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Abstract: SA-PO349

Non-Invasive Hemodynamic Monitoring in Hemodialysis Using Electrical Impedance Tomography

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Oh, Tongin, Kyung Hee University, Seoul, Korea (the Republic of)
  • Mok, Jinwon, Kyung Hee University, Seoul, Korea (the Republic of)
  • Moon, Ju young, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
  • Kim, Yang gyun, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
  • Lee, Sangho, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
  • Jung, Su Woong, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)

Intradialytic hypotension (IDH) is the most common complication in 20-30% of patients during hemodialysis (HD). Although blood pressure is monitored intermittently, it is insufficient to detect an IDH in real-time due to the rapidly changing hemodynamic status. Electrical impedance tomography (EIT) obtained from the thorax could simultaneously measure air-volume and blood-volume changes. We monitored the hemodynamic parameters from high-speed EIT images during HD.


In this clinical trial (IRB No.: KHNMC2020-08-006), 75 measurements were performed on 19 patients who had IDH in the past 3 months. An E-pad including 16 electrodes was attached to the surface of the thorax. Impedance images were acquired at 100 frames/s using a high-speed EIT system (AirTom-R, BiLab, Korea). Additionally, blood pressure was periodically obtained every 15 minutes using the NIBP unit in a hemodialysis machine. Extracted cardiac volume signal (CVS) from EIT images was used to calculate hemodynamic parameters like stroke volume (SV) and so on. Additionally, we obtained the thoracic fluid content (TFC) from the electrical admittivity changes at the end-expiration points. The equivalence of processed hemodynamic variables before and after the IDH occurrence or interventions was examined using the paired t-test.


When various hemodynamic parameters were observed from 10 minutes before the onset of IDH to IDH time, we found that the SV significantly decreased by about 40-50%. As analyzing the type of clinical interventions during HD, SV was about 20-30% increase after 150 seconds of reducing the ultrafiltration rate (UF-) and about 50-60% increase after 180 seconds of injection of normal saline (S+) in Figure 1(a) and (b).


In this paper, real-time EIT images were non-invasively collected from patients during HD, and they could monitor hemodynamic changes caused by IDH and clinical interventions. In the future study, we will apply this hemodynamic information to predict IDH, which allows personalized treatment based on real-time monitoring of hemodynamic indicators.

Figure 1. Relative percentile changes of TFC, SV, HR, and CO when applying (a) UF- and (b) S+.


  • Government Support – Non-U.S.