title: Relative blood volume measurements during hemodialysis: comparisons between three noninvasive devices.
abstract: The monitoring of relative blood volume changes (DeltaRBV) has been advocated for the prevention of hemodialysis (HD) hypotension. Stand-alone devices (Crit-Line) or devices incorporated into the HD apparatus (blood volume monitor [BVM], Hemoscan) are widely used for this purpose. Comparisons between devices are scarce. The aim of this study was, first, to compare DeltaRBV results from these 3 devices with DeltaRBV calculated from changes in laboratory-derived hemoglobin (DeltaRBV-lab-Hb) and, second, to compare DeltaRBV results between the different devices. Fourteen patients received 2 HD treatments in a randomized order: one with the Hemoscan and Crit-Line combination and one with the BVM and Crit-Line combination. DeltaRBV-lab-Hb was measured at 2 and 4 hr into the HD session. Bland-Altman analyses showed that DeltaRBV results from the 3 devices differed systematically from DeltaRBV-lab-Hb, i.e., the difference between the 3 devices and DeltaRBV-lab-Hb varied significantly (p<0.05) with the magnitude of the measurement. The interdevice comparison showed considerable differences in DeltaRBV results. At the end of the treatment, a significant difference (p<0.05) between DeltaRBV measured by the Hemoscan and Crit-Line device (-9.8+/-2.7% and -11.5+/-4%, respectively) was found. In most patients, a systematic difference between Crit-Line and Hemoscan and between Crit-Line and BVM was observed. Relative blood volume change measurements by Crit-Line, Hemoscan, and BVM yield results that differ systematically from the results obtained from laboratory-derived Hb changes. Furthermore, there are substantial differences in DeltaRBV results between the 3 DeltaRBV devices.
authors.affiliation: Dialysis Center Groningen, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Dasselaar
authors.forename: Roel M
authors.initials: RM
authors.lastname: Huisman
authors.forename: Paul E
authors.initials: PE
authors.lastname: DE Jong
authors.forename: Casper F M
authors.initials: CF
authors.lastname: Franssen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015924:Blood Pressure Monitors / Q000592:standards*; D001810:Blood Volume; D001811:Blood Volume Determination / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007022:Hypotension / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis; D006435:Renal Dialysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D006454:Hemoglobins; D011506:Proteins