < 0.001) and from 1.35 ± 0.29 to 1.54 ± 0.38 mPa.s (P < 0.001), respectively. The change in MV (ΔMV) was not significantly different from zero and correlated significantly with change in Hct. During HD, mean arterial pressure (MAP) in 15 patients changed within the normal range (group I), whereas 3 patients developed hypotension (group II) and their MAP decreased from 99 ± 5 to 60 ± 8 mm Hg (P < 0.05). In both groups, ΔMV were not significant. Conclusion: Results of this study suggest that CBF does not appear to be diminished significantly during HD.

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KW - Fibrinogen

KW - Hematocrit (Hct)

KW - Hemodialysis (HD)

KW - Hemorheology

KW - Transcranial Doppler (TCD)

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