Intra-dialytic blood oxygen saturation (SO2): association with dialysis hypotension (the SOGLIA Study)

Mancini, Elena; Perazzini, Claudia; Gesualdo, Loreto; Aucella, Filippo; Limido, Aurelio; Scolari, Francesco; Savoldi, Silvana; Tramonti, Michele; Corazza, Luca; Atti, Mauro; Severi, Stefano; Bolasco, P.G.; Santoro, Antonio

doi:10.1007/s40620-016-0346-x

Cited by 15 publications

(21 citation statements)

References 27 publications

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“…In a study in 11 hypotension-prone and 9 stable HD patients, ScvO 2 dropped by 7.7% ± 1.7 in hypotension prone patients, in contrast to a rise of 1.0 ± 1.3% in the stable group. It has also been suggested that continuous assessment of arterial oxygen saturation (SaO 2 ), in patients with arteriovenous fistulae, or ScvO 2 could both be useful in the early prediction of IDH [37]. Future studies should be performed to investigate whether treatment guided by changes in ScvO 2 would be of clinical benefit to the patient in preventing IDH.…”

Section: Changes In Perfusion Are Important But How Can They Be Measmentioning

confidence: 99%

Novel Insights into the Pathogenesis and Prevention of Intradialytic Hypotension

et al. 2018

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Background: Intradialytic hypotension (IDH) is a common complication of haemodialysis (HD) and associated with adverse outcomes, especially when a nadir definition (systolic blood pressure <90 mm Hg) is used. The pathogenesis of IDH is directly linked to the discontinuous nature of the HD treatment, in combination with patient-related factors such as age, diabetes mellitus and cardiac failure. Summary: Although the decline in blood volume due to removal of fluid by ultrafiltration is the prime mover, thermally induced reflex vasodilation compromises the haemodynamic response to hypovolemia. Recent studies have stressed the relevance of changes in tissue perfusion during HD, which may translate in long-term organ damage. Monitoring changes in tissue perfusion, for which emerging evidence becomes available, appears to have great promise in the fine-tuning of the dialysis procedure. Key Messages: While it is unlikely that IDH can be completely prevented, reduction in inter-dialytic weight gain, prevention of an increase in core temperature by adjusting the dialysate temperature and more frequent or prolonged dialysis treatment remain cornerstones in providing a more comfortable and safe treatment.

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Section: Changes In Perfusion Are Important But How Can They Be Measmentioning

confidence: 99%

Novel Insights into the Pathogenesis and Prevention of Intradialytic Hypotension

et al. 2018

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“…Several [25]. Relative blood volume is defined as the relative variation in volume of the body's blood compartment in comparison with that at the beginning of the session.…”

Section: B Optical Sensors In Hemodialysis and Hemofiltrationmentioning

confidence: 99%

“…Non-invasive sensors are particularly useful to avoid the expense of disposable material and probes [16], [18], [20], [21]. Optical sensors are mainly used for the purpose of relative blood volume (RBV) estimation [22], [23], but other uses have also been proposed [16], [17], [19], [24], [25]. Relative blood volume is defined as the relative variation in volume of the body's blood compartment in comparison with that at the beginning of the session.…”

Section: B Optical Sensors In Hemodialysis and Hemofiltrationmentioning

confidence: 99%

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

Visotti¹,

Ravagli

Perazzini³

et al. 2018

IEEE Sensors J.

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Abstract-Hemofiltration (HF) is a group of blood purification therapies used to treat patients with kidney injury. HF works using a process called ultrafiltration (UF) that removes excess liquid accumulated in the patient's body caused by lack of excretion. UF progress is monitored by the HF machine, but the state-of-the-art method is cumbersome and could be more accurate. In this work, a system composed by two optical sensors is proposed for real-time non-invasive estimation of ultrafiltration rate. This new system is simple, rugged, low-cost and operates on sound theoretical foundations. The sensor system has been tested with two different experimental protocols and showed good correlation between its output and the reference value of the ultrafiltration rate (R 2 =0.97), as well as improved accuracy compared to the available commercial machine (≃12ml/h). This system also has the potential to simplify the architecture required by critical care blood purification machines to perform UF control.Index Terms -Biomedical Measurement, Blood, Blood Purification, Hemofiltration, Hemoglobin, Measurement, Optical Sensor, Ultrafiltration I. INTRODUCTIONRenal replacement therapies (RRTs) have been developed to treat individuals affected by kidney failure, known as nephropathic patients. RRTs have the following targets:• Removal of excess fluid accumulated by the patient due to lack of kidney excretion.• Re-balancing concentration of specific substances in blood, for example electrolytes such as sodium.• Removal of the toxic by-products of metabolism, such as urea.Several types of therapies and machines have been developed. The main distinction of therapies is between those developed † First two authors A. Visotti and E. Ravagli contributed equally to this work. A. Visotti, C. Perazzini, D. Drudi, and C. Ghidini are with the company IBD Srl (https://www.ibdsrl.com/), Forlì, Italy.E. Ravagli and S. Severi* are with the Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy (e-mail: stefano.severi@unibo.it).to treat patients with acute kidney injury (AKI), who are expected to partially or fully regain kidney functionality, and those for patients with chronic kidney disease (CKD), who require periodic treatment for the rest of their lives or until kidney transplant. Therapies such as hemodialysis [1]-[3] and peritoneal dialysis [4] are the standard for CKD patients; while for AKI, slow, prolonged, one-time treatments are chosen to perform blood purification until kidney function is regained [5]- [7]. The effect of RRTs on the patient has been studied both clinically and with mathematical tools such as kinetic models, developed to describe the transfer of water and solutes across body compartments during .This work represents a technological improvement for AKI therapies where fluid removal is the main target -therapies also known as hemofiltration (HF). Fluid removal is performed by means of a physical principle called ultrafiltration (UF) [11]-[13]. Example...

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“…However, to date, almost all methods or parameters have failed to predict IDH onset [3]. Here, we report the first case of deterioration of hepatic regional saturation of oxygen (rSO 2 ) using near-infrared spectroscopy, as a marker of hepatic oxygenation preceding IDH onset.…”

mentioning

confidence: 97%

“…However, even under continuous %ΔBV monitoring, predicting IDH is difficult [3]. Plasma volume is translocated from microcirculation to central circulation as a compensatory cardiovascular mechanism in response to hypovolemia during HD with ultrafiltration [10].…”

mentioning

confidence: 99%

Deterioration of Hepatic Oxygenation Precedes an Onset of Intradialytic Hypotension with Little Change in Blood Volume during Hemodialysis

Imai¹,

Ookawara

et al. 2018

Blood Purif

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Intra-dialytic blood oxygen saturation (SO2): association with dialysis hypotension (the SOGLIA Study)

Abstract: Intradialytic SO variability could be a valid parameter to detect in advance the hemodynamic worsening that precedes IDH. Appropriate timely intervention could help prevent IDH onset.

Cited by 15 publications

References 27 publications

Novel Insights into the Pathogenesis and Prevention of Intradialytic Hypotension

Novel Insights into the Pathogenesis and Prevention of Intradialytic Hypotension

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

Deterioration of Hepatic Oxygenation Precedes an Onset of Intradialytic Hypotension with Little Change in Blood Volume during Hemodialysis

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