title: Method to observe hemodynamic and metabolic changes during hemodiafiltration therapy with exercise.
abstract: Intradyalitic exercise programas are important to improve patient's hemodynamic stability. Blood pressure and metabolic changes are correlated when heat accumulation is due to increment of the body core temperature (+1.0 °C). However, increase in temperature could be controlled by lowering dialysate's temperature using two main modalities techniques (isothermic and thermoneural) with different patient's thermal balance consequences, not yet well studied. In this work, a new method to observe the main physiological parameters (hearth rate variability (HRV), blood pressure, BTM dialysate temperature control and substrate utilization by indirect calorimtery) which are involved in hemodiafitration (HDF), are displayd. An experiment was carried out in a group of 5 patients waiting kidney transplant. In each patient, EE was assessed as well as the HRV during isothermic and thermoneutral modalities as a manner of cross and prospective study (a) at before therapy, (b) during therapy and (c) at the end of the HDF therapy. Power extraction was also measured by a BTM (Blood Temperature Monitor from Fresenius Inc), in order to determine how the dialysate temperature was controlled. The results showed important method's advantages which place the BTM performance as unstable control system with the possibility to produce undesirable HRV changes as the vagotonical response. However more patient cases are needed in order to identify the real advantage of this new method.
authors.affiliation: Universidad Autónoma Metropolitana-Iztapalapa, Departamento de Ingeniería Eléctrica, México D.F. 09340, Mexico. mcm@xanum.uam.mx
authors.forename: Miguel
authors.initials: M
authors.lastname: Cadena
authors.forename: Héctor
authors.initials: H
authors.lastname: Pérez-Grovas
authors.forename: Pedro
authors.initials: P
authors.lastname: Flores
authors.forename: Joaquín
authors.initials: J
authors.lastname: Azpiroz
authors.forename: Gisella
authors.initials: G
authors.lastname: Borja
authors.forename: Humberto
authors.initials: H
authors.lastname: Medel
authors.forename: Fausto
authors.initials: F
authors.lastname: Rodriguez
authors.forename: Francisco
authors.initials: F
authors.lastname: Flores
mesh_terms: D000328:Adult; D000465:Algorithms; D001185:Artificial Intelligence; D001795:Blood Pressure Determination / Q000295:instrumentation; D001833:Body Temperature Regulation; D002151:Calorimetry / Q000295:instrumentation; D003196:Computer Graphics; D003198:Computer Simulation; D004562:Electrocardiography / Q000295:instrumentation; D004734:Energy Metabolism; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D006339:Heart Rate; D017583:Hemodiafiltration / Q000295:instrumentation*; D015312:Hemodialysis Solutions / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D016247:Information Storage and Retrieval / Q000379:methods*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation*; D008297:Male; D008954:Models, Biological; D015233:Models, Statistical; D009716:Numerical Analysis, Computer-Assisted; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D013382:Subtraction Technique; D013813:Therapy, Computer-Assisted / Q000295:instrumentation*; D014584:User-Computer Interface
chemical_list: D015312:Hemodialysis Solutions