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Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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Relative Blood Volume Monitoring during Continuous Renal Replacement Therapy: A Prospective Observational Study.

Akinori Maeda1,2, Ian Baldwin3, Sofia Spano3

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|August 13, 2024
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Continuous monitoring of relative blood volume (RBV) during continuous renal replacement therapy (CRRT) is feasible. Decreased RBV indicates potential volume depletion, especially with higher net ultrafiltration rates, aiding clinical management.

Keywords:
Acute kidney injuryBlood volumeFluid balanceHematocritUltrafiltration

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Area of Science:

  • Nephrology
  • Intensive Care Medicine
  • Biomedical Engineering

Background:

  • Hematocrit monitoring during CRRT estimates relative blood volume (RBV).
  • RBV monitoring may enable early detection of intravascular volume depletion.
  • Investigated feasibility and epidemiology of RBV monitoring during CRRT.

Purpose of the Study:

  • Assess the feasibility of extended RBV monitoring in CRRT patients.
  • Examine the epidemiology of RBV changes during CRRT.
  • Determine the association between RBV changes and net ultrafiltration (NUF) rates.

Main Methods:

  • Continuous noninvasive optical sensor monitoring of hematocrit and RBV.
  • Analysis of temporal RBV changes in adult ICU patients on CRRT.
  • Correlation of RBV changes with low, moderate, and high NUF rates.

Main Results:

  • Over 1,000 CRRT hours and 60,000 measurements obtained in 36 patients.
  • 69% of patients showed a decrease in median RBV, with a median peak change of -9.3%.
  • RBV decreased significantly more with high NUF rates compared to low/moderate rates (p < 0.001).

Conclusions:

  • Continuous RBV monitoring during CRRT is feasible.
  • RBV significantly decreases during CRRT, particularly with high NUF rates.
  • RBV monitoring can optimize NUF management and prevent volume depletion.