scholarly journals Use of Handheld Ultrasound to Estimate Fluid Status of Hemodialysis Patients

2018 ◽  
Vol 1 (2) ◽  
pp. 65-69
Author(s):  
Sanjaya Kumar Shrestha ◽  
Anupam Ghimire ◽  
Safiur Rahman Ansari ◽  
Ashok Adhikari
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Vena Cava ◽  
Dry Weight ◽  
Hemodialysis Patients ◽  
Clinical Parameters ◽  
Fluid Status ◽  
Before And After ◽  
Handheld Ultrasound ◽  
End Stage

Introduction: Accurate assessment of fluid status in hemodialysis patients presents a significant challenge. Nephrologists have long relied on dry weight estimation based solely on clinical parameters to decide the ultrafiltration volume for patients with end-stage kidney disease on dialysis. However, this method is far from accurate and many patients recurrently suffer from signs and symptoms of fluid overload or circulatory collapse from overaggressive ultrafiltration. Invasive methods such as measurement of central venous pressure cannot be used routinely. We evaluated the usefulness of inferior vena cava (IVC) diameter measured by handheld ultrasound in the estimation of fluid status in patients before and after hemodialysis. Materials and Methods: Clinical assessment included patients’ symptoms, weight, blood pressure, heart rate, and presence of edema before and after dialysis session. Dry weight was assessed based on the above parameters. Each patient underwent measurement of inferior vena cava before and after hemodialysis. The anteroposterior IVC diameter (IVCD) was measured 1.5 cm below the diaphragm in the hepatic segment in supine position during normal inspiration and expiration.Results:  Thirty hemodialysis patients (mean age 51.6±18.03 years) were evaluated in outpatient dialysis unit. Following hemodialysis mean IVCe (IVC diameter in expiration) decreased from 1.40±0.38 to 0.91±0.30 cm (p<0.001). Similarly, mean IVCi (IVC diameter in inspiration) decreased from 0.67±0.34 to 0.35±0.19 cm (p<0.001). Changes in IVCD were significantly correlated with alterations in body weight following dialysis (p<0.0001). The IVC collapsibility index (IVC-CI, per cent of change in IVC diameter in expiration vs. inspiration) increased significantly from 0.53±0.18 to 0.68±0.18 after dialysis (p=0.002). IVC diameter and IVC-CI clearly reflected alterations in fluid status. Regarding the clinical parameters of fluid status, following hemodialysis, mean heart rate increased from 81.17±5.21 beats per minute to 86.50±7.99, (p=0.003), systolic blood pressure increased from 148.67±26.36 mmHg to 155.00±28.50, (p=0.05), and diastolic blood pressure increased from 78.62±12.74 mmHg to 84.83±14.55, (p<0.001).Conclusions:  Our findings support the applicability of IVCD measurement and IVC-CI in the estimation of fluid status in end stage kidney disease patients on hemodialysis. The clinical parameters of fluid status including heart rate, systolic blood pressure, and diastolic blood pressure suggest that significant numbers of patients underwent excess ultrafiltration based on their traditional dry weight calculation. Thus, using IVC parameters before and during hemodialysis might give a better estimation of fluid status of the patient and guide the amount of ultrafiltration to be done. 

scholarly journals Inferior vena cava diameter and collapsibility index as a marker of fluid status in regular hemodialysis patients

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Mohamed Abd El Hamid Hafiz ◽  
Emad Allam Mohamed ◽  
Mohamed Abo El Naga Mohamed ◽  
Mohamed Ahmed El Sayed Ahmed
Keyword(s):  
Inferior Vena ◽  
Fluid Overload ◽  
Vena Cava ◽  
Dry Weight ◽  
Hemodialysis Patients ◽  
Clinical Parameters ◽  
Fluid Status ◽  
Group A ◽  
Group B ◽  
Regular Hemodialysis

