Nephrology Dialysis Transplantation, Vol 14, Issue 2 376-383, Copyright © 1999 by Oxford University Press
D Schneditz, E Wang and N Levin
Background: Recirculation (R) and
access blood flow (Qac measurements are considered
useful indicators of adequate delivery of haemodialysis. It was the purpose
of this study to compare measurements of R and
Qac obtained by two different techniques which are
based on the same principle of indicator dilution, but which differ because
of the characteristics of the injection and detection of the different
indicators used. Methods: Recirculation measured by a
thermal dilution technique using temperature sensors (BTM, Fresenius
Medical Care) was compared with recirculation measured by a validated
saline dilution technique using ultrasonic transducers placed on arterial
and venous segments of the extracorporeal circulation (HDM, Transonic
Systems, Inc.). Calculated access flows were compared by Bland-Altman
analysis. Data are given as mean±SD.
Results: A total of 104 measurements obtained in 52
treatments (17 patients, 18 accesses) were compared. Recirculation measured
with correct placement of blood lines and corrected for the effect of
cardiopulmonary recirculation using the 'double recirculation technique'
was -0.02±0.14% by the BTM technique and not different from the
0% measured by the HDM technique. Recirculation measured with reversed
placement of blood lines and corrected for the effect of cardiopulmonary
recirculation was 19.66±10.77% measured by the BTM technique
compared with 20.87±11.64% measured by the HDM technique. The
difference between techniques was small (-1.21±2.44%) albeit
significant. Access flow calculated from BTM recirculation was
1328±627 ml/min compared with 1390±657 ml/min
calculated by the HDM technique. There was no bias between techniques.
Conclusion: BTM thermodilution yields results which
are consistent with the HDM ultrasound dilution technique with regard to
both recirculation and access flow measurement. Key
words: access flow; haemodialysis; recirculation;
thermodilution; ultrasound dilution; vascular access
ORIGINAL ARTICLES
Validation of haemodialysis recirculation and access blood flow measured by thermodilution
Renal Research Institute and Division of Nephrology and Hypertension, Department of Medicine at Beth Israel Medical Center, New York, NY 10128, USA; Corresponding author at: Renal Research Institute, Yorkville Dialysis, 1555 3rd Avenue, 2nd floor, New York, NY 10128, USA
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Schneditz Glucose-added dialysis fluid prevents asymptomatic hypoglycaemia in regular haemodialysis Nephrol. Dial. Transplant., March 1, 2008; 23(3): 1066 - 1067. [Full Text] [PDF]
|
|
|
|
|
|
F. Locatelli, U. Buoncristiani, B. Canaud, H. Kohler, T. Petitclerc, and P. Zucchelli Haemodialysis with on-line monitoring equipment: tools or toys? Nephrol. Dial. Transplant., January 1, 2005; 20(1): 22 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-C. Lin, C.-F. Chang, H.-J. Chiou, Y.-C. Sun, S.-S. Chiang, M.-W. Lin, P.-C. Lee, and W.-C. Yang Variable Pump Flow-Based Doppler Ultrasound Method: A Novel Approach to the Measurement of Access Flow in Hemodialysis Patients J. Am. Soc. Nephrol., January 1, 2005; 16(1): 229 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Donauer, C. Schweiger, B. Rumberger, B. Krumme, and J. Bohler Reduction of hypotensive side effects during online-haemodiafiltration and low temperature haemodialysis Nephrol. Dial. Transplant., August 1, 2003; 18(8): 1616 - 1622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Donauer, C. Schweiger, B. Rumberger, B. Krumme, and J. Bohler Reduction of hypotensive side effects during online-haemodiafiltration and low temperature haemodialysis Nephrol. Dial. Transplant., August 1, 2003; 18(88): 1616 - 1622. [Abstract] [Full Text]
|
|
|
|
|
|
J. L. Ragg, J. P. Treacy, P. Snelling, M. Flack, and S. Anderton Confidence limits of arteriovenous fistula flow rate measured by the 'on-line' thermodilution technique Nephrol. Dial. Transplant., May 1, 2003; 18(5): 955 - 960. [Abstract] [Full Text] [PDF]
|
|