Document Detail


Can extracellular fluid volume expansion in hemodialysis patients be safely reduced using the hemocontrol biofeedback algorithm? A randomized trial.
MedLine Citation:
PMID:  18496276     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Extracellular fluid volume (ECFV) expansion in hemodialysis patients is associated with increased mortality. Attempts to remove excess fluid often result in intradialytic hypotension (IDH). Blood volume monitoring has been used to aid selection of ultrafiltration rates and dialysate conductivity to minimize IDH. Automating ultrafiltration and dialysate conductivity using the Hemocontrol Biofeedback System (HBS) has reduced IDH in IDH-prone subjects. We undertook a randomized controlled trial to determine if the HBS could safely reduce ECFV in ECF-expanded subjects. Patients with ECFV >45% of total body water were randomized to receive hemodialysis by either HBS or best clinical practices for 6 months. The primary endpoint was change in ECFV; exploratory variables included frequency of IDH, interdialytic weight gain, and changes in serum Na. Treatment with HBS did not result in any change in ECFV, even after multivariable adjustment. The frequency of IDH was however significantly lower with HBS when compared with best clinical practices without differences in other variables.
Authors:
Gihad E Nesrallah; Rita S Suri; Heather Thiessen-Philbrook; Paul Heidenheim; Robert M Lindsay
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  54     ISSN:  1538-943X     ISO Abbreviation:  ASAIO J.     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-05-22     Completed Date:  2008-07-03     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  270-4     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Humber River Regional Hospital, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Biofeedback, Psychology / methods*
Blood Volume
Extracellular Fluid / physiology*
Female
Hemodynamics
Humans
Hypotension / etiology,  prevention & control
Male
Middle Aged
Renal Dialysis / adverse effects,  methods*,  statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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