Abstract Background Patients with renal failure suffer from fluid overload which is a risk factor for mortality and morbidity. Therefore, fluid status assessment in patients on regular hemodialysis is very important. Dry weight assessment by clinical parameters is not always reliable. We evaluate the role of inferior vena cava ultrasound in estimating fluid overload in regular hemodialysis patients. Results A total of 45 persons, 30 end-stage renal disease patients on regular hemodialysis in group A (18 men and 12 women) and 15 healthy persons in group B (10 men and 5 women), were included in the study. The patients in group A ages ranged from 29 to 70 years with a mean of 48.38 ± 12.70 years and in group B ages ranged from 25 to 55 years with a mean of 34.93 ± 8.26. By clinical methods, the mean dry weight was 68.37 kg (68.37 ± 10.42). After HD mean, IVCe decreased from 2.01 ± 0.29 to 1.79 ± 0.22 cm (P < 0.001) similarly, mean IVCi decreased from 0.99 ± 0.48 to 0.64 ± 0.39 cm (P < 0.001). Changes in IVCD were significantly correlated with alterations in body weight following dialysis (P < 0.001). The IVC-CI increased significantly after dialysis (P < 0.001). IVCD and its IVC-CI reflected alterations in fluid status (P < 0.001). Considering the clinical parameters of fluid status, following HD mean, heart rate increased from 81.80 ± 5.15 beats per minute to 89.87 ± 6.42, (P < 0.001), systolic blood pressure decreased from 130 ± 18.43 mmHg to 113.33 ± 15.27 (P < 0.001), and diastolic blood pressure decreased from 80.17 ± 10.12 mmHg to 71.50 ± 9.29 (P < 0.001). Conclusion It was found a significant correlation between IVCD and IVC-CI with ultrafiltration of hemodialysis. Thus, IVC ultrasound can be used in dry weight assessment in ESRD patients on regular HD by measurement of IVCD and IVC-CI before and after hemodialysis.

scholarly journals ESTUDO COMPARATIVO ENTRE OS EFEITOS DA MASSAGEM CLÁSSICA RELAXANTE, MÉTODO IMEDIATT E MASSAGEM YBÁ PARA GESTANTES A PARTIR DO TERCEIRO TRIMESTRE

2019 ◽  
pp. 132-143
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Vena Cava ◽  
Well Being ◽  
Third Trimester ◽  
Maximum Value ◽  
Postural Changes ◽  
Before And After

Introduction: Gestation is the period of development of a new being. At this stage of a woman's life many hormone-related changes occur. Among these changes are swelling, increased frequency of urination, nausea and sickness, body mass gains, muscle tensions and discomforts. To relieve these discomforts there are different massage techniques on the market. The manual massage for pregnant women, the Imediatt method and the Ybá massage are manual resources that provide a series of benefits to the pregnant woman, each one with its peculiarities. Manual massage provides relief from muscle tensions, decreases anxiety and pain, and produces emotional benefits. The Imediatt massage for pregnant women promotes the improvement of edema and relaxation of the pregnant woman. Ybá massage relaxes the mother and calms the baby through touch, aromatherapy, music therapy and chromotherapy through silk. Objective: To compare the effects of classic relaxing massage, Imediatt method and Ybá massage for pregnant women from the third trimester. Methodology: This comparative and qualitative study consists of applying the three different techniques of massage with data collection (blood pressure, heart rate and perimetry), before and after the procedure, to measure the real benefits of each technique and to compare them . Results: At the end of the massages, heart rate and blood pressure increased, resulting from cardiac output in the gestational period, where it increased (30 to 50%) reaching a maximum value between 20 (twentieth) and 40 (fortieth) week, which makes postural changes more sensitive (due to the fact that the growing uterus compresses the inferior vena cava, decreasing venous return). Conclusion: It was observed after the end of the massages that the methods Relaxing Classical Massage, Ybá Method and Imediatt Method, presented good results in the evaluation for sleep and relief of back pain. In decreasing edema through perimetry the Imediatt Method had better results. In terms of relaxation, the pregnant women reported a better sensation of lightness and connection with the baby, especially for Ybá massage. It was concluded that the pregnant client should receive the massage treatments in this period to promote well-being, relaxation, improve edema and have more connection with the life that is generating.

