Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/35468
Title: Relative Blood Volume Monitoring during Continuous Renal Replacement Therapy: A Prospective Observational Study.
Austin Authors: Maeda, Akinori;Baldwin, Ian C ;Spano, Sofia;Chaba, Anis;Phongphithakchai, Atthaphong;Pattamin, Nuttapol;Hikasa, Yukiko;Bellomo, Rinaldo ;See, Emily J 
Affiliation: Intensive Care
Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Data Analytics Research and Evaluation (DARE) Centre
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Issue Date: 13-Aug-2024
Date: 2024
Publication information: Blood Purification 2024-08-13
Abstract: Hematocrit monitoring during continuous renal replacement therapy (CRRT) allows the continuous estimation of relative blood volume (RBV). This may enable early detection of intravascular volume depletion prior to clinical sequelae. We aimed to investigate the feasibility of extended RBV monitoring and its epidemiology during usual CRRT management by clinicians unaware of RBV. Moreover, we studied the association between changes in RBV and net ultrafiltration (NUF) rates. In a cohort of adult intensive care unit patients receiving CRRT, we continuously monitored hematocrit and RBV using a pre-filter noninvasive optical sensor. We analyzed temporal changes in RBV and investigated the association between RBV change and NUF rates, using the classification of NUF rates into low, moderate, or high based on predefined cut-offs. We obtained >60,000 minute-by-minute measurements in >1,000 CRRT hours in 36 patients. The median RBV change was negative (decrease) in 69% of patients and the median peak change in RBV was -9.3% (interquartile range: -3.9% to -14.3%). Moreover, the median RBV decreased from baseline by >5% in 40.2% of measurements and by >10% in 20.6% of measurements. Finally, RBV decreased significantly more when patients received a high NUF rate (>1.75 mL/kg/h) compared to low or moderate NUF rates (5.32% vs. 1.93% or 1.97%, p < 0.001). Continuous hematocrit and RBV monitoring during CRRT was feasible. RBV decreased significantly during CRRT, and decreases were greater with higher NUF rates. RBV monitoring may help optimize NUF management and prevent the occurrence of intravascular volume depletion.
URI: https://ahro.austin.org.au/austinjspui/handle/1/35468
DOI: 10.1159/000540838
ORCID: 
Journal: Blood Purification
Start page: 1
End page: 9
PubMed URL: 39137744
ISSN: 1421-9735
Type: Journal Article
Subjects: Acute kidney injury
Blood volume
Fluid balance
Hematocrit
Ultrafiltration
Appears in Collections:Journal articles

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