Stiller S, Wirtz D, Waterbär F, Gladziwa U, Dakshinamurty K V, Mann H
Medical Clinic II, Technical University, Aachen, Germany.
ASAIO Trans. 1991 Jul-Sep;37(3):M139-41.
Symptomatic hypotension due to ultrafiltration (UF) is one of the most frequent unwanted side effects of dialysis therapy. Using hemoglobinometry for continuous monitoring of blood volume (BV), ultrafiltration rate (UFR) can be adapted to actual changes in BV. A control system is shown in which UFR is set according to a predefined profile of BV. The conditions of control are: relative BV shall decrease steadily; BV shall decrease rapidly during the first 60 min of dialysis, thereafter decrease in BV should be less; UFR shall be as high as possible; and dry weight should be obtained within a given time. Application of this controlled UF method in 10 dialysis patients shows significantly fewer hypotensive periods and muscle cramps compared to conventionally constant UFR. It is concluded that BV controlled UF is an important step toward optimizing dialysis therapy.
超滤导致的症状性低血压是透析治疗最常见的不良副作用之一。通过血红蛋白测定法持续监测血容量（BV），超滤率（UFR）可根据BV的实际变化进行调整。展示了一种控制系统，其中UFR根据预先定义的BV曲线进行设置。控制条件为：相对BV应稳步下降；透析的前60分钟内BV应快速下降，此后BV的下降应较小；UFR应尽可能高；并且应在给定时间内达到干体重。与传统的恒定UFR相比，在10名透析患者中应用这种受控超滤方法显示低血压期和肌肉痉挛明显减少。得出的结论是，BV控制的超滤是优化透析治疗的重要一步。
