Microcirculation During Haemodialysis
- SDF is validated by measuring changes in microcirculation in sepsis patients with MOF (Boerma studies).
- SDF is validated by measuring changes in microcirculation in stable chronic hemodialysis patients (NDT 2009 Bemelmans).
- Ultrafiltration in stable chronic hemodialysis leads to a decrease in sublingual microcirculatory flow (NDT 2009 Bemelmans).
- Trendelenburg position improves the sublingual microcirculatory flow at the end of hemodialysis treatment (NDT 2009 Bemelmans).
- Hemodialysis with ultrafiltration leads to a significant reduction of myocardial perfusion and cardiac output (NDT 2009 Dasselaar)
- Cardiac output measurement during dialysis is not practical.
- BVM is a validated method for hypotension due to ultrafiltration to prevent the amount of ultrafiltration online change based on the measured haemoconcentration (ref Dasselaar et al NDT 2005).
- BCM is a validated measurement to the dry weight in hemodialysis patients measured by a bioimpedance technique (NDT Passauer et al 2009).
Complication of Hemodialysis
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Sublingual Microcirculatory Flow Measurements During Haemodialysis in Relation to Blood Volume Change|
- Difference between sublingual microvascular flow index between 2 types of ultrafiltration [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
|Study Start Date:||September 2011|
|Study Completion Date:||February 2012|
|Primary Completion Date:||January 2012 (Final data collection date for primary outcome measure)|
dialysis patients, stabil, dialysis dependancy for more than 3 months, with adequate access
The search for an optimal method of ultrafiltration with minimal hypoperfusion of vital organs.
- Stabile hemodialysis patients with dialysis dependancy for more than 3 months, with adequate access
- Study duration 3 weeks
- Number of hemodialysis treatment for purposes of study: 3
Timing hemodialysis treatments for Study session Monday or Tuesday after the weekend (randomized design in the sessions)
- session a: 5 hours total duration: 4 hours HD without UF followed by 1 hour GUF
- Session b: 4 hours total duration: 4 hours HD with UF
- session c: 4 hours total duration: 4 hours HD with UF and BVM
- UF is determined by actual target weight.
Measurements during sessions:
- In each session in advance: blood pressure, pulse, weight, BCM, laboratory tests (Hb, Hct, Na, K, urea, creatinine, calcium, albumin, phosphate, nt-proBNP, troponin T, CRP)
- During each session at t = 0, t = 1 hour, t =2 hours and t = 4 hours: SDF, blood pressure, pulse, UF at that time, UF rate at that time
- End each session: blood pressure, pulse, weight, BCM, laboratory tests (Hb, Hct, Na, K, urea, creatinine, calcium, albumin, phosphate, nt-proBNP, troponin T, CRP)