Hansen Emilie K, Lindhard Kristine, Hansen Ditte
Department of Nephrology, Herlev Hospital, Herlev, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark.
J Vasc Access. 2023 Jul;24(4):739-746. doi: 10.1177/11297298211052864. Epub 2021 Oct 29.
The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD) treatment and preservation of a stable vascular access is crucial. Long term Far Infrared Radiation (FIR) has been found to increase access flow together with an enhanced maturation and patency of the AVF. The acute effects of FIR on access flow have been sparsely described and the results are contradictory, perhaps due to differences in measurement conditions and other factors of importance for access flow.
Twenty patients in HD with an AVF were included. Each patient was randomized to receive either FIR (FIR group) or no FIR (control group). The acute changes in access flow were investigated in both groups on the second dialysis day of the week and during the first 1.5 h of the dialysis session. Concomitant changes in hemodynamic parameters of importance for access flow were also explored.
There was no significant change in access flow in the FIR group compared with the control group (median (Interquartile Range)) (-10 (-413.8; 21.3) ml/min vs -17.5 (-83.8; 76.3) ml/min, = 0.58). There was no significant difference in any of the hemodynamic parameters between the FIR and the control group; cardiac output (-0.7 (-1.2; -0.2) l/min vs -0.4 (-0.9; 0.1) l/min, = 0.58), cardiac index (-0.3 (-0.5; -0.1)) l/min/m vs -0.3 (-0.4; 0) l/min/m, = 0.68), mean arterial pressure (5.5 (-1.8; 8.4) mmHg vs 1.5 (-3; 6.3) mmHg, = 0.35) and total peripheral resistance (2 (1.8; 3.4) mmHg × min/l vs 1 (-0.3; 3.1) mmHg × min/l, = 0.12).
In this trial, with a highly standardized set-up, one session of FIR did not result in any acute changes in access flow. This was not due to differences in the hemodynamic parameters between the groups.
动静脉内瘘（AVF）是血液透析（HD）治疗的首选血管通路，维持稳定的血管通路至关重要。长期远红外辐射（FIR）已被发现可增加通路血流量，并增强AVF的成熟度和通畅性。FIR对通路血流量的急性影响鲜有描述，且结果相互矛盾，这可能是由于测量条件的差异以及其他对通路血流量有重要影响的因素所致。
纳入20例接受HD治疗且有AVF的患者。每位患者随机分为接受FIR治疗组（FIR组）或不接受FIR治疗组（对照组）。在一周的第二次透析日以及透析 session 的前1.5小时，对两组患者的通路血流量急性变化进行研究。同时还探讨了对通路血流量重要的血流动力学参数的伴随变化。
与对照组相比，FIR组的通路血流量无显著变化（中位数（四分位间距））（-10（-413.8；21.3）ml/min对-17.5（-83.8；76.3）ml/min，P = 0.58）。FIR组和对照组之间的任何血流动力学参数均无显著差异；心输出量（-0.7（-1.2；-0.2）l/min对-0.4（-0.9；0.1）l/min，P = 0.58），心脏指数（-0.3（-0.5；-0.1）l/min/m对-0.3（-0.4；0）l/min/m，P = 0.68），平均动脉压（5.5（-1.8；8.4）mmHg对1.5（-3；6.3）mmHg，P = 0.35）和总外周阻力（2（1.8；3.4）mmHg×min/l对1（-0.3；3.1）mmHg×min/l，P = 0.12）。
在本试验中，采用高度标准化的设置，一次FIR治疗并未导致通路血流量出现任何急性变化。这并非由于两组之间血流动力学参数的差异所致。
