Effect of Blood Volume Monitoring on Reducing Hypotensive Episodes in Hemodialysis Patients

Objective: To compare the frequency of intradialytic hypotensive episodes in haemodialysis (HD) patients by using conventional hemodialysis versus assessment with Crite-Line.

Study Design: Cross-sectional survey.

Place and Duration of Study: The study was conducted at Hemodialysis unit of Sheikh Zayed Federal Postgraduate Medical Institute Lahore from 1st August 2009 to 31 January 2010.

Methodology: Fifty patients were included in the study according to inclusion criteria and the study was divided into two phases. In the first phase, all 50 patients underwent two sessions of haemodialysis by conventional haemodialysis machine. In the second phase same 50 patients underwent two sessions of haemodialysis by blood volume monitor by Crit-line. The intradialytic hypotensive episode was recorded in both phases when there was a decrease in systolic blood pressure by ≥20 mm Hg and a decrease in MAP by 10 mm Hg. All this information was collected through proforma. Statistical analyses were conducted by SPSS version 16.

Results: Total 200 hemodialysis sessions were included, there were 62 (62%) sessions of intradialytic hypotension in conventional hemodialysis (phase 1) and 43 (43%) sessions of intradialytic hypotension in Crit-line (phase II). The mean age was 47.02±14.63 in both phases of the study. Male to female ratio was 1:1.4.

Conclusions: It is concluded that the closed-loop system for automatic profiling of ultrafiltration by Crit-line provides reliable blood pressure stabilization in patients during all phases of HD treatment. The Crit-line method of hemodialysis is better in reducing hypotensive episode during hemodialysis then the other methods of conventional hemodialysis.