Age dependence of brachial cuff-based ambulatory PWV in end-stage kidney disease patients undergoing long-term peritoneal dialysis

2021 ◽  
pp. 089686082199692
Author(s):  
Vasilios Vaios ◽  
Panagiotis I Georgianos ◽  
Georgia Vareta ◽  
Dimitrios Divanis ◽  
Evangelia Dounousi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Pulse Wave ◽  
Age Dependence ◽  
End Stage Kidney Disease ◽  
End Stage

Background: The newly introduced device Mobil-O-Graph (IEM, Stolberg, Germany) combines brachial cuff oscillometry and pulse wave analysis, enabling the determination of pulse wave velocity (PWV) via complex mathematic algorithms during 24-h ambulatory blood pressure monitoring (ABPM). However, the determinants of oscillometric PWV in the end-stage kidney disease (ESKD) population remain poorly understood. Methods: In this study, 81 ESKD patients undergoing long-term peritoneal dialysis underwent 24-h ABPM with the Mobil-O-Graph device. The association of 24-h oscillometric PWV with several demographic, clinical and haemodynamic parameters was explored using linear regression analysis. Results: In univariate analysis, among 21 risk factors, 24-h PWV exhibited a positive relationship with age, body mass index, overhydration assessed via bioimpedance spectroscopy, diabetic status, history of dyslipidaemia and coronary heart disease, and it had a negative relationship with female sex and 24-h heart rate. In stepwise multivariate analysis, age ( β: 0.883), 24-h systolic blood pressure (BP) ( β: 0.217) and 24-h heart rate ( β: −0.083) were the only three factors that remained as independent determinants of 24-h PWV (adjusted R 2 = 0.929). These associations were not modified when all 21 risk factors were analysed conjointly or when the model included only variables shown to be significant in univariate comparisons. Conclusion: The present study shows that age together with simultaneously assessed oscillometric BP and heart rate are the major determinants of Mobil-O-Graph-derived PWV, explaining >90% of the total variation of this marker. This age dependence of oscillometric PWV limits the validity of this marker to detect the premature vascular ageing, a unique characteristic of vascular remodelling in ESKD.

Blood pressure, heart rate, and adrenal catecholamines prior to ventricular fibrillation

1961 ◽  
Vol 201 (1) ◽  
pp. 109-111 ◽  
Author(s):  
Noel M. Bass ◽  
Vincent V. Glaviano
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Ventricular Fibrillation ◽  
Coronary Occlusion ◽  
Marked Decrease ◽  
Mean Blood Pressure ◽  
Plasma Adrenaline ◽  
Acute Coronary Occlusion ◽  
Before And After

Heart rate, mean blood pressure, adrenal blood flow, and adrenal plasma adrenaline and noradrenaline were compared before and after ligation of the anterior descending coronary artery in dogs anesthetized with chloralose. One group of 12 dogs responded to acute coronary occlusion with a sudden and marked decrease in mean blood pressure (mean, 31%) and heart rate (mean, 18%) followed by an early onset (mean, 227 sec) of ventricular fibrillation. Another group of nine dogs responded with slight decreases in mean blood pressure (mean, 13%) and heart rate (mean, 5%), during which time ventricular fibrillation occurred late (mean, 30 min) or not at all. While the two groups were statistically different in mean blood pressure and heart rate, the minute output of adrenal catecholamines in either group was not found to be related to the early or late occurrence of ventricular fibrillation.

