Why cardiac function assessment is
essential during hemodialysis, new cardiac
function parameters to know, and much more.
Complications and death: CVD is the leading cause of morbidity and mortality and is a major cause of complications during hemodialysis treatments in patients with ESRD
30x: In ESRD patients, CVD mortality rates are approximately 30 times higher than those of the general population
35% of deaths occur within the first 12 hours from the beginning of the dialysis session
Patients who do not feel well at the end of a dialysis session are subject to an unidentified decrease in Cardiac Index (CI) to critical ICU levels of <2 L/min/m2
Hemodynamic monitoring provides a unique data set to gain insight into the hemodynamic profile of an individual HD patient with regard to cardiac performance, congestion and compensation of Access Flow (indicated by AF/CO). It also allows the identification of patients at increased mortality risk using TEF, which promises to be a robust risk marker that could be implemented for repeated monitoring of HD patients. While cardiac biomarkers represent static risk markers, many of the hemodynamic parameters are amenable to treatment that, in turn, could improve HD treatment and most importantly prognosis of HD patients. Another advantage of hemodynamic monitoring is the fact that it is directly carried out by the dialysis team without the need for external resources or referrals.
The ratio of access flow to cardiac output is an important clinical indicator. Cardiac function should be assessed with ultrasound dilution technology if the patient displays values in the yellow or red ranges below, recommends MacRae JM et al.
MacRae JM et al, “Arteriovenous Fistula-associated High-output Cardiac Failure: A
Blood pressure changes cannot quantify the cardiac status of HD patients; the most accurate assessment of cardiac function is through ultrasound dilution measurements.
The Transonic HD03 can measure a full complement of cardiac parameters during dialysis through a simple innocuous bolus of saline thus safeguarding the patient from cardiovascular collapse. All HD patients should be regularly monitored for cardiac issues and HD patients with active cardiovascular disease should be frequently assessed.
Saline Indicator Route: Body temperature saline is injected into the venous line, travels through the heart and lungs and returns via the arterial system where a flow/dilution sensor records the diluted concentration.
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