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Abstract: PO1235

Relationship Between Cardiac Output (CO) and Estimated Upper Body Blood Flow (eUBBF) During Hemodialysis (HD)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Derk, Gwendolyn, University of Illinois at Urbana Champaign, Champaign, Illinois, United States
  • Fox, Maria, University of Illinois at Urbana Champaign, Champaign, Illinois, United States
  • Poozhikunnel, Elizabeth G., University of Illinois at Urbana Champaign, Champaign, Illinois, United States
  • Thijssen, Stephan, Renal Research Institute, New York, New York, United States
  • Wilund, Kenneth Robert, University of Illinois at Urbana Champaign, Champaign, Illinois, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

Cardiopulmonary monitoring during HD could improve outcomes. Upper body oxygen consumption, arterial and central-venous oxygen saturation and hemoglobin concentration allows the calculation of eUBBF (Rosales 2019). We studied the association between eUBBF and CO during HD.

Methods

In patients with central-venous catheter we measured central-venous oxygen saturation and hemoglobin levels during HD using the Crit-Line Monitor (Fresenius Medical Care North America, Waltham, USA). We measured CO using the Task Force Monitor (CNSystems, Graz, Austria). We tested the time series for stationarity using the Dickey-Fuller test, employed differencing to make the time series stationary, analyzed the association between the time series using cross-correlations and Granger Causality test.

Results

We studied 13 patients (59±14 years, 5 (38%) male, 93±22 kg pre-dialysis weight 170±7 cm tall) during 34 hemodialyses. Averaged across all treatments, CO and UBBF were 4.7±1.0 and 1.3±0.4 L/min, respectively. CO showed a weak downward trend during hemodialysis. Cross-correlations showed no meaningful relationship between CO and eUBBF; Granger causality index was less than 20% in 8 treatments, albeit without clearly discernible patterns.

Conclusion

CO and eUBBF remained considerably stable during HD. Cross-correlations showed no significant relationships and Granger causality test suggests some form of a relationship which requires some further investigation. The clinical usefulness of eUBBF and future investigations will need to take additional parameters and dynamic relationships into account.

Figure 1: Dynamic of CO and eUBBF flow during 34 HD; correlation coefficient from cross-correlations and Granger Causality index at a lag of -2 minutes.