Does Blood Volume Monitor Use Decrease Episodes of Intradialytic Hypotension in Chronic Hemodialysis Treatments?

摘要

Intradialytic hypotension (IDH) is a common complication of nemo dialysis treatment. IDH results from a mismatch between the intravascular refill rate and the rate at which fluid is removed during hemodialysis. IDH is defined as a decrease in systolic blood pressure equal to or greater than 20 mmHg or a decrease in mean arterial pressure (MAP) by 10 mmHg and is associated with symptoms that include "abdominal discomfort, yawning, sighing, nausea, vomiting, muscle cramps, restlessness, dizziness or fainting, and anxiety" (National Kidney Foundation [NKF], 2005, p. S76). The frequency of IDH episodes has been consistently reported as 20% to 30% of all hemodialysis (HD) sessions (Palmer & Henrich, 2008). IDH can induce cardiac arrhythmias and can predispose patients to coronary and cerebral ischemic events (NKF, 2005). Between 2008 and 2010, the rate of death due to arrhythmia or cardiac arrest for the incident and prevalent populations were 24.3% and 26.5%, respectively (United States Renal Data System [USRDS], 2012). IDH "greatly contributes to overall patient morbidity and not only limits fluid removal during a dialysis session, but also increases the need for nursing intervention" (Santoro et al., 2002, p. 1034).