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Short-term manual compression of hemodialysis fistula leads to a rise in cerebral oxygenation.

短期手工压迫血液透析内瘘导致脑氧合升高。

  • 影响因子:1.12
  • DOI:10.1177/1129729820924561
  • 作者列表:"Kovarova L","Valerianova A","Michna M","Malik J
  • 发表时间:2021-01-01
Abstract

BACKGROUND:Decreased cerebral perfusion and oxygenation are common in hemodialysis patients. Magnitude of the arteriovenous fistula involvement in this phenomenon is not known. The aim of this study was to investigate the effect that a short-term arteriovenous fistula flow interruption has on cerebral oxygenation and to review and suggest possible explanations. METHODS:In 19 patients, basic laboratory and clinical data were obtained and arteriovenous fistula flow volume was measured by ultrasonography. Baseline regional cerebral oxygen saturation (rSO2) was measured by near-infrared spectroscopy. Manual pressure was then applied on the fistula, resulting in total blood flow interruption. After 1 min of manual compression, rSO2 and blood pressure values were noted again. The compression-related change in rSO2 was assessed, as well as its association with arteriovenous fistula flow volume, blood pressure, and other parameters. RESULTS:Mean cerebral rSO2 increased after arteriovenous fistula compression (from 53.6% ± 11.4% to 55.6% ± 10.8%; p = 0.000001; 95% confidence interval = 1.39-2.56). The rSO2 increase was higher in patients with lower rSO2 at baseline (r = -0.46; p = 0.045). CONCLUSION:A significant rise in cerebral oxygenation was observed following the manual compression of arteriovenous fistula. Therefore, the arteriovenous fistula could have a role in impaired cerebral oxygenation in hemodialysis patients.

摘要

背景: 脑灌注和氧合降低在血液透析患者中很常见。动静脉瘘参与这一现象的程度尚不清楚。本研究的目的是调查短期动静脉内瘘血流中断对脑氧合的影响,并回顾和提出可能的解释。 方法: 对19例患者进行基本的实验室和临床资料的获取和动静脉内瘘流量的超声测量。通过近红外光谱测量基线区域脑氧饱和度 (rSO2)。然后对瘘管施加手动压力,导致总血流中断。手动按压1分钟后,再次记录rSO2和血压值。评估rSO2的压缩相关变化,以及其与动静脉瘘流量、血压和其他参数的相关性。 结果: 平均脑rSO2在动静脉内瘘压迫后增加 (从53.6% ± 11.4% 到55.6% ± 10.8%; p = 0.000001; 95% 置信区间 = 1.39-2.56)。基线rSO2较低的患者rSO2增加较高 (r = -0.46; p = 0.045)。 结论: 人工压迫动静脉瘘后,脑氧合显著升高。因此,动静脉内瘘可能与血液透析患者脑氧合功能受损有关。

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