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Pediatric Nephrology

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01-04-2020 | Stroke | Original Article

Effect of hemodialysis on impedance cardiography (electrical velocimetry) parameters in children

Authors: Meike Wilken, Jun Oh, Hans O. Pinnschmidt, Dominique Singer, Martin E. Blohm

Published in: Pediatric Nephrology | Issue 4/2020

Abstract

Background

Pediatric hemodialysis (HD) patients have a high incidence of cardiovascular morbidity and mortality. The study aim was to investigate whether impedance cardiography (electrical velocimetry, EV) is suitable as a hemodynamic trend monitoring tool in pediatric patients during HD.

Methods

Measurements by EV were obtained before, during, and after HD in a prospective single-center pediatric observational study. In total, 54 dialysis cycles in four different pediatric patients with end-stage kidney disease on chronic HD were included. EV parameters analyzed were heart rate (HR), stroke volume (SV), stroke volume index (SI), cardiac output (CO), cardiac index (CI), thoracic fluid content (TFC), index of contractility (ICON), stroke volume variation (SVV), variation of ICON (VIC), R-R interval (TRR), pre-ejection period (PEP), left ventricular ejection time (LVET), and systolic time ration (STR). Systemic vascular resistance index (SVRI) was calculated.

Results

EV did measure significant changes in cardiovascular parameters associated with HD. The following parameters increased after HD: HR (9%), SVV (19%), VIC (33%), PEP (8%), and STR (18%). A decrease after HD was measured in SV (18%), SI (18%), CO (10%), CI (10%), TFC (10%), ICON (7%), TRR (7%), LVET (8%), and LVET (8%). SVRI was not affected by HD. The changes were correlated to ultrafiltration. HD cycles without fluid withdrawal also altered cardiovascular parameters.

Conclusions

Pediatric HD with and without fluid withdrawal changes hemodynamic EV monitoring parameters. Possibly EV may be useful to optimize HD management in pediatric patients.

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Title: Effect of hemodialysis on impedance cardiography (electrical velocimetry) parameters in children
Authors: Meike Wilken
Jun Oh
Hans O. Pinnschmidt
Dominique Singer
Martin E. Blohm
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keyword: Stroke
Published in: Pediatric Nephrology / Issue 4/2020
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-019-04409-1

At a glance: The STEP trials

Springer Medicine

Effect of hemodialysis on impedance cardiography (electrical velocimetry) parameters in children

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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