Impact of blood volume monitoring on fluid removal during intermittent hemodialysis of critically ill children with acute kidney injury

Mérouani, Aïcha; Kechaou, W.; Litalien, Catherine; Ducruet, Thiérry; Jouvet, Philippe

doi:10.1093/ndt/gfq855

Cited by 12 publications

(14 citation statements)

References 31 publications

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“…Therefore, they concluded that with RBV monitoring, additional fluid removal can be achieved even in the absence of hypovolemic symptoms [105]. Similar conclusion has been stated by Merouani et al [106] in pediatric patients. About morbidity and mortality, 2 studies found favorable results [107,108].…”

Section: Doi: 101159/000487702supporting

confidence: 70%

Effects of Volume Overload and Current Techniques for the Assessment of Fluid Status in Patients with Renal Disease

et al. 2018

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Volume overload is an important, may be the foremost, independent prognostic factor determining the outcome of hemodialysis patients. Therefore, it is crucial to measure fluid status of these patients and avoid volume overload. This review aims to evaluate volume overload, its effects on patients with renal diseases and current methodologies measuring volume status in the body. These techniques will be first classified as clinical evaluation and non-clinical and/or instrumental techniques, which includes biomarkers, ultrasonography, relative blood volume monitoring, bioimpedance, echocardiography, pulmonary artery catheterization, esophageal and/or suprasternal Doppler, and blood viscosity. Advantages and limitations of these different techniques will be reviewed extensively by comparing each other. At last, insights gained from this review can highlight the future prospects in this active area of research.

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Section: Doi: 101159/000487702supporting

confidence: 70%

Effects of Volume Overload and Current Techniques for the Assessment of Fluid Status in Patients with Renal Disease

et al. 2018

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“…But, there are only scarce data on RBV monitoring in AKI [16][17][18][19][20] . In some studies, measuring RBV in acute RRT seemed to allow higher UF rates [17][18][19][20] , but there was no evidence for favorable hemodynamic stability or reduction in episodes of intradialytic hypotension. In those critically ill patients, apparently other parameters were of more influence [20] .…”

Section: Discussionmentioning

confidence: 99%

Relative Blood Volume Monitoring during Renal Replacement Therapy in Critically Ill Patients with Septic Shock: A Preliminary Report

et al. 2015

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Background: Volume management during renal replacement therapy (RRT) in septic shock is always in the conflict between aggravating hypovolemia by undue ultrafiltration (UF) and insufficient reduction of fluid overload which is associated with adverse outcome. Relative blood volume (RBV) monitoring could be helpful for timely transition from fluid resuscitation to fluid removal. Methods: Data of RBV were continuously monitored and used for guidance of UF and fluid resuscitation in 21 consecutive patients with severe septic multiple organ failure. RRT was applied with extended daily hemodiafiltration for median 11 h (range 6-23). Changes in RBV were analyzed during the first 4 treatment sessions. Results: During 26 treatments, RBV monitoring revealed an internal volume loss substituted by a median infusion volume of 2.38 l (maximum 8.07 l) per treatment to keep the RBV constant. In the remaining 40 sessions, a median net-UF of 1.00 l (range 0.40-4.40) was achieved. In the first 2 days predominantly substitution was necessary whereas from the third day UF became increasingly possible. The 28-day survival rate was 81%. Conclusion: Blood volume monitoring proved to be an easy and feasible tool for safe guidance of fluid management maintaining the balance between UF and vascular refilling. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=433415.

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“…Accurate and meticulous volume and fluid management is crucial in AKI, as hypervolemia is associated with increased mortality [36,37]. The use of blood volume monitoring systems have been associated with improved ultrafiltration [38,39] without worsening hypotensive episodes [38,39,40]. Matching this with cardiac output may provide further improvements [41].…”

Section: Leveraging Data Capture In Dialysis To Improve Patient Carementioning

confidence: 99%

Integrating Real Time Data to Improve Outcomes in Acute Kidney Injury

Hirsch

Mohan²

2015

Nephron

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Critically ill patients with acute kidney injury requiring renal replacement therapy have a poor prognosis. Despite well-known factors, which contribute to outcomes, including dose delivery, patients frequently miss the target dose and volume removal. One major barrier to effective care of these patients is the traditional dissociation of dialysis device data from other clinical information systems, notably the electronic health record (EHR). This lack of integration and the resulting manual documentation leads to errors and biases in documentation and missed opportunities to intervene in a timely fashion. This review summarizes the technological advancements facilitating direct connection of dialysis devices to EHRs. This connection facilitates automated data capture of many variables - including delivered dose, ultrafiltration rate and pressure measurements - which in turn can be leveraged for data mining, quality improvement and real-time targeted therapy adjustments. These interventions hold the promise to significantly improve outcomes for this patient population.

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Impact of blood volume monitoring on fluid removal during intermittent hemodialysis of critically ill children with acute kidney injury

Cited by 12 publications

References 31 publications

Effects of Volume Overload and Current Techniques for the Assessment of Fluid Status in Patients with Renal Disease

Effects of Volume Overload and Current Techniques for the Assessment of Fluid Status in Patients with Renal Disease

Relative Blood Volume Monitoring during Renal Replacement Therapy in Critically Ill Patients with Septic Shock: A Preliminary Report

Integrating Real Time Data to Improve Outcomes in Acute Kidney Injury

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