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Pneumatic compression devices during hemodialysis: a randomized crossover trial.

Davina J Tai1, Sofia B Ahmed, Luz Palacios-Derflingher

  • 1Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|November 9, 2012
PubMed
Summary

Pneumatic compression devices (PCDs) do not alter central blood volume (CBV) during hemodialysis (HD). However, PCDs may enhance fluid removal capacity, warranting further investigation into hemodynamic changes during HD.

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Area of Science:

  • Nephrology
  • Cardiovascular Physiology
  • Medical Devices

Background:

  • Central blood volume (CBV) maintenance is critical for hemodynamic stability during hemodialysis (HD).
  • The preservation of CBV during HD is not well understood.
  • Pneumatic compression devices (PCDs) are a potential intervention to help maintain CBV during HD.

Purpose of the Study:

  • To investigate the effect of PCDs on CBV during HD.
  • To assess changes in other hemodynamic and volume status parameters during HD with PCDs.

Main Methods:

  • A randomized, crossover trial was conducted.
  • Patients underwent two consecutive HD sessions, with randomization to use PCDs or not.
  • The study stratified patients based on intradialytic hypotension (IDH)-prone status.

Main Results:

  • No significant difference in CBV change was observed between PCD and control sessions (median change -0.08 L vs. -0.05 L, P=0.62).
  • Cardiac output and systemic vascular resistance also showed no significant differences.
  • PCDs were associated with a greater reduction in total body water and intracellular fluid volume.

Conclusions:

  • PCDs do not impact intradialytic hemodynamic parameters, including CBV, compared to standard care.
  • PCDs may facilitate a greater capacity for fluid removal during HD.
  • Further research is needed to elucidate physiological and hemodynamic changes during HD with PCDs.