Impact of Extracorporeal Blood Flow on Blood Pressure, Pulse Rate and Cardiac Output in Hemodialysis Patients

Document Type : Original Article

Authors

Internal Medicine Department, Faculty of Medicine - Aswan University

Abstract

Background: If blood pressure (BP) falls during hemodialysis (HD) (intradialytic hypotension (IDH)) a common clinical practice is to reduce the extracorporeal blood flow rate (EBFR). Consequently, the efficacy of the HD (Kt/V) is reduced. Aim of the Work: The aim of the present study is to investigate the impact of changes in extracorporeal blood flow rate (EBFR) on blood pressure (BP), pulse rate (PR) and cardiac output (COP) in hemodynamically stable patients during hemodialysis. Patients and Methods: The population of this study consisted of 40 patients that on renal dialysis (RD) three sessions weekly. Patients were investigated prior to and after one conventional hemodialysis session. Prior to the hemodialysis session, an echocardiograph was performed to evaluate left ventricular ejection fraction (LVEF) and establish the degree of potential heart failure. Result: In the present study regarding measure of BP, PR and COP in EBFR 200 ml/min, 300 ml/min and 400 ml/min, there was significant increase in systolic BP at an EBFR 200 ml/min as compared with EBFR 300 ml/min and EBFR 400 ml/min. but there was no significant change in systolic BP at an EBFR 300 ml/min as compared with an EBFR 400 ml/min. Conclusion: IDH has been associated with many adverse clinical events including myocardial stunning, cerebral atrophy and increased mortality. Change of BFR from 400 ml/min or from 300 ml/min to EBFR 200 ml/min can increase in BP so help in decrease occurrence of complications of IDH beside other methods of increasing BP during hemodialysis.

Keywords

The Egyptian Journal of Hospital Medicine
Volume 74, Issue 6
January 2019
Pages 1348-1352

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