Introduction Patients with end-stage renal disease (ESRD) cannot regulate their fluid balance, and are dependent on dialysis for fluid removal. Hemodialysis Complication End Stage Renal Diseaseĭiagnostic Test: sonographic measurement of inferior vena cava diameter A crossover design is intended to examine the effect of IVCD measurement on quality of life and rate of hemodynamic adversities as compared with traditional estimation of dry weight. In this study, we aim to assess the applicability and clinical utility of this method in our dialysis units. In a single-center, blinded and controlled trial it has been shown to improve clinical outcomes in patients receiving hemodialysis. It is available, inexpensive and efficient, yet operator-dependent. Sonographic measurement of the inferior vena cava diameter (IVCD) is a method under investigation for assessing hydration status. Several techniques have been proposed to asses hydration status in dialysis patient, among them measurement of bioimpedance and biochemical markers. Current methods are imprecise, and thus many patients are hype- or hypovolemic, and suffer respective consequences such as hypertension, pulmonary congestion, cardiac hypertrophy, chronic dehydration, hypotension and shock. Why Should I Register and Submit Results?ĭetermination of dry weight in patients with end-stage renal disease treated with hemodialysis is an unmet challenge in clinical nephrology.IVCc = Inferior vena cava collapsibility index IVCd = inferior vena cava diameter IVCdmax = maximum inferior vena cava diameter IVCdmin = minimum inferior vena cava diameter LLA = lower limit of agreement NA = not applicable ULA = upper limit of agreement.ĭaily cumulative fluid balance (mL) by day after fluid therapy among patients with and without dengue shock. (C) IVCd (cm) after fever onset among patients with and without dengue shock (D) IVCc (%) after fever onset among patients with and without dengue shock. The mean IVCdmin (cm) of each patient was plotted against the difference in IVCd (cm) between two measurements (811 measurements each) obtained by the same observer. (B) A Bland-Altman plot of data from the intraobserver reliability study. The mean IVCdmax (cm) of each patient was plotted against the difference in IVCd (cm) between two measurements (811 measurements each) obtained by the same observer. (A) A Bland-Altman plot of data from the intraobserver reliability study. Inferior vena cava parameters by day after fever onset among patients with and without dengue shock. CI = cardiac index HR = heart rate MAP = mean arterial pressure NA = not applicable PP = pulse pressure SVI = stroke volume index TPRI = total peripheral resistance index. (F) SVI (mL/m 2/beat) after fever onset among patients with and without dengue shock. (E) TPRI (dynes∙sec/cm 5/m 2) after fever onset among patients with and without dengue shock. (D) CI (L/min/m 2) after fever onset among patients with and without dengue shock. (C) HR (beats/min) after fever onset among patients with and without dengue shock. (B) PP (mmHg) after fever onset among patients with and without dengue shock. (A) MAP (mmHg) after fever onset among patients with and without dengue shock. Hemodynamic parameters by day after fever onset among patients with and without dengue shock. Flow diagram for the recruitment of study patients.Ĭhange in hematocrit (Hct) from baseline (%) by day after fever onset among patients with and without dengue shock.īaseline characteristics, clinical parameters, laboratory parameters, and outcomes among 162 hospitalized adults with dengue, subdivided by patients with and without dengue shock.
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