Bioelectric impedance in the estimation of hemodynamic and fluid status in dialysis patients.
In order to estimate the hemodynamic and fluid changes, "dry body weight" and intradialytic stability, electric bioimpedance cardiography was performed in 37 dialysis patients during dialysis procedure, i.e. before, at 2 h and after dialysis. The following parameters were estimated: systemic vascular resistance index-fl. Ohm/m2 (SVRI), mean arterial pressure-Torr (MAP), thoracic fluid conductivity/Ohm (TFC), cardiac index-L/min/m2 (CI), left cardiac work index-kg m/m2 (LCWI) and ejection fraction % (EF). Results were compared with changes in total body water estimated by the urea kinetic model (UKM). The patients were divided into three groups: normotensive (n = 12), hypertensive (n = 15) and hypotensive (n = 10). EF was increased in all the three groups, but only in hypotensives this change was significant (from 40.5 +/- 9.1 to 50.2 +/- 5.41, p < 0.01). The changes in other hemodynamic parameters (CI, LCWI, SVRI) did not reach statistical significance. TFC decreased significantly in all the three groups: normotensive from 0.056 +/- 0.009 to 0.048 +/- 0.009 (p < 0.001), hypotensive from 0.043 +/- 0.009 to 0.035 +/- 0.058 (p < 0.001) and hypertensive from 0.054 +/- 0.016 to 0.045 +/- 0.014 (p < 0.001). These changes were accompanied by a significant decrease in total body water (TBW): from 34.05 +/- 4.19 to 32.72 +/- 4.51 in the hypotensive group, from 34.06 +/- 7.18 to 32.91 +/- 7.27 in the normotensive group, and from 38.92 +/- 7.06 to 37.59 +/- 7.04 in the hypertensive group. The technique was found to be simple, noninvasive and helpful for the estimation of individual hemodynamic changes during dialysis procedure.
Ristovska
V
V
Department of Nephrology, Medical Faculty, Sv. Kiril i Metodij University, Skopje, Republic of Macedonia.
Masin
G
G
Ivanovski
N
N
Lazarov
L
L
Hristovski
Z
Z
Cakalaroski
K
K
Polenaković
M
M
D001794:Blood Pressure; D001823:Body Composition; D001826:Body Fluids / Q000502:physiology*; D002302:Cardiac Output; D017097:Electric Impedance; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013318:Stroke Volume; D014655:Vascular Resistance