Yu Soo-Jeong, Kim Do-Hyoung, Oh Dong-Jin, Yu Suk-Hee, Kang Eung-Tack
Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.
J Korean Med Sci. 2006 Feb;21(1):75-80. doi: 10.3346/jkms.2006.21.1.75.
Fluid shifts are commonplace in chronic hemodialysis patients during the intra- and interdialytic periods. In this study, we evaluated fluid shifts of body compartments using both bioimpedance spectroscopy and blood volume monitoring from the start to the end of hemodialysis. 24 stable hemodialysis patients were included on the study. Relative change of blood volume was progressively reduced from the start to the end of hemodialysis (1 hr, -7.22+/-3.23%; 2 hr, -9.78+/-4.69%; 3 hr, -12.88+/-5.65%; 4 hr, -15.41+/-6.54%, respectively). Mean % reduction of intracellular fluid was not significantly different to that of extracellular fluid at the end of hemodialysis (delta ICF, -6.58+/-5.34% vs. delta ECF, -7.07+/-5.12%). Mean % fluid reduction of arms, legs and trunk was -11.98+/-6.76%, -6.43+/-4.37% and -7.47+/-4.56%, respectively at the end of hemodialysis. There were 3 characteristic patterns in blood-volume change. Similar amounts of fluid were removed from the extracellular and intracellular compartments during hemodialysis, with the arms showing the greatest loss in terms of body segments. The pattern of blood volume change measured by blood volume monitoring may be useful for more accurate determination of dry-weight and for correcting volume status in hemodialysis patients.
在慢性血液透析患者的透析期间及透析间期,体液转移很常见。在本研究中,我们在血液透析开始至结束期间,使用生物电阻抗光谱法和血容量监测评估了身体各腔室的体液转移情况。24名稳定的血液透析患者纳入了该研究。从血液透析开始至结束,血容量的相对变化逐渐降低(1小时,-7.22±3.23%;2小时,-9.78±4.69%;3小时,-12.88±5.65%;4小时,-15.41±6.54%)。血液透析结束时,细胞内液平均减少百分比与细胞外液相比无显著差异(细胞内液变化量,-6.58±5.34% 对比 细胞外液变化量,-7.07±5.12%)。血液透析结束时,手臂、腿部和躯干的平均体液减少百分比分别为-11.98±6.76%、-6.43±4.37% 和-7.47±4.56%。血容量变化有3种特征模式。血液透析期间,细胞外和细胞内腔室去除的液体量相似,就身体部位而言,手臂的液体损失最大。通过血容量监测测得的血容量变化模式可能有助于更准确地确定干体重以及纠正血液透析患者的容量状态。