Emre Erdem1,2. 1. Diaverum Merzifon Hemodialysis Center, Merzifon, Amasya, Turkey. emredlk@yahoo.com. 2. Diaverum Samsun Hemodialysis Center, Samsun, Turkey. emredlk@yahoo.com.
Abstract
PURPOSE: Hemodialysis-associated hypotension, one of the more serious issues in hemodialysis patients, can be treated by passive leg raising (PLR) and ultrafiltration (UF) stopping. We investigated the effects of PLR and UF stopping on blood pressure in hemodialysis patients. METHODS: The study was conducted in 76 end-stage renal disease patients. After the second hour of dialysis, systolic and diastolic blood pressure (SBP and DBP) of the patients who did not develop intradialytic hypotension (IDH) were measured in the supine position. Thereafter, PLR was performed by raising the legs 20°; and after 3 min, SBP and DBP were measured again. UF was then stopped in the PLR position; SBP and DBP were repeated 3 min later. The same procedure was performed during IDH in the patients that developed IDH. RESULTS: A mean 5-mmHg (p < 0.05) increase in SBP and a mean 2-mmHg increase in DBP (p < 0.05) were observed by PLR in the supine position. UF stopping during PLR increased SBP by a mean of 1 mmHg (p < 0.05) while no change was observed in DBP (p = ns). IDH occurred in 19 (25 %) patients. PLR positioning increases SBP and DBP by a mean of 8 mmHg (p < 0.05) and 3 mmHg (p < 0.05), respectively, in the supine position during IDH. During IDH, UF stopping in the PLR position did not significantly increase SBP and DBP in patients as compared to the PLR position. CONCLUSIONS: SBP and DBP increase during PLR. UF stopping during PLR does not lead to a higher increase in blood pressure as compared to PLR positioning.
PURPOSE: Hemodialysis-associated hypotension, one of the more serious issues in hemodialysis patients, can be treated by passive leg raising (PLR) and ultrafiltration (UF) stopping. We investigated the effects of PLR and UF stopping on blood pressure in hemodialysis patients. METHODS: The study was conducted in 76 end-stage renal diseasepatients. After the second hour of dialysis, systolic and diastolic blood pressure (SBP and DBP) of the patients who did not develop intradialytic hypotension (IDH) were measured in the supine position. Thereafter, PLR was performed by raising the legs 20°; and after 3 min, SBP and DBP were measured again. UF was then stopped in the PLR position; SBP and DBP were repeated 3 min later. The same procedure was performed during IDH in the patients that developed IDH. RESULTS: A mean 5-mmHg (p < 0.05) increase in SBP and a mean 2-mmHg increase in DBP (p < 0.05) were observed by PLR in the supine position. UF stopping during PLR increased SBP by a mean of 1 mmHg (p < 0.05) while no change was observed in DBP (p = ns). IDH occurred in 19 (25 %) patients. PLR positioning increases SBP and DBP by a mean of 8 mmHg (p < 0.05) and 3 mmHg (p < 0.05), respectively, in the supine position during IDH. During IDH, UF stopping in the PLR position did not significantly increase SBP and DBP in patients as compared to the PLR position. CONCLUSIONS:SBP and DBP increase during PLR. UF stopping during PLR does not lead to a higher increase in blood pressure as compared to PLR positioning.
Entities:
Keywords:
Blood pressure; Hemodialysis; Passive leg raising; ultrafiltration stopping
Authors: E Kupersztych-Hagege; J-L Teboul; A Artigas; A Talbot; C Sabatier; C Richard; X Monnet Journal: Br J Anaesth Date: 2013-08-28 Impact factor: 9.166