Fluid balance modelling in patients with kidney failure

Chamney, Paul; Johner, Carl H.; Aldridge, C.; M, Kramer; Valasco, N.; Tattersall, James; Aukaidey, T.; Gordon, Ron; Greenwood, Roger

doi:10.1080/030919099294276

Cited by 24 publications

(29 citation statements)

References 7 publications

(1 reference statement)

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“…The two physiological factors with the greatest effect on the results were the concentration of proteins in plasma (C Pro,P ), and the amount of IntF (P IntF ). Their influence on the fluid shift rate between interstitium and capillary spaces has been reported in simulations [5] and measurements [11] and is interrelated with fluid volume state (see Fig. 3).…”

Section: Consideration Of Individual Differencesmentioning

confidence: 85%

“…In addition, the composition of the model (an 11-cylinder including in each cylinder a two-pool model) allows to simulate changes at almost any body segment, based on fluid shifts between capillary space and interstitial fluid. As several processes that affect impedance measurements are related to body fluid redistribution between those spaces (e.g., Med Biol Eng Comput (2010) 48:531-541 537 ambient temperature, food and fluids consumption, ultrafiltration, changes in body posture) [5,21,27,34], in the future the present model might be used to investigate or reproduce some of these processes. The correction of segmental bioimpedance measurements on specific body postures may be of future importance [17,27,34].…”

Section: Model Implementation and Usabilitymentioning

confidence: 99%

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Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements

Medrano

Eitner

Walter

et al. 2010

Med Biol Eng Comput

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Bioimpedance spectroscopy (BIS) is suitable for continuous monitoring of body water content. The combination of body posture and time is a well-known source of error, which limits the accuracy and therapeutic validity of BIS measurements. This study evaluates a model-based correction as a possible solution. For this purpose, an 11-cylinder model representing body impedance distribution is used. Each cylinder contains a nonlinear two-pool model to describe fluid redistribution due to changing body position and its influence on segmental and hand-to-foot (HF) bioimpedance measurements. A model-based correction of segmental (thigh) and HF measurements (Xitron Hydra 4200) in nine healthy human subjects (following a sequence of 7 min supine, 20 min standing, 40 min supine) has been evaluated. The model-based compensation algorithm represents a compromise between accuracy and simplicity, and reduces the influence of changes in body position on the measured extracellular resistance and extracellular fluid by up to 75 and 70%, respectively.

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Section: Consideration Of Individual Differencesmentioning

confidence: 85%

Section: Model Implementation and Usabilitymentioning

confidence: 99%

Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements

Medrano

Eitner

Walter

et al. 2010

Med Biol Eng Comput

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show abstract

“…Unlike fluid removed using ultrafiltration pulses that has been used before to study cardiovascular response and vascular refilling, 1,8,10 blood shifted to the extracorporeal circulation can rapidly be returned to the patient after the test. The perturbation with this method is several times faster than the perturbation rate using ultrafiltration pulses.…”

Section: Discussionmentioning

confidence: 99%

Device and Technique for Extracorporeal Blood Volume Sequestration During Hemodialysis

Wimmer¹,

Bachler²,

Haditsch³

et al. 2006

ASAIO Journal

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We developed a technique for a controlled and reversible volume perturbation of the cardiovascular system during hemodialysis. The capacitance of the extracorporeal circulation was modified by an expansion bag, using separate filling and draining lines connected to postpump and prepump sections of the arterial line segment, respectively. The connection to this bag was manually operated by three-way valves. The volume sequestered into the blood bag was continuously measured by a weighing scale. Filling and draining of the expansion bag was measured in eight patients in two subsequent routine dialysis treatments. Four volume shifts were done in each treatment. Filling and draining rates and times depended on extracorporeal blood flow as well as arterial and venous line pressures. Bag inflow and outflow volumes were 215.8 +/- 28.5 ml/min and 221.6 +/- 37.0 ml/min, respectively. The total volume transiently sequestered in the bag was 479.8 +/- 61.3 ml. The duration of the whole test was 4.5 +/- 0.8 minutes. During filling, residual dialyzer blood flow was transiently reduced to 58.5 +/- 21.6 ml/min and the filtration fraction reached 30 +/- 13%. There were no adverse events such as clotting in the blood bag or in the dialyzer. The method provides rapid, reversible, and safe volume shifts between the patient and the extracorporeal circulation with the potential to elicit a hemodynamic response for characterizing the patient during each dialysis treatment.

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“…29,30 Changes in hematocrit following a trend can be accounted for, but changes in body position and movements, especially of the legs, as well as the uptake of food will lead to unpredictable changes in hematocrit and will therefore interfere with the accuracy of ICG calculations. In hemodialysis, hematocrit is known to change because of ultrafiltration and vascular refilling.…”

Section: Discussionmentioning

confidence: 99%

Absolute Blood Volume and Hepatosplanchnic Blood Flow Measured by Indocyanine Green Kinetics During Hemodialysis

et al. 2014

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A technique to measure absolute blood volume and hepatosplanchnic blood flow (Q(h)) during hemodialysis (HD) is explored. The dispersion and elimination of indocyanine green (ICG) were measured using a noninvasive optical device attached to the extracorporeal system and compared with transcutaneous measurements. Distribution volume (V) and elimination rate constant (k) were determined from arterial indicator concentrations assuming standard single-pool behavior. Cardiac output (Q(c)) and access flow (Q(a)) were measured by saline dilution technique. Duplicate dilutions were available in seven subjects (two female subjects, 78.0 ± 9.66 kg dry weight). k was not different between measuring techniques (0.246 ± 0.07 vs. 0.249 ± 0.064 min⁻¹, p = n.s.). V was 4.71 ± 0.75 L (60.86 ± 10.21 ml/kg dry body weight) as anticipated for anthropometric blood volume (p = n.s). Indocyanine green half-life was 3.05 ± 0.89 min and in the range of normal liver function. Therefore, ICG clearance (K = kV, 1.14 ± 0.32 L/min) was assumed to correspond to Q(h). Systemic blood flow (Q(s)) calculated as difference between Q(c) (7.11 ± 1.47 L/min) and Q(a) (1.56 ± 0.88 L/min) was 5.55 ± 1.33 L/min. Thus, during HD 21 ± 5% of Q(s) were consumed by the hepatosplanchnic circulation. The analysis of ICG distribution and elimination using available online technology for routine HD provides plausible point-of-care information, which could be of clinical interests in extracorporeal applications.

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Fluid balance modelling in patients with kidney failure

Cited by 24 publications

References 7 publications

Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements

Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements

Device and Technique for Extracorporeal Blood Volume Sequestration During Hemodialysis

Absolute Blood Volume and Hepatosplanchnic Blood Flow Measured by Indocyanine Green Kinetics During Hemodialysis

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