School of Nursing, Edith Cowan University, Joondalup, WA, Australia.
School of Medicine, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
J Clin Nurs. 2018 Apr;27(7-8):e1561-e1570. doi: 10.1111/jocn.14309. Epub 2018 Mar 30.
To measure the prevalence of symptomatic (S-IDH) and asymptomatic intradialytic hypotension (A-IDH) or postdialysis overhydration in a satellite haemodialysis clinic in Western Australia.
Intradialytic hypotension is one of the most common side effects of haemodialysis caused by ultrafiltration provoking a temporary volume depletion. The prevalence of asymptomatic hypotension during dialysis has been rarely reported, but is considered to have the same negative consequences as symptomatic hypotension on various end organs like the brain and the gastrointestinal tract.
Observational study on a retrospective 3-month period of nursing recorded fluid-related adverse events.
Data collection on the occurrence of S-IDH and A-IDH during a total of 2,357 haemodialysis treatments in 64 patients. Body weight of patients at the time of cessation of treatment was recorded, and patients, whose weight exceeded their ideal body weight by at least 0.5 kg, were classified as overhydrated. Data analysis was performed using spss version 24 software.
Symptomatic intradialytic hypotension was the most common adverse event measured in this cohort, and occurred during 221 (9.4%) of all treatments, whereas asymptomatic intradialytic hypotension occurred in 88 (3.7%) of all treatments. The total occurrence of intradialytic hypotension was 13.1%, and symptomatic was observed in 30 patients, implying that nearly every second patient had at least one symptomatic episode within 3 months. Overhydration occurred in a total of 103 (4.4%) of all treatments, and involved 17 patients.
Symptomatic and asymptomatic intradialytic hypotension were the most commonly observed adverse events in this cohort; overhydration occurrence was considerably less common.
The high occurrence of hypotension-related events demonstrates that ultrafiltration treatment goals in satellite dialysis clinics are sometimes overestimated, resulting in regular significant symptomatic episodes for the patient. Raising the awareness of the prevalence of IDH amongst renal nurses could be an essential initial step before collectively preventative strategies in haemodialysis satellite units are implemented.
测量西澳大利亚卫星血液透析诊所中症状性（S-IDH）和无症状性透析内低血压（A-IDH）或透析后过度水化的患病率。
透析内低血压是血液透析最常见的副作用之一，由超滤引起的短暂容量耗竭引起。透析期间无症状性低血压的患病率很少被报道，但被认为与症状性低血压对大脑和胃肠道等各种终末器官有相同的负面后果。
对护理记录的 3 个月回顾性期间的流体相关不良事件进行观察性研究。
对 64 例患者的总共 2357 次血液透析治疗期间 S-IDH 和 A-IDH 的发生情况进行数据收集。记录治疗结束时患者的体重，体重超过理想体重至少 0.5kg 的患者被归类为过度水化。使用 spss 版本 24 软件进行数据分析。
在该队列中，症状性透析内低血压是测量的最常见不良事件，发生在所有治疗的 221 例（9.4%）中，而无症状性透析内低血压发生在所有治疗的 88 例（3.7%）中。透析内低血压的总发生率为 13.1%，30 例患者出现症状性低血压，这意味着近每两个患者在 3 个月内至少有一次症状性发作。所有治疗中共有 103 例（4.4%）发生过度水化，涉及 17 例患者。
症状性和无症状性透析内低血压是该队列中最常见的观察到的不良事件；过度水化的发生相对较少。
低血压相关事件的高发生率表明，卫星透析诊所中的超滤治疗目标有时被高估，导致患者经常出现明显的症状性发作。在血液透析卫星单位实施集体预防策略之前，提高肾病护士对 IDH 患病率的认识可能是一个重要的初始步骤。
