-
Something wrong with this record ?
The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation
J. Malik, A. Valerianova, V. Tuka, P. Trachta, V. Bednarova, Z. Hruskova, M. Slavikova, MH. Rosner, V. Tesar
Language English Country Great Britain
Document type Journal Article, Research Support, Non-U.S. Gov't
NLK
Directory of Open Access Journals
from 2014
Free Medical Journals
from 2014
PubMed Central
from 2015
Europe PubMed Central
from 2015
ProQuest Central
from 2014-09-01
Open Access Digital Library
from 2014-09-01
Open Access Digital Library
from 2014-01-01
Health & Medicine (ProQuest)
from 2014-09-01
Wiley-Blackwell Open Access Titles
from 2014
ROAD: Directory of Open Access Scholarly Resources
from 2014
PubMed
33755355
DOI
10.1002/ehf2.13305
Knihovny.cz E-resources
- MeSH
- Arteriovenous Fistula * MeSH
- Arteriovenous Shunt, Surgical * MeSH
- Renal Dialysis MeSH
- Hemodynamics MeSH
- Humans MeSH
- Brain diagnostic imaging MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
AIMS: High-flow arteriovenous fistula (AVF) for haemodialysis leads to profound haemodynamic changes and sometimes to heart failure (HF). Cardiac output (CO) is divided between the AVF and body tissues. The term effective CO (COef) represents the difference between CO and AVF flow volume (Qa) and better characterizes the altered haemodynamics that may result in organ hypoxia. We investigated the effects of Qa reduction on systemic haemodynamics and on brain oxygenation. METHODS AND RESULTS: This is a single-centre interventional study. Twenty-six patients on chronic haemodialysis with high Qa (>1500 mL/min) were indicated for surgical Qa reduction for HF symptoms and/or signs of structural heart disease on echocardiography. The included patients underwent three sets of examinations: at 4 months and then 2 days prior and 6 weeks post-surgical procedure. Clinical status, echocardiographical haemodynamic assessment, Qa, and brain oximetry were recorded. All parameters remained stable from selection to inclusion. After the procedure, Qa decreased from 3.0 ± 1.4 to 1.3 ± 0.5 L/min, P < 0.00001, CO from 7.8 ± 1.9 to 6.6 ± 1.5 L/min, P = 0.0002, but COef increased from 4.6 ± 1.4 to 5.3 ± 1.4 L/min, P = 0.036. Brain tissue oxygen saturation increased from 56 ± 11% to 60 ± 9%, P = 0.001. CONCLUSIONS: Qa reduction led to increased COef. This was explained by a decreased proportion of CO running through the AVF in patients with Qa > 2.0 L/min. These observations were mirrored by higher brain oxygenation and might explain HF symptoms and improved haemodynamics even in asymptomatic high Qa patients.
References provided by Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc21025654
- 003
- CZ-PrNML
- 005
- 20211026133623.0
- 007
- ta
- 008
- 211013s2021 xxk f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1002/ehf2.13305 $2 doi
- 035 __
- $a (PubMed)33755355
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a xxk
- 100 1_
- $a Malik, Jan $u Third Department of Internal Medicine, General University Hospital, First Faculty of Medicine, Charles University, U Nemocnice 1, Prague, 128 08, Czech Republic
- 245 14
- $a The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation / $c J. Malik, A. Valerianova, V. Tuka, P. Trachta, V. Bednarova, Z. Hruskova, M. Slavikova, MH. Rosner, V. Tesar
- 520 9_
- $a AIMS: High-flow arteriovenous fistula (AVF) for haemodialysis leads to profound haemodynamic changes and sometimes to heart failure (HF). Cardiac output (CO) is divided between the AVF and body tissues. The term effective CO (COef) represents the difference between CO and AVF flow volume (Qa) and better characterizes the altered haemodynamics that may result in organ hypoxia. We investigated the effects of Qa reduction on systemic haemodynamics and on brain oxygenation. METHODS AND RESULTS: This is a single-centre interventional study. Twenty-six patients on chronic haemodialysis with high Qa (>1500 mL/min) were indicated for surgical Qa reduction for HF symptoms and/or signs of structural heart disease on echocardiography. The included patients underwent three sets of examinations: at 4 months and then 2 days prior and 6 weeks post-surgical procedure. Clinical status, echocardiographical haemodynamic assessment, Qa, and brain oximetry were recorded. All parameters remained stable from selection to inclusion. After the procedure, Qa decreased from 3.0 ± 1.4 to 1.3 ± 0.5 L/min, P < 0.00001, CO from 7.8 ± 1.9 to 6.6 ± 1.5 L/min, P = 0.0002, but COef increased from 4.6 ± 1.4 to 5.3 ± 1.4 L/min, P = 0.036. Brain tissue oxygen saturation increased from 56 ± 11% to 60 ± 9%, P = 0.001. CONCLUSIONS: Qa reduction led to increased COef. This was explained by a decreased proportion of CO running through the AVF in patients with Qa > 2.0 L/min. These observations were mirrored by higher brain oxygenation and might explain HF symptoms and improved haemodynamics even in asymptomatic high Qa patients.
- 650 12
- $a arteriovenózní píštěl $7 D001164
- 650 12
- $a arteriovenózní zkrat $7 D001166
- 650 _2
- $a mozek $x diagnostické zobrazování $7 D001921
- 650 _2
- $a hemodynamika $7 D006439
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a dialýza ledvin $7 D006435
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a práce podpořená grantem $7 D013485
- 700 1_
- $a Valerianova, Anna $u Third Department of Internal Medicine, General University Hospital, First Faculty of Medicine, Charles University, U Nemocnice 1, Prague, 128 08, Czech Republic
- 700 1_
- $a Tuka, Vladimir $u Third Department of Internal Medicine, General University Hospital, First Faculty of Medicine, Charles University, U Nemocnice 1, Prague, 128 08, Czech Republic
- 700 1_
- $a Trachta, Pavel $u Third Department of Internal Medicine, General University Hospital, First Faculty of Medicine, Charles University, U Nemocnice 1, Prague, 128 08, Czech Republic
- 700 1_
- $a Bednarova, Vladimira $u Department of Nephrology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
- 700 1_
- $a Hruskova, Zdenka $u Department of Nephrology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
- 700 1_
- $a Slavikova, Marcela $u Second Department of Surgery, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
- 700 1_
- $a Rosner, Mitchell H $u Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
- 700 1_
- $a Tesar, Vladimir $u Department of Nephrology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
- 773 0_
- $w MED00197251 $t ESC heart failure $x 2055-5822 $g Roč. 8, č. 3 (2021), s. 2165-2171
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/33755355 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y p $z 0
- 990 __
- $a 20211013 $b ABA008
- 991 __
- $a 20211026133629 $b ABA008
- 999 __
- $a ok $b bmc $g 1714622 $s 1146161
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2021 $b 8 $c 3 $d 2165-2171 $e 20210323 $i 2055-5822 $m ESC heart failure $n ESC Heart Fail $x MED00197251
- LZP __
- $a Pubmed-20211013
