Blood volume- and blood temperature-controlled hemodialysis in critically ill patients: a 6-month, case-matched, open-label study.

BACKGROUND/AIMS: Online monitoring devices for intermittent hemodialysis have been developed to improve intradialytic cardiovascular stability in chronic dialysis patients. We propose to test blood volume and blood temperature biofeedback control systems in critically ill patients with acute kidney injury (AKI).
METHODS: Twenty patients were prospectively dialyzed with machines equipped with online monitoring new devices and compared with 42 historical controls. In addition to feasibility and safety appraisals, efficacy was assessed by the intradialytic hypotension rate.
RESULTS: During the study period, controlled temperature was assessed by a mean Delta(max) body temperature of -0.3 +/- 0.2 degrees C, and all but 7% of dialysis sessions achieved relative blood volume-guided ultrafiltration profiling without increased dialysis-related complications. This was associated with decreased intradialytic hypotension rate.
CONCLUSION: The combination of active controlled body temperature and profiled ultrafiltration by online monitoring systems is feasible and safe in critically ill AKI patients, and suggests possibilities for improvement in intradialytic hemodynamic stability. Copyright 2009 S. Karger AG, Basel.