The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F21%3A10427896" target="_blank" >RIV/00216208:11110/21:10427896 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064165:_____/21:10427896

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4R6BQPf24q" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4R6BQPf24q</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1002/ehf2.13305" target="_blank" >10.1002/ehf2.13305</a>

Jazyk výsledku

angličtina

Název v původním jazyce

The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation

Popis výsledku v původním jazyce

Aims: High-flow arteriovenous fistula (AVF) for haemodialysis leads to profound haemodynamic changes and sometimes to heart failure (HF). Cardiac output (CO) is divided between the AVF and body tissues. The term effective CO (COef) represents the difference between CO and AVF flow volume (Qa) and better characterizes the altered haemodynamics that may result in organ hypoxia. We investigated the effects of Qa reduction on systemic haemodynamics and on brain oxygenation. Methods and results: This is a single-centre interventional study. Twenty-six patients on chronic haemodialysis with high Qa (&gt;1500 mL/min) were indicated for surgical Qa reduction for HF symptoms and/or signs of structural heart disease on echocardiography. The included patients underwent three sets of examinations: at 4 months and then 2 days prior and 6 weeks post-surgical procedure. Clinical status, echocardiographical haemodynamic assessment, Qa, and brain oximetry were recorded. All parameters remained stable from selection to inclusion. After the procedure, Qa decreased from 3.0 +- 1.4 to 1.3 +- 0.5 L/min, P &lt; 0.00001, CO from 7.8 +- 1.9 to 6.6 +- 1.5 L/min, P = 0.0002, but COef increased from 4.6 +- 1.4 to 5.3 +- 1.4 L/min, P = 0.036. Brain tissue oxygen saturation increased from 56 +- 11% to 60 +- 9%, P = 0.001. Conclusions: Qa reduction led to increased COef. This was explained by a decreased proportion of CO running through the AVF in patients with Qa &gt; 2.0 L/min. These observations were mirrored by higher brain oxygenation and might explain HF symptoms and improved haemodynamics even in asymptomatic high Qa patients.

Název v anglickém jazyce

The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation

Popis výsledku anglicky

Aims: High-flow arteriovenous fistula (AVF) for haemodialysis leads to profound haemodynamic changes and sometimes to heart failure (HF). Cardiac output (CO) is divided between the AVF and body tissues. The term effective CO (COef) represents the difference between CO and AVF flow volume (Qa) and better characterizes the altered haemodynamics that may result in organ hypoxia. We investigated the effects of Qa reduction on systemic haemodynamics and on brain oxygenation. Methods and results: This is a single-centre interventional study. Twenty-six patients on chronic haemodialysis with high Qa (&gt;1500 mL/min) were indicated for surgical Qa reduction for HF symptoms and/or signs of structural heart disease on echocardiography. The included patients underwent three sets of examinations: at 4 months and then 2 days prior and 6 weeks post-surgical procedure. Clinical status, echocardiographical haemodynamic assessment, Qa, and brain oximetry were recorded. All parameters remained stable from selection to inclusion. After the procedure, Qa decreased from 3.0 +- 1.4 to 1.3 +- 0.5 L/min, P &lt; 0.00001, CO from 7.8 +- 1.9 to 6.6 +- 1.5 L/min, P = 0.0002, but COef increased from 4.6 +- 1.4 to 5.3 +- 1.4 L/min, P = 0.036. Brain tissue oxygen saturation increased from 56 +- 11% to 60 +- 9%, P = 0.001. Conclusions: Qa reduction led to increased COef. This was explained by a decreased proportion of CO running through the AVF in patients with Qa &gt; 2.0 L/min. These observations were mirrored by higher brain oxygenation and might explain HF symptoms and improved haemodynamics even in asymptomatic high Qa patients.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

<a href="/cs/project/NV17-31796A" target="_blank" >NV17-31796A: Tkáňová hypoxie u pacientů s chronickým onemocněním ledvin – metabolické a hemodynamické souvislosti</a><br>

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

ESC Heart Failure [online]

ISSN

2055-5822

e-ISSN

—

Svazek periodika

8

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

7

Strana od-do

2165-2171

Kód UT WoS článku

000631526200001

EID výsledku v databázi Scopus

2-s2.0-85102875270