Relative blood volume based biofeedback during haemodialysis.
Intra-dialytic hypotension is the most frequently occurring complication during haemodialysis and can lead to serious complications. Devices that continuously and non-invasively monitor relative blood volume (RBV) changes during HD are being advocated as a tool to maintain an adequate volume of the intravascular compartment in order to avoid dialysis hypotension. Nowadays, most manufacturers have incorporated a RBV monitor in their dialysis apparatus and two manufacturers have designed biofeedback devices that control intra-dialytic RBV changes. The goal of RBV based biofeedback systems is to prevent a severe or abrupt decrease in blood volume in order to prevent the development of dialysis hypotension. Biofeedback technologies can diminish the severity and/or frequency of dialysis hypotension. At present, however, a completely symptom-free HD is not a reality. The major reasons for this are patient characteristics such as cardiovascular co-morbidity and high UF rates and a lack of understanding of the relation between RBV changes and blood pressure/cardiovascular stability.
Dasselaar
J J
JJ
Dialysis Centre, Groningen, The Netherlands. j.j.dasselaar@dcg.umcg.nl
D001676:Biofeedback, Psychology / Q000379:methods* / Q000502:physiology; D001810:Blood Volume; D001811:Blood Volume Determination / Q000379:methods* / Q000451:nursing; D006706:Homeostasis; D006801:Humans; D007022:Hypotension / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D008991:Monitoring, Physiologic / Q000379:methods* / Q000451:nursing; D009730:Nursing Assessment; D011322:Primary Prevention; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods / Q000451:nursing; D012307:Risk Factors; D012720:Severity of Illness Index