University Biology and Music Majors' Emotional Ratings of Musical Stimuli and Their Physiological Correlates of Heart, Rate, Finger Temperature, and Blood Pressure

1994 ◽  
Vol 79 (3) ◽  
pp. 1391-1397 ◽  
Author(s):  
Sherman D. Vanderark ◽  
Daniel Ely
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Physiological Responses ◽  
Anechoic Chamber ◽  
Music Majors ◽  
Finger Temperature ◽  
Biology Students ◽  
Before And After ◽  
Experimental Group

Physiological responses associated with the ratings of musical stimuli were investigated. For 101 university music and biology students in the experimental group, heart rate, blood pressure, and finger temperature were measured before and after listening to about 10 min. of music (Venus and Jupiter from Holst's The Planets) in an anechoic chamber. They also served as their own controls by sitting in silence for about 10 min. No significant differences were found on the three measures for the two musical stimuli between the musical or control conditions or between the two majors.

Comparative study on effect of neutral spinal bath and neutral spinal spray on blood pressure, heart rate and heart rate variability in healthy volunteers

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Arundhati Goley ◽  
A. Mooventhan ◽  
NK. Manjunath
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Healthy Volunteers ◽  
Group Analysis ◽  
Low Frequency ◽  
Single Session ◽  
Arterial Blood ◽  
Before And After ◽  
Instantaneous Heart Rate

Abstract Background Hydrotherapeutic applications to the head and spine have shown to improve cardiovascular and autonomic functions. There is lack of study reporting the effect of either neutral spinal bath (NSB) or neutral spinal spray (NSS). Hence, the present study was conducted to evaluate and compare the effects of both NSB and NSS in healthy volunteers. Methods Thirty healthy subjects were recruited and randomized into either neutral spinal bath group (NSBG) or neutral spinal spray group (NSSG). A single session of NSB, NSS was given for 15 min to the NSBG and NSSG, respectively. Assessments were taken before and after the interventions. Results Results of this study showed a significant reduction in low-frequency (LF) to high-frequency (HF) (LF/HF) ratio of heart rate variability (HRV) spectrum in NSBG compared with NSSG (p=0.026). Within-group analysis of both NSBG and NSSG showed a significant increase in the mean of the intervals between adjacent QRS complexes or the instantaneous heart rate (HR) (RRI) (p=0.002; p=0.009, respectively), along with a significant reduction in HR (p=0.002; p=0.004, respectively). But, a significant reduction in systolic blood pressure (SBP) (p=0.037) and pulse pressure (PP) (p=0.017) was observed in NSSG, while a significant reduction in diastolic blood pressure (DBP) (p=0.008), mean arterial blood pressure (MAP) (p=0.008) and LF/HF ratio (p=0.041) was observed in NSBG. Conclusion Results of the study suggest that 15 min of both NSB and NSS might be effective in reducing HR and improving HRV. However, NSS is particularly effective in reducing SBP and PP, while NSB is particularly effective in reducing DBP and MAP along with improving sympathovagal balance in healthy volunteers.

scholarly journals Dental anxiety in patients undergoing oral surgery and its effects on blood pressure and heart rate

2020 ◽  
Vol 9 (8) ◽  
pp. e316985536
Author(s):  
Jaqueline Oliveira Barreto ◽  
Julliana Cariry Palhano Freire ◽  
Arthur Willian de Lima Brasil ◽  
Cristian Statkievicz ◽  
Francisley Ávila Souza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Oral Surgery ◽  
Dental Anxiety ◽  
Waiting Room ◽  
Demographic Questionnaire ◽  
Significant Difference ◽  
Before And After ◽  
Evaluation Anxiety

Objective: To assess dental anxiety in patients undergoing oral surgery, as well as its impact on blood pressure and heart rate. Material and Methods: A total of 233 patients answered a socio-demographic questionnaire and another one based on the Corah dental anxiety scale. Blood pressure and heart rate were assessed at three moments while: patients were in the waiting room, immediately before and after the procedure. Results: This study revealed a prevalence of anxiety of 77.3%. There was a statistically significant difference in mean systolic blood pressure and heart rate at the three moments of the evaluation. Anxiety was prevalent in the sample and was observed from the time in the waiting room until the time when local anesthesia was performed, causing variations in systolic blood pressure and heart rate, anxiety levels decreased after the end of the service. In conclusion, we observed that oral surgery is directly related to increased anxiety, and anxiety is mainly related to the change in heart rate.

