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Hemodynamic response to non-pneumatic anti-shock compression garments in patients with renal dysfunction

Authors
  • Marinovich, R.1
  • Li, Z.1
  • Tamasi, T.2
  • Quinn, K.1, 2
  • Wong, S.1
  • McIntyre, C. W.1, 2
  • 1 Western University, London, ON, N6A 5C1, Canada , London (Canada)
  • 2 London Health Sciences Centre, 800 Commissioners Rd E, London, ON, N6A 5W9, Canada , London (Canada)
Type
Published Article
Journal
BMC Nephrology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jan 14, 2020
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12882-019-1680-8
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundPatients with chronic kidney disease are at higher risk of developing cardiovascular disease. Chronic exposure to intermittent hemodialysis may be a source of added stress to the cardiovascular system; intradialytic hypotension is a common complication of hemodialysis, and repeated events may lead to hemodynamic stress and ischemic injuries. Administration of non-pneumatic compression stockings to the lower limbs has demonstrated hemodynamic stabilizing effects in other settings and may provide similar benefits in the kidney disease population. Therefore, we conducted this pilot study assessing the feasibility and tolerability of the application of non-pneumatic compression stockings to patients with kidney disease. We also assessed the changes in hemodynamic measurements following the application of the compression stockings to explore the biological feasibility of this being an effective intervention for intradialytic hypotension.MethodsFifteen individuals were enrolled in the study (5 healthy, 5 chronic kidney disease patients, and 5 dialysis patients). Outcomes including hemodynamic parameters such as cardiac output, peripheral vascular resistance, and blood pressure were measured using continuous pulse wave analysis. Changes in global longitudinal strain were measured via echocardiography. These outcome measurements were made before and after the application of compression stockings.ResultsAll study participants tolerated the compression garments well and without complication. Hemodynamic response to lower body compression caused varying effects on cardiac output, mean arterial pressure and global longitudinal strain. Some individuals saw large improvements in hemodynamic parameters while in others the opposite effect was observed. No consistent response was elicited.ConclusionsApplication of compression stockings to patients with renal dysfunction is well-tolerated. However, significant variations in hemodynamic outcomes exist, and may be a barrier for larger scale trials without prior identification of specific patient characteristics indicating likely benefit from the application of external compression.Trial registrationClinicalTrials.gov, Identifier: NCT02915627, Registration Date: Sept 27, 2016.

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