Abstract
Intradialytic hypotension (IDH) is one of the most common complications of hemodialysis (HD) treatment. The initiating factor of IDH is a decrease in blood volume, which is related to an imbalance between ultrafiltration (UF) and refilling rate. Impaired reactivity of resistance and capacitance vessels in reaction to hypovolemia plays possibly a major role in the occurrence of IDH. These vessels also fulfill an important function in body temperature regulation. UF-induced cutaneous vasoconstriction would result in a reduced surface heat loss and an increase in core temperature. To release body heat, skin blood flow is increased at a later stage of the HD treatment, whereby possibly IDH can occur. The aim of the study is to develop a mathematical model that can provide insight into the impact of thermoregulatory processes on the cardiovascular (CV) system during HD treatment. The mathematical procedure has been created by coupling a thermo-physiological model with a CV model to study regulation mechanisms in the human body during HD + UF. Model simulations for isothermal versus thermoneutral HD + UF were compared with measurement data of patients on chronic intermittent HD (n = 13). Core temperature during simulated HD + UF sessions increased within the range of measurement data (0.23 degrees C vs. 0.32 +/- 0.41 degrees C). The model showed a decline in mean arterial pressure of -7% for thermoneutral HD + UF versus -4% for isothermal HD + UF after 200 min during which relative blood volume changed by -13%. In conclusion, simulation results of the combined model show possibilities for predicting circulatory and thermal responses during HD + UF.
Original language | English |
---|---|
Pages (from-to) | 797-811 |
Number of pages | 15 |
Journal | Artificial Organs |
Volume | 36 |
Issue number | 9 |
DOIs | |
Publication status | Published - Sept 2012 |
Keywords
- Cardiovascular modeling
- Hemodialysis
- Hypotension
- Thermoregulation
- RELATIVE BLOOD-VOLUME
- ARTERIAL-PRESSURE RESPONSE
- INDUCED HYPOVOLEMIA
- HUMAN THERMOREGULATION
- WIDE-RANGE
- TEMPERATURE
- HYPOTENSION
- ULTRAFILTRATION
- COLD