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Kidney Week

Abstract: SA-PO548

Near-Infrared Spectroscopy in Hemodialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Mahmood, Arslan, Lenox Hill Hospital, New York, New York, United States
  • Moses, Andrew A., Lenox Hill Hospital, New York, New York, United States
Background

Near-infrared spectroscopy (NIRS) is a noninvasive monitoring of cerebral oxygenation commonly used in monitoring for ischemia in surgical patients. Sensors are placed to measure oxygenation in the designated area. Infrared waves pass through a regional area to detect deoxygenation prior to widespread ischemia. During Hemodialysis (HD), ESKD patients are known to have abnormalities in cerebral blood flow, but few studies have looked at changes in cerebral oxygenation during HD in these patients. The aim of this study was to evaluate cerebral regional O2 saturation (rSO2) during HD, and to assess any correlation with vital signs such as blood pressure (BP) and heart rate.

Methods

Six inpatients with ESKD undergoing dialysis were enrolled. We used the FDA cleared device, INVOS PM 7100 patient monitor (K211561) and the INVOS Adult rSO2 sensor (K182868) produced by Medtronic. A sensor was secured on each side of the scalp, to measure temporal lobe oxygenation. NIRS monitor was placed at the beginning of HD and was removed 5 minutes after the session ended. Baseline was established during the first five minutes of the treatment. Desaturation was defined as a 20% or greater relative reduction from baseline local blood oxygen level for at least 1 minute.

Results

Patients' ages ranged from 59-85 years. Baseline rSO2 was adequately obtained in all patients. Desaturation was observed in one out of six patients (Figure). This was a 25% desaturation lasting for 2 minutes and 40 seconds, during which patient was asymptomatic and without change in vital signs. The same patient had a one-time drop in BP to 87/46 but no desaturation was observed during this time. Another patient had a one-time drop in BP to 91/63, without any desaturation observed in this time.

Conclusion

This pilot study was conducted to establish baseline cerebral oxygenation data for ESKD patients undergoing HD. Though a small sample size, this approach has potential to reveal interesting and useful insights to effects of HD on neurological function. We are continuing to gather patients and will use this group to establish norms of NIRS in ESKD patients.

Figure: NIRS data of patient with desaturation marked in red box