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Do You Know Your HD Patient’s Cardiac Status? It Could Be a Matter of Life and Death!

By Susan Eymann, MS19 Feb 2020

In recognition of February as American Heart Awareness month, Transonic is pleased to share this blog heart blog along with an offer for a free Transonic Flowprobe. To learn more about the offer, click here.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality End-Stage Renal Disease (ESRD) patients.1,2

 It accounts for half of the deaths and one-third of hospitalizations of dialysis patients.3 Screen Shot 2020-02-07 at 11.39.30 AMMoreover, cardiovascular collapse is not only a major complication during hemodialysis treatments but also between sessions.4 “Thirty-five percent of HD deaths occurred in the first 12-hour interval ... 27% of these deaths occurred during dialysis and 33% occurred in the first hour after the dialysis treatment.”5

Congestive heart failure in ESRD patients results from cardiac overload, anemia, severe hypertension and cardiac dysfunction. With CVD mortality rates approximately 30 times that of the general population1, you need to know your patient’s cardiac status? It might mean the difference between life and death.

Now, the Transonic HD03 Hemodialysis Monitor can give you the necessary information to diagnose your patient’s cardiac status. In addition to measuring delivered blood flow, recirculation and vascular access flow, the HD03 can tell your patient’s:

  • Cardiac Index (CI);
  • Ratio of Access Flow to Cardiac Output (AF/CO).
  • Peripheral Resistance Index (PRI);
  • Central Blood Volume Index (CBVI);
  • Total End Diastolic Volume Index (TEDVI);
  • Total Ejection Fraction (TEF %)
  • Active Circulation Volume Index (ACVI)
  • Systemic Vascular Resistance Index (SVRI)
  • Stroke Volume Index (SVI).

Measuring Cardiac Output with the HD03:

  • Provides optimum treatment to the patient;
  • Doesn’t extend the time a patient spends in the clinic;
  • Gives caregivers peace of mind by knowing the status of a patient’s heart.

This Cardiac Function Monitoring with the HD03 provides a way to integrate cardiac function assessment into your clinic’s treatment protocol to forestall the devastating effects of cardiovascular disease. Knowing these parameters identifies:

1) Excessively high and prolonged levels of access flow (>1,600-2,000 mL/min) stress the heart causing cardiomegaly and heart failure. This can be identified by an access flow to cardiac output ratio (AVF/CO) exceeding 25-30%.

2) Low cardiac output (CI < 2 L/min/m2) which places patients at high risk for cardiovascular complications and failure.

3) Significant 20 - 30% decrease of Cardiac Index during hemodialysis to dangerously low levels due to inaccurate dry weight estimation and/or inadequate medication that places patients at high risk for cardiovascular complications and sudden death following a dialysis session.

4) Significant decreases in Central Blood Volume during dialysis that may portend hypotensive episodes.

1. Cardiovascular Disease ó An ESRD Epidemic. Am J Kid Dis 1998; 32(5): Suppl 3.
2. MacRae JM et al, “The Cardiovascular Effects of Arteriovenous Fistulas in Chronic Kidney Disease: A Cause for Concern?” Sem in Dialysis 2006; 19(15): 349-352. (Transonic Reference # HD7337A)
3. Locatelli F et al, “Cardiovascular Disease in Chronic Renal Failure; the Challenge Continues,” Nephrol Dial Transplant 2000; 15(Suppl 5): 69-80. (Transonic Reference # HD9643R
4. Tucker T et al, “Unrecognized Deterioration of Cardiac Function during Hemodialysis,” J Am Soc of Nephrol Abstracts 2002; 13: 213A. (Transonic Reference # HD267A).
5. Bleyer AJ et al, “The Timing and Characteristics of Sudden Death in Hemodialysis Patients,” J Am Soc Nephrol 2002; 13: SU-PO737.

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