Veenstra, G. (Gerke) (2012) SUBLINGUALE MICROCIRCULATOIRE FLOWMETINGEN TIJDENS HEMODIALYSE IN RELATIE TOT BLOEDVOLUME VERANDERINGEN. thesis, Medicine.
Full text available on request.Abstract
Sidestream darkfield imaging (SDF) is a form of in-vivo microscopy and can be used to observe the microcirculatory perfusion. In sepsis but also during haemodialysis (HD) there is a reduction in perfusion without signs in blood pressure and pulserate. One of the possibilities for this reduction is the ultrafiltration (UF). To date new methods of UF have been introduced. One of them is the BVM (blood volume monitoring). This way of UF is based on automatic feedback resulting in reduction of intra and post-haemodialysis hypotension. The purpose of this study is a comparison between the different methods of UF. During the study patients were treated with three different UF-methods: HD (+GUF), HD with linear UF and HD with BVM-controlled UF. At each hour of the treatment the perfusion of the microcirculation was observed by SDF-imaging. From these images microvascular flow index (MFI) and total vessel density (TVD) were derived. During HD without UF no significant reduction of MFI was observed. In the GUF period the reduction of the MFI was significant, 2.5 [2.2-2.8] vs 2.8 [2.8-3.9] (p=0.03). During linear UF significant reduction of the MFI was not observed. During BVM-controlled UF an downward trend of the MFI was observed in the 3th hour, 2.5[1.8-2.7] versus 2.8[2.5-3.0] (p= 0.05). However there where no significant differences between the two UF-modalities. The TVD, blood pressure and pulse did not change significantly during treatment. The fluid extraction during HD is perhaps the main reason for reduction in MFI during HD. There is no difference in the alterations in MFI between BVM-controlled UF and the linear UF.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Boerma, Dr. E.C.internist-intensivist. and Hemmelder, Dr. M.H. internist-nefroloog. and Locatie: Intensive Care/Dialysekliniek Leeuwarden |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:45 |
| Last Modified: | 25 Jun 2020 10:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/626 |
Actions (login required)
 |
View Item |