Hemodynamic Monitoring: Updated Cardiac Function Parameters

Hemodialysis patients who do not feel well at the end of a session are subject to an unidentified decrease in Cardiac Index. End-stage renal disease (ESRD) patients are at increased risk of complications and death from cardiovascular disease (CVD). In fact, mortality rates from CVD are up to 30 times higher for ESRD patients than those in the general population.

Though it’s extensively documented in literature, AV access flow is a commonly overlooked source of cardiac dysfunction. By bypassing the customary arteriole/capillary beds and establishing a direct high-flow connection between the arterial and venous systems, an AV access creates a drop in peripheral arterial resistance, which significantly affects blood flow.

The Role of Ultrasound Dilution Technology

Changes in blood pressure cannot quantify the cardiac status of hemodialysis patients. To get the most accurate assessment of cardiac function, the patient should be assessed with ultrasound dilution technology.

Hemodynamic monitoring helps you gain insight into the hemodynamic profile of an individual HD patient with regard to cardiac performance, congestion and compensation of Access Flow (indicated by AF/CO). It also allows you to identify patients at increased risk for mortality, can improve hemodialysis treatment and patient prognosis and cuts down on external resources and referrals.

Updated Cardiac Function Parameters

The updated cardiac function parameters for the Flow-QC® are:

1. Cardiac Output (CO) 5-8 L/min
2. Cardiac Index (CI) 2.2 - 3.8 L/min/m²
3. Stroke Volume Index (SVI) 32 – 56 mL/m²
4. Total Ejection Fraction (TEF) 40 – 76 %
5. Systemic Vascular Resistance (SVRI) 1900 – 3200 DYNES SEC/CM⁵ /M²
6. Total End Diastolic Volume Index (TEDVI) 6 - 11 mL/kg
7. Central Blood Volume Index (CBVI) ML/KG 13 - 23 mL/kg
8. Active Circulation Volume Index (ACVI) 40 - 70 mL/kg
9. Oxygen Delivery Index (ODI) 420 -500 mL O2/min/m²