Procena statusa volemije ultrazvučnim pregledom donje šuplje vene i spektroskopskom bioimpendancom kod bolesnika na hemodijalizi

  • Tatjana Lazarević University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Dejan Petrović University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Ljiljana Novković University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Katarina Janićijević University of Kragujevac, Faculty of Medical Sciences, Department of Social Medicine, Kragujevac, Serbia
  • Mirjana A. Janićijević Petrović University of Kragujevac, Faculty