Changes in tissue oxygenation in response to sudden intradialytic hypotension

Kitano, Taisuke; K, Ito; Ookawara, Susumu; Shindo, Mitsutoshi; Uchida, Takayuki; Kofuji, Masaya; Hayasaka, Hideyuki; Miyazawa, Haruhisa; Ueda, Yoshimichi; Hirai, Keiji; Hoshino, Taro; Morishita, Yoshiyuki

doi:10.1007/s10047-019-01147-x

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…Low tissue oxygenation may have negative influence on HD patients. Anemic conditions, overhydrated status, and hypotension could induce organ hypoxia in the brain or intra-abdominal organs [20][21][22][26][27][28] . Furthermore, cerebral oxygenation impairment could be related to cognitive impairment 29,30 , and access hand rSO 2 was reportedly associated with grip strength 31 .…”

Section: Discussionmentioning

confidence: 99%

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Sugiyama

K²,

Ookawara³

et al. 2023

Sci Rep

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In hemodialysis (HD) patients with arteriovenous fistula (AVF), changes in systemic or peripheral tissue circulation occur non-physiologically via the presence of AVF; however, associations between blood flow and tissue oxygenation in the brain and access hand are uncertain. In this study, 85 HD patients with AVF were included and evaluated for changes in flow volume (FV) and regional oxygen saturation (rSO2) in the brain and hands with AVF before and after percutaneous transluminal angioplasty (PTA). Furthermore, we evaluated the factors that determine access hand rSO2 without stenosis after PTA. Brachial arterial FV increased after PTA (p < 0.001), and carotid FV decreased (p = 0.008). Access hand rSO2 significantly decreased after PTA (p < 0.001), but cerebral rSO2 did not significantly change (p = 0.317). In multivariable linear regression analysis of factors associated with access hand rSO2, serum creatinine (standardized coefficient: 0.296) and hemoglobin (standardized coefficient: 0.249) were extracted as independent factors for access hand rSO2. In conclusion, a decrease in access hand oxygenation and maintenance of cerebral oxygenation were observed throughout PTA. To maintain access hand oxygenation, it is important to adequately manage Hb level and maintain muscle mass, in addition to having an AVF with appropriate blood flow.

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Section: Discussionmentioning

confidence: 99%

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Sugiyama

K²,

Ookawara³

et al. 2023

Sci Rep

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“…8 In addition, hepatic rSO 2 is stable during HD, 9 whereas it decreases at the onset of IDH. 10,11 According to previous reports, the burden of the HD procedure, including ultrafiltration and changes in systemic BP, could lead to a reduction of the blood volume in the hepato-splanchnic circulation during HD; therefore, a decrease in intradialytic hepatic oxygenation would be expected in response to these influences. However, few clinical studies have investigated the association between changes in intradialytic hepatic rSO 2 and clinical factors such as ultrafiltration, changes in systemic BP, and the onset of IDH.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting intradialytic hepatic oxygenation: Associations between ultrafiltration rate and changes in systemic blood pressure

Ookawara

Ueda

et al. 2023

Int J Artif Organs

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Introduction: Hepato-splanchnic circulation influences the oxygenation of abdominal organs and is important in preventing a reduction in intradialytic blood volume. However, the association between changes in intradialytic hepato-splanchnic circulation and clinical factors remain unknown. Methods: We enrolled 91 hemodialysis (HD) patients (20 with intradialytic hypotension (IDH) and 71 without IDH). During HD, hepatic regional oxygen saturation (rSO2), a marker of hepatic oxygenation reflecting hepato-splanchnic circulation and oxygenation, was monitored. Changes in hepatic rSO2 at the lowest systolic blood pressure (BP) during HD were analyzed to identify associations with clinical factors. Results: Hepatic rSO2 levels were 55.8 ± 15.3% before HD and 53.8 ± 14.9% at the lowest systolic BP; therefore, % changes in hepatic rSO2 were −2.7 ± 11.3%. These values were significantly lower in patients with IDH than in those without IDH (−13.8 ± 9.3% vs 0.4 ± 9.8%, p < 0.001). Multivariable regression analysis showed that % changes in hepatic rSO2 were independently associated with % changes in systolic BP (standardized coefficient: 0.416) and ultrafiltration rate (−0.206). Furthermore, % changes in mean BP (0.304) were identified as affecting % changes in hepatic rSO2 instead of those in systolic BP. Conclusions: Changes in intradialytic hepatic oxygenation is associated with ultrafiltration rate and changes in systemic BP. Further studies are required to clarify the directionality of the association between changes in hepatic oxygenation and changes in systemic BP during HD.

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Section: Introductionmentioning

confidence: 99%

“…The clinical importance of measuring the regional tissue oxygen saturation (rSO 2 ) using near-infrared spectroscopy has recently gained great attention [8][9][10][11][12]. Measurement of the rSO 2 is a real-time and non-invasive method for evaluating organ tissue oxygenation in various clinical settings [8][9][10][11][12]. The rSO 2 is not a parameter that directly indicates organ blood flow, but it assesses the organ tissue oxygenation, which is calculated using the ratio of oxyhemoglobin and deoxyhemoglobin in the targeted tissue.…”

Section: Introductionmentioning

confidence: 99%

Differences between Hepatic and Cerebral Regional Tissue Oxygen Saturation at the Onset of Intradialytic Hypotension

Kaneko

Ookawara

et al. 2023

JCM

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Background: Intradialytic hypotension (IDH) is a critical pathological condition associated with all-cause mortality in patients undergoing hemodialysis (HD). However, few studies have investigated IDH-related changes in hepatic and cerebral regional tissue oxygen saturation (rSO2). This study investigated IDH-induced changes in hepatic and cerebral rSO2. Methods: Hepatic and cerebral rSO2 during HD were measured using an INVOS 5100C oxygen saturation monitor, and their percentage (%) changes during the development of IDH were analyzed. Ninety-one patients undergoing HD were investigated, including twenty with IDH. Results: In patients with IDH, % changes in hepatic and cerebral rSO2 decreased at the onset of IDH. Additionally, the % change in hepatic rSO2 was significantly larger than that in cerebral rSO2 (p < 0.001). In patients without IDH, no significant differences were found between the % changes in hepatic and cerebral rSO2 at the time of the lowest systolic blood pressure during HD. Multivariable linear regression analysis showed that the difference between the % changes in cerebral and hepatic rSO2 was significantly associated with the development of IDH (p < 0.001) and the ultrafiltration rate (p = 0.010). Conclusions: Hepatic and cerebral rSO2 significantly decreased during the development of IDH, and hepatic rSO2 was more significantly decreased than cerebral rSO2 at the onset of IDH.

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Changes in tissue oxygenation in response to sudden intradialytic hypotension

Cited by 7 publications

References 19 publications

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Factors affecting intradialytic hepatic oxygenation: Associations between ultrafiltration rate and changes in systemic blood pressure

Differences between Hepatic and Cerebral Regional Tissue Oxygen Saturation at the Onset of Intradialytic Hypotension

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