Relative blood volume measurements during hemodialysis: Comparisons between three noninvasive devices

Authors

  • Judith J. DASSELAAR,

    1. Dialysis Center Groningen, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
    2. Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
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  • Roel M. HUISMAN,

    1. Dialysis Center Groningen, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
    2. Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
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  • Paul E. DE JONG,

    1. Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
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  • Casper F.M. FRANSSEN

    1. Dialysis Center Groningen, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
    2. Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
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C.F.M. Franssen, Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
E-mail: c.f.m.franssen@int.umcg.nl

Abstract

The monitoring of relative blood volume changes (ΔRBV) has been advocated for the prevention of hemodialysis (HD) hypotension. Stand-alone devices (Crit-Line) or devices incorporated into the HD apparatus (blood volume monitor [BVM], Hemoscan) are widely used for this purpose. Comparisons between devices are scarce. The aim of this study was, first, to compare ΔRBV results from these 3 devices with ΔRBV calculated from changes in laboratory-derived hemoglobin (ΔRBV-lab-Hb) and, second, to compare ΔRBV results between the different devices. Fourteen patients received 2 HD treatments in a randomized order: one with the Hemoscan and Crit-Line combination and one with the BVM and Crit-Line combination. ΔRBV-lab-Hb was measured at 2 and 4 hr into the HD session. Bland-Altman analyses showed that ΔRBV results from the 3 devices differed systematically from ΔRBV-lab-Hb, i.e., the difference between the 3 devices and ΔRBV-lab-Hb varied significantly (p<0.05) with the magnitude of the measurement. The interdevice comparison showed considerable differences in ΔRBV results. At the end of the treatment, a significant difference (p<0.05) between ΔRBV measured by the Hemoscan and Crit-Line device (−9.8±2.7% and −11.5±4%, respectively) was found. In most patients, a systematic difference between Crit-Line and Hemoscan and between Crit-Line and BVM was observed. Relative blood volume change measurements by Crit-Line, Hemoscan, and BVM yield results that differ systematically from the results obtained from laboratory-derived Hb changes. Furthermore, there are substantial differences in ΔRBV results between the 3 ΔRBV devices.

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