Effect of Intradialytic Aerobic Exercise on Relative Blood Volume in Patients Undergoing Maintenance Hemodialysis

ASAIO Journal ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hiroki Yabe ◽  
Kenichi Kono ◽  
Koji Wakayama ◽  
Norio Hanafusa ◽  
Ken Tsuchiya
Keyword(s):  
Aerobic Exercise ◽  
Blood Volume ◽  
Maintenance Hemodialysis ◽  
Relative Blood Volume

Low-Intensity Intradialytic Exercise Attenuates the Relative Blood Volume Drop Due to Intravascular Volume Loss during Hemodiafiltration

2021 ◽  
pp. 1-8
Author(s):  
José Rodríguez-Chagolla ◽  
Raúl Cartas-Rosado ◽  
Claudia Lerma ◽  
Oscar Infante-Vázquez ◽  
Raúl Martínez-Memije ◽  
...  
Keyword(s):  
Aerobic Exercise ◽  
Blood Volume ◽  
Hemodynamic Response ◽  
Intradialytic Hypotension ◽  
Volume Loss ◽  
Vascular Volume ◽  
Acute Response ◽  
Relative Blood Volume ◽  
Intradialytic Exercise ◽  
Cardiovascular Variables

<b><i>Introduction:</i></b> Patients in hemodiafiltration (HDF) eliminate volume overload by ultrafiltration. Vascular volume loss is among the main mechanisms contributing to adverse events such as intradialytic hypotension. Here, we hypothesize that the intradialytic exercise (IDEX) is an intervention that could improve the acute response of physiological mechanisms involved during vascular volume loss. To test this hypothesis, we evaluated the hemodynamic response to mild aerobic exercise during HDF. <b><i>Methods:</i></b> Nineteen end-stage renal disease (ESRD) patients (11 women: 40 ± 10.8 years old, and 8 men: 42 ± 21 years old) receiving HDF thrice a week, with 6 months of previous physical conditioning, participated in this study. Three HDF sessions were scheduled for each patient: 1 resting in supine position, 1 resting in sitting position, and 1 doing aerobic exercise. The first 2 sessions were taken as control. The ultrafiltration rate was set to 800 mL/h in each session. The hemodynamic response was monitored through the relative blood volume (RBV), and cardiovascular variables measured noninvasively by photoplethysmography. Adequacy variables such as Kt/V and percentage reduction of urate, urea, creatinine (Cr), and phosphate were also monitored. <b><i>Findings:</i></b> The decrease rate of the RBV was smaller in the session with IDEX compared to the sessions with no exercise. No differences were found neither in the cardiovascular variables nor in the adequacy variables among the 3 sessions. There were no hypotension events during the session with exercise, and 8 events during the sessions without exercise (<i>p</i> = 0.002). <b><i>Discussion:</i></b> Mild exercise during HDF decreased the RBV drop and was associated with less hypotension events. The lack of differences in the hemodynamic variables suggests an adequate acute response of cardiovascular compensation variables to intradialytic hypovolemia.

scholarly journals Effects of Relative Blood Volume???Controlled Hemodialysis on Blood Pressure and Volume Status in Hypertensive Patients

ASAIO Journal ◽  
2007 ◽  
Vol 53 (3) ◽  
pp. 357-364 ◽  
Author(s):  
Judith J. Dasselaar ◽  
Roel M. Huisman ◽  
Paul E. de Jong ◽  
Johannes G. M. Burgerhof ◽  
Casper F. M. Franssen
Keyword(s):  
Blood Pressure ◽  
Blood Volume ◽  
Volume Status ◽  
Hypertensive Patients ◽  
Relative Blood Volume ◽  
Volume Controlled

Effect of blood volume change related to intensity of intradialytic aerobic exercise on hemodialysis adequacy: a pilot study

2021 ◽  
Author(s):  
Naoto Usui ◽  
Akimi Uehata ◽  
Junichiro Nakata ◽  
Akihito Inatsu ◽  
Atsuhiro Tsubaki ◽  
...  
Keyword(s):  
Pilot Study ◽  
Aerobic Exercise ◽  
Blood Volume ◽  
Volume Change

scholarly journals FP526EFFECTS OF SODIUM CHANGES ON MEASURING RELATIVE BLOOD VOLUME: COMPARISONS BETWEEN THREE HEMODIALYSIS DEVICES

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii247-iii248
Author(s):  
Susanne Kron ◽  
Reinhard Wenkel ◽  
Til Leimbach ◽  
Sabine Aign ◽  
Joachim Kron
Keyword(s):  
Blood Volume ◽  
Relative Blood Volume

scholarly journals P1524ABSOLUTE BLOOD VOLUME AND VASCULAR REFILLING IN HAEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marta Álvarez Nadal ◽  
Elizabeth Viera Ramírez ◽  
Irene Martin ◽  
Gloria Ruíz-Roso López ◽  
María Delgado Yagüe ◽  
...  
Keyword(s):  
Blood Volume ◽  
Strong Correlation ◽  
Volume Overload ◽  
Intradialytic Hypotension ◽  
Noninvasive Method ◽  
Dialysis Duration ◽  
The Difference ◽  
Relative Blood Volume

Abstract Background and Aims The imbalance between UF and refilling rate is considered a major cause for intradialytic hypotension. Recent studies report a feasable and noninvasive method to estimate vascular refilling by determining absolute blood volume. It was the aim of this study to analyze absolute blood volume in a group of haemodialysis patients and to examine vascular refilling volume. Method Thirty stable chronic HD patients were studied (36,7% female, 63,3% male), aged 71,07 ± 13,31 years. Dialysis duration and UF requirements were based on physician prescription. Vascular refilling was calculated as: VREF = VUF – ΔV, where ΔV is the difference between absolute blood volume at the beginning and the end of dialysis. Relative blood volume monitor (BVM) was used. Hemodial Int. 2016;20(3):484–91. Results Absolute blood volume at the beginning of the dialysis was 6,27 ± 2,78 L (92,44 ± 32,66 ml/kg) and at the end 5,83 ± 2,77 L (85,94 ± 30,44 ml/kg). Ultrafiltration (UF) volume was 2,64 ± 0,82 L (11,14 ± 4,02 ml/kg/h). Vascular refilling was calculated as 2,24 ± 0,74 L, with a refilling fraction of 85,33 ± 11,07%. We found a strong correlation between refilling volume and UF volume (r2 0,861) (Figure 1), and a mild correlation between refilling volume and predialysis volume overload (r2 0,529). Conclusion Measurement of absolute blood volume is easy and noninvasive, and it allows us to study refilling volume. We found a strong correlation between UF volume and refilling volume.

Relative Blood Volume Estimation from Clinical Super-Resolution US Imaging in Breast Cancer

2018 ◽  
Author(s):  
Stefanie Dencks ◽  
Marion Piepenbrock ◽  
Tatjana Opacic ◽  
Barbara Krauspe ◽  
Elmar Stickeler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Volume ◽  
Super Resolution ◽  
Volume Estimation ◽  
Relative Blood Volume

Linear decay of relative blood volume during ultrafiltration predicts hemodynamic instability

2002 ◽  
Vol 40 (3) ◽  
pp. 556-565 ◽  
Author(s):  
Sandip Mitra ◽  
Paul Chamney ◽  
Roger Greenwood ◽  
Ken Farrington
Keyword(s):  
Blood Volume ◽  
Hemodynamic Instability ◽  
Relative Blood Volume ◽  
Linear Decay

scholarly journals P1079NOVEL ULTRAFILTRATION RATE FEEDBACK CONTROLLER FOR ATTAINMENT OF RELATIVE BLOOD VOLUME TARGETS DURING HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Lemuel Rivera-Fuentes ◽  
Leticia Tapia ◽  
Stephan Thijssen ◽  
Sabrina Rogg ◽  
Peter Kotanko
Keyword(s):  
Pilot Study ◽  
Blood Volume ◽  
Feedback Controller ◽  
Target Range ◽  
Great Promise ◽  
Ultrafiltration Rate ◽  
Black Line ◽  
Interdialytic Weight Gain ◽  
Dialysis Vintage ◽  
Relative Blood Volume

Abstract Background and Aims Preciado et al. have identified half-hourly relative blood volume (RBV) targets (at 30, 60…180 min) during hemodialysis (HD) that are associated with significantly improved patient survival. Attainment of these RBV targets would necessitate incessant adjustments to the ultrafiltration rate (UFR) by the dialysis nurse, which is logistically not feasible. We developed a novel proportional-integral controller that takes RBV data from the commercially available CLiC® device as an input and provides UFR suggestions to guide the RBV curve into the desired targets. The clinician specifies the desired UF goal and the maximum allowed upward/downward deviation from this goal, and the Controller then optimizes the RBV trajectory within the limits allowed by the clinician’s prescription. The present study is aimed to characterize the behavior of this novel feedback controller. Method We conducted a single-arm, prospective, interventional pilot study in subjects on chronic HD at three Avantus Renal Therapy Dialysis Centers in New York City. Subjects were treated with Fresenius 2008T HD machines. RBV was measured with the CLiC® device. CLiC® and HD machine data were fed into a research laptop running the UFR Feedback Controller software. The UFR recommendations (generated every 10 minutes) were evaluated by dialysis nurses who then either implemented or rejected them as they deemed clinically appropriate. The nurses were instructed to only override Controller recommendations if medically indicated, but not in an attempt to manage the subjects’ RBV trajectories themselves. Results Fifteen subjects (58.9 ± 15.3 years, 33% white, 53% black, dialysis vintage 4.1 ± 2.4 years, baseline interdialytic weight gain 2.6 ± 0.8 L, treatment time 222 ± 28 min) were studied (63 study visits, 4.2 ± 1.9 visits per subject). Of 300 analyzed RBV target timepoints, 63% had RBVs within the desired target range, 33% of the RBVs were above and 4% were below target. Stratified by timepoint, the on-target percentage increased from 37% at 30 min to 73% at 180 min into HD, while the proportion of RBVs above or below target decreased. In subjects with at least 4 complete study visits (N=8), looking at each of their first 4 complete visits, on average 71.8% of subjects were within the desired RBV target at 180 min into HD. The rate of intradialytic morbid events did not appear to be outside of the ordinary. There was no indication of adverse events related to the use of the UFR Feedback Controller. The Figure shows an example study visit where the UFR Feedback Controller modulates the UFR on an ongoing basis throughout the treatment to keep the RBV curve close to the ideal target trajectory (red line, defined by connecting the RBVs associated with the lowest all-cause mortality). Solid black line: RBV curve (left y-axis); dashed black line: UFR (right y-axis); green boxes: half-hourly RBV target ranges associated with improved survival. Conclusion The UFR Feedback Controller behaves as expected, steering the patients’ RBV curves toward the predefined target ranges where possible, while simultaneously guaranteeing that the prescribed fluid removal goal will be achieved. Preciado et al. had reported approx. one third of patients within the favorable RBV target range at 3h into HD. In contrast, while our pilot study was relatively small, with use of our novel UFR Feedback Controller, approx. 72% of subjects were within the desired RBV target range at 3h into HD. This novel UFR feedback control technology holds great promise for improving fluid management and clinical outcomes in HD patients without requiring additional staff time.

Sign in / Sign up

Export Citation Format

Share Document