Monitoring of pulmonary fluid volume and stroke volume by impedance cardiography in patients on hemodialysis.

Changes of intrathoracic fludi volume during maintenance therapy with hemodialysis were studied in ten patients with the aid of impedance cardiography. It was found that there was a statistically significant correlation between the decrease in body weight and the increase in basic thoracic impedance in the individual patients, but the values differed considerably from one patient to another. Therefore, comparison of sequential measurements is feasible only in one and the same patient. Out of 16 patients with overhydration undergoing dialysis, the stroke volume could not be determined by impedance cardiographic studies in eight, owing to the abnormal morphology of the dZ/dt curve. Moreover, because the basic thoracic impedance was not constant during treatment, the calculated changes in stroke volume did not appear to be reliable. This has to be taken into account when repeated measurements are made under clinical conditions. In some of the patients, the dZ/dt curve displayed interesting anomalies, probably resulting from hemodynamic alterations. The diagnostic meaning of these features is not yet known.