Predicting episodes of hypotension by continuous blood volume monitoring among critically ill patients in acute renal failure on intermittent hemodialysis.

BACKGROUND Acute renal failure (ARF) develops in 23% of all critically ill patients. Hypotension occurs in 25% to 50% of patients during intermittent hemodialysis (IHD) for ARF. Blood volume (BV) monitoring has been used in chronic renal failure, with limited use in ARF during IHD. Continuous BV monitoring in the stable critically ill patient with ARF could predict, and possibly prevent, development of hypotensive episodes. METHODS This prospective observational study examined the relationship of BV and BV slopes to hypotension in 11 critically ill adults with ARF over three consecutive IHD Runs. The hypothesis was that there is a patient-specific critical BV and/or a specific BV slope that indicates forthcoming hypotension. RESULTS The incidence of hypotension, according to mean arterial pressure < 70 mmHg, was 70%. No relationship was found between BV and blood pressure, and occurrence of hypotension in critically ill patients with ARF on IHD. CONCLUSION Monitoring BV was not shown to predict hypotension in this cohort dialyzed via central venous catheters.