Near-infrared spectroscopy parameters in patients undergoing continuous venovenous hemodiafiltration

• Published in: Einstein (São Paulo, Brazil) Vol. 17; no. 1; p. eAO4439
• Main Authors: Chaves, Renato Carneiro de Freitas, Tafner, Philipe Franco do Amaral, Chen, Felipe Ko, Meneghini, Letícia Bagatini, Corrêa, Thiago Domingos, Rabello Filho, Roberto, Cendoroglo Neto, Miguel, Santos, Oscar Fernando Pavão Dos, Serpa Neto, Ary
• Format: Journal Article
• Language: English
• Published: Brazil Instituto Israelita de Ensino e Pesquisa Albert Einstein 14-02-2019
• Subjects: Acute Kidney Injury - diagnostic imaging; Acute Kidney Injury - physiopathology; Acute Kidney Injury - therapy; Cuidados críticos; Espectroscopia de luz próxima ao infravermelho; Female; Hemodiafiltration - methods; Hemodinâmica; Humans; Lesão renal aguda; Male; MEDICINE, GENERAL & INTERNAL; Microcirculation - physiology; Microcirculação; Middle Aged; Original; Oxigenação; Pilot Projects; Prospective Studies; Spectroscopy, Near-Infrared; Terapia de substituição renal; Critical care; Hemodinâmica; Oxigenação; Microcirculation; Terapia de substituição renal; Microcirculação; Espectroscopia de luz próxima ao infravermelho; Acute kidney injuries; Spectroscopy, near-infrared; Hemodynamics; Renal replacement therapy; Cuidados críticos; Oxygenation; Lesão renal aguda
• ISSN: 1679-4508; 2317-6385; 2317-6385
• DOI: 10.31744/einstein_journal/2019AO4439

To investigate the impacts of continuous venovenous hemodiafiltration on the microcirculation in patients with acute kidney injury.
A prospective observational pilot study conducted in a 40-bed, open clinical-surgical intensive care unit of a private tertiary care hospital located in the city of São Paulo (SP), Brazil. Microcirculation was assessed using near-infrared spectroscopy by means of a 15mm probe placed over the thenar eminence. Vascular occlusion test was performed on the forearm to be submitted to near-infrared spectroscopy by inflation of a sphygmomanometer cuff to 30mmHg higher than the systolic arterial pressure. The primary endpoint was the assessment of near-infrared spectroscopy-derived parameters immediately before, 1, 4 and 24 hours after the initiation of continuous venovenous hemodiafiltration.
Nine patients were included in this pilot study over a period of 2 months. Minimum tissue oxygen saturation measured during the vascular occlusion test was the only near-infrared spectroscopy-derived parameter to differed over the time (decrease compared to baseline values up to 24 hours after initiation of continuous venovenous hemodiafiltration).
The impacts of microcirculatory dysfunction on clinical outcomes of patients undergoing to continuous venovenous hemodiafiltration need to be further investigated.