Department of Electrical and Computer Engineering, University of Kashan, Kashan, Iran.
James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK.
J Healthc Eng. 2022 Jun 23;2022:8160269. doi: 10.1155/2022/8160269. eCollection 2022.
Acute kidney failure patients while detoxificated by hemodialysis (HD) mostly or continuously faced regular problems such as low blood pressure (hypotension), muscle cramps, nausea, or vomiting. Higher intradialytic symptom leads to low-quality HD treatment. Although more known therapeutic interventions are used to relieve the HD side effects, this study was designed to investigate how intelligent systems can make highly beneficial alterations in dialysis facilities and equipment to ease intradialytic complications and help the staff deliver high-quality treatment. A search was performed among relevant research articles based on nonpharmacological intervention methods considered to prevent adverse effects of renal replacement therapy until 2020 in the PubMed databases using the terms "intradialytic complications," "intradialytic complication interventions," "nonpharmacological interventions," "intradialytic exercises," and "adequacy calculation methods." Studies included the prevalence of intradialytic complications, different strategies with the aim of preventing complications, the outcome of intradialytic exercises on dialysis symptoms, and dialysis dose calculation methods. The results showed the incidence of hypotension varying between 5% and 30%, fatigue, muscular cramps, and vomiting as the most common complications during dialysis, which greatly affect the outcome of HD sessions. To prevent hypotension, ultrafiltration profiling, sodium modeling, low dialysate temperature, and changing the position to Trendelenburg are some strategies. Urea reduction ratio (URR), formal urea kinetic modeling (FUKM), formal single-pool urea kinetics, and online clearance monitoring (OCM) are methods for calculating the delivered dose of dialysis in which OCM is a low-cost and accessible way to monitor regularly the quality of dialysis delivered. Integration of the chair and HD machine which is in direct contact with the patient provides an intelligent system that improves the management of the dialysis session to enhance the quality of healthcare service.
急性肾衰患者在接受血液透析（HD）治疗时，大多会持续出现低血压（低血压）、肌肉痉挛、恶心或呕吐等问题。较高的透析中症状会导致 HD 治疗质量下降。尽管已经使用了更多已知的治疗干预措施来缓解 HD 的副作用，但本研究旨在探讨智能系统如何对透析设施和设备进行有益的改进，以减轻透析中并发症，并帮助工作人员提供高质量的治疗。在 PubMed 数据库中，使用“透析中并发症”、“透析中并发症干预”、“非药物干预”、“透析中运动”和“充分性计算方法”等术语，对考虑预防肾替代治疗不良影响的非药物干预方法的相关研究文章进行了检索，检索时间截至 2020 年。研究包括透析中并发症的发生率、不同的预防并发症策略、透析中运动对透析症状的影响以及透析剂量计算方法。结果表明，低血压的发生率在 5%至 30%之间，疲劳、肌肉痉挛和呕吐是透析过程中最常见的并发症，这极大地影响了 HD 治疗的效果。为预防低血压，可以采取超滤曲线、钠模型、低温透析液和体位改变等策略。尿素减少率（URR）、正式尿素动力学模型（FUKM）、正式单池尿素动力学和在线清除率监测（OCM）是透析剂量计算的方法，其中 OCM 是一种低成本且易于定期监测透析效果的方法。将与患者直接接触的椅子和 HD 机器集成在一起，可以提供一个智能系统，以改善对透析过程的管理，从而提高医疗保健服务的质量。