scholarly journals RELATIONSHIP BETWEEN INTERDIALYTIC WEIGHT GAIN AND PRE HEMODIALYSIS BLOOD PRESSURE IN HEMODIALYSIS PATIENTS

2020 ◽  
pp. 169-171
Author(s):  
M Manasa ◽  
Aravind Reddy. Gangula
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Water Retention ◽  
Salt Intake ◽  
Hemodialysis Patients ◽  
Interdialytic Weight Gain ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
Esrd Patients

Interdialytic weight gain in patients with hemodialysis depends on fluid, salt intake in interdialytic period and compliance of dialysis patients. In end stage renal disease(ESRD) patients due to decreased and absent residual urine output there is salt and water retention in body which leads to interdialytic weight gain. Overhydration and IDWG is assumed to be the main cause of pre hemodialysis raised blood pressure(BP) in ESRD patients. Here the relationship between IDWG and pre HD blood pressure is studied in 40 hemodialysis patients. We recorded pre HD BP and IDWG in four subsequent hemodialysis sessions for each patient during the period of 2 weeks in patients who are on twice weekly hemodialysis. so, in total we studied 160 hemodialysis sessions. Mean of four pre HD BP is compared with mean of four IDWG for each patient. Then correlation between 40 mean IDWG and 40 mean pre HD BP is studied and also correlation between IDWG and pre HD blood pressure during 160 hemodidlysis sessions studied individually.

scholarly journals Usefulness of foot-to-foot bioimpedance analysis for assessing volume status in chronic hemodialysis patients at the Aristide Le Dantec University Hospital (Senegal)

2021 ◽  
Vol 5 (2) ◽  
pp. 056-060
Author(s):  
Keita Niakhaleen ◽  
Faye Maria ◽  
Seck Sidy Mouhamed ◽  
Ndong Boucar ◽  
Faye Moustapha ◽  
...  
Keyword(s):  
Bioelectrical Impedance ◽  
Dry Weight ◽  
Impedance Analysis ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
University Hospital ◽  
Single Frequency ◽  
Cross Sectional ◽  
Before And After

Introduction: Determination of dry weight is one of the daily goals to achieve in hemodialysis. The aim of this study was to validate the use of bioelectrical impedance analysis (BIA) in estimation of dry weight in a population of Senegalese chronic hemodialysis patients. Patients and methods: A 9-week cross-sectional study was carried out at the hemodialysis unit of Aristide Le Dantec University Hospital. Adult patients with no previous hospital history were included. The total body water (TBW) was measured with a single frequency bioelectric impedance foot-to-foot analyzer, before and after six successive hemodialysis sessions. These results were compared with those from clinical measurements with the Watson equation using a Student’s t-test and Bland-Altman analysis. Results: 264 measurements were made in 22 patients (46.6 years, 54.5% men, 92.3 months on dialysis, 62.7 kg mean dry weight). A significant reduction in weight (ΔWeight = 2.0 ± 1.1 kg; p < 0.0001) and in TBW measured by the BIA (ΔTBWBIA = 3.3 ± 1.0 liters; p < 0.0001)) or calculated by Watson’s equation (ΔTBWWatson = 0.5 ± 0.2 liter; p = 0.0001) was observed. There was a strong linear correlation and agreement between the 2 TBW measurements in pre-dialysis. In post-dialysis the concordance diagram indicated a bias = –2.2 and wide agreement limits. Conclusion: The BIA allows reproducible and reliable measurements and a fair estimate of the TBW in pre-dialysis.

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