Short-term manual compression of hemodialysis fistula leads to a rise in cerebral oxygenation
Language English Country United States Media print-electronic
Document type Clinical Study, Journal Article
- Keywords
- arteriovenous fistula, cerebral oxygenation, cognitive impairment, dialysis, dialysis access, near-infrared spectroscopy, prosthetic grafts,
- MeSH
- Arteriovenous Shunt, Surgical * MeSH
- Biomarkers blood MeSH
- Spectroscopy, Near-Infrared MeSH
- Time Factors MeSH
- Renal Dialysis MeSH
- Oxygen blood MeSH
- Middle Aged MeSH
- Humans MeSH
- Cerebrovascular Circulation * MeSH
- Regional Blood Flow MeSH
- Blood Flow Velocity MeSH
- Aged MeSH
- Pressure MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Study MeSH
- Names of Substances
- Biomarkers MeSH
- Oxygen MeSH
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.
References provided by Crossref.org
The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation
