PhD Scientific Days 2022

Clinical Medicine VI. (Poster discussion will take place on the terrace of the room during the Coffee Break)

The Value of Non-invasive Hemodynamic Monitoring During Pediatric Hemodialysis.

Előadó neve

Dr. Végh, Anna

Előadó munkahelye

I. sz. Gyermekgyógyászati Klinika

Előadó telefonszáma

20/4936016

Előadó e-mail címe

annus.vegh@gmail.com

Az előadás címe

The Value of Non-invasive Hemodynamic Monitoring During Pediatric Hemodialysis.

Szerző(k) neve és munkahelye

Anna Végh1, Lóránt Sagát2, Ágnes Liebhardt2, György S. Reusz1
1 First Department of Pediatrics Semmelweis University, 2 Faculty of Medicine Semmelweis University

Bemutatás módja

Poszter

Szekció

Clinical Medicine VI. (Poster discussion will take place on the terrace of the room during the Coffee Break)

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Aims
Optimizing fluid status is a key element in preventing cardiovascular (CV) complications in chronic kidney disease (CKD) patients requiring maintenance hemodialysis (HD). HD causes shifts in fluid status, due to intravascular volume reduction, as well as fluid and electrolyte shift, which puts the CV system under stress and leads to complex compensatory mechanisms to maintain tissue perfusion. Currently blood pressure (BP) is the only routinely monitored parameter concerning intradialytic hemodynamics. However, change in BP is a late marker of hemodynamic instability leading to intradialytic hypotension. The aim of this study is to assess hemodynamic changes by non-invasive monitoring with electrical velocimetry ™ (EV) during hemodialysis (HD) on pediatric patients.
Methods
Thirteen pediatric maintenance HD patients of a single center participated in this study. Anthropometric data, laboratory results and history were collected. Multiple HD sessions were analyzed for each patient. Hemodynamic data was recorded during HD with an ICON® monitor (Osypka Medical, Germany), BP was measured every 25 minutes. Fluid status and body composition was assessed before and after dialysis with a Body Composition Monitor device (Fresenius, USA).
Results
Thirty-eight dialysis sessions of thirteen pediatric patients (10 (71,42%) males, median [IQR] age 15,8 [13,3-16,2] years) were recorded in this study. Median [IQR] predialytic overhydration was 2,8 % [0,4-5,2] of dry weight.
Significant decrease of stroke volume (SV) (p=0,015) and thoracic fluid content (TFC) (p<0,0001), as well as increase of heart rate (HR) (p=0,046) could be observed, with a correlation to UF: SV (r=0.88; p=0,004), TFC (r=0.98; p<0,0001), HR (R=0.70; p=0,05). Although cardiac output (CO) and mean arterial pressure (MAP) was stable in the whole cohort, subgroup analysis revealed different patterns. Pre- and postdyalitic hypertension was present in 18-18 (47,4-47,4%) sessions. No hypotensive event occurred. CO increased (>10%) at 15 (39,5%), decreased (>10%) at 12 (31,6%), and stayed stable at 11 (28,9%) sessions.
Conclusions
While the MAP remained stable, EV provided more detailed insight into the compensatory mechanisms during HD. EV could optimize HD management in pediatric patients by revealing hemodynamic changes that go unnoticed by BP monitoring.
Funding
This study recieved no special funding.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Prof. Dr. Reusz György

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4631

Start

11:30

End

11:35

Authors (legacy)

Anna Végh1, Lóránt Sagát2, Ágnes Liebhardt2, György S. Reusz1
1 First Department of Pediatrics Semmelweis University, 2 Faculty of Medicine Semmelweis University