Asymptomatic intradialytic hypotension: the need for pre-emptive intervention

Bradshaw, Wendi and Bennett, Paul N. 2015, Asymptomatic intradialytic hypotension: the need for pre-emptive intervention, Nephrology nursing journal, vol. 42, no. 5, September-October, pp. 479-485.

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Title Asymptomatic intradialytic hypotension: the need for pre-emptive intervention
Author(s) Bradshaw, Wendi
Bennett, Paul N.ORCID iD for Bennett, Paul N. orcid.org/0000-0001-9174-3499
Journal name Nephrology nursing journal
Volume number 42
Issue number 5
Season September-October
Start page 479
End page 485
Total pages 7
Publisher American Nephrology Nurses' Association
Place of publication Pitman, N.J.
Publication date 2015-09
ISSN 1526-744X
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Nursing
Urology & Nephrology
Asymptomatic intradialytic hypotension
hemodialysis
hypoperfusion
mean arterial pressure
CHRONIC KIDNEY-DISEASE
HEMODIALYSIS-PATIENTS
BLOOD-VOLUME
PULSE PRESSURE
MESENTERIC ISCHEMIA
RISK-FACTOR
ASSOCIATION
MORTALITY
OUTCOMES
ULTRAFILTRATION
Summary Intradialytic hypotension (IDH) remains the most common severe side effect of hemodialysis despite numerous technological advancements. Recent evidence emphasises the significance of asymptomatic hypotensive episodes, as well as the hypoperfusive consequences of both relative blood pressure drops and repetitive, symptomatic events. This article reviews the physiological importance of rapid blood pressure decrease during hemodialysis, and highlights the pathological consequences of repeated asymptomatic and symptomatic hypoperfusive episodes. In proposing a view concerned with asymptomatic IDH, a practicalpre-emptive intervention is offered to improve the long-term outcomes of patients on hemodialysis. Ongoing monitoring of individual patient's mean arterial pressure (MAP) throughout the dialysis treatment can facilitate the identification of an asymptomatic hypotensive episode. A brief pause in ultrafiltration enables vascular refill and subsequent increase in MAP, allowing resumption of safe fluid removal. Such enhanced assessment results in a reduction off patient risk, allowing safe and optimal fluid removal.
Language eng
Field of Research 1103 Clinical Sciences
1110 Nursing
1117 Public Health And Health Services
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, American Nephrology Nurses’ Association
Persistent URL http://hdl.handle.net/10536/DRO/DU:30082553

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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