Feedback control of absolute blood volume: A new technical approach in hemodialysis.
Absolute blood volume
automated volume management
blood volume monitoring
chronic hemodialysis
target blood volume
Journal
Hemodialysis international. International Symposium on Home Hemodialysis
ISSN: 1542-4758
Titre abrégé: Hemodial Int
Pays: Canada
ID NLM: 101093910
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
16
11
2019
revised:
06
02
2020
accepted:
17
02
2020
pubmed:
3
3
2020
medline:
20
3
2021
entrez:
3
3
2020
Statut:
ppublish
Résumé
The success of automatic feedback control systems to improve hemodynamic stability by preventing relative blood volume from dropping beyond a critical value during dialysis is limited. The aim of this study was to use one of these systems for control of absolute rather than relative blood volume to prevent volume-dependent morbid events. Dialysis was delivered by a machine providing feedback control of ultrafiltration rates, relative blood volume monitoring, and accurate bolus infusion of 240 mL of dialysate to measure absolute blood volume at the beginning of dialysis. Critical relative blood volume required by the control algorithm was calculated from absolute blood volume at the beginning and a critical absolute blood volume of 67 mL/kg. In 40 stable patients, ultrafiltration was guided by blood volume using the feedback algorithm of the integrated program. Blood volume was maintained in a narrow range above the prespecified minimal value of 67 mL/kg. At the end of dialysis, absolute blood volume ranged from 67.5 to 72.5 mL/kg (69.4 ± 1.3 mL/kg). No volume-dependent intradialytic morbid event occurred. A feedback control system for relative blood volume-controlled ultrafiltration can be used for control of absolute blood volume. A prescribed target of absolute blood volume can be converted into relative blood volume, and this can subsequently be reached automatically with the integrated feedback system of the dialysis machine. Intradialytic morbid events could be considerably reduced. The whole procedure could be completely automated without altering the hardware of the dialysis device.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
344-350Informations de copyright
© 2020 International Society for Hemodialysis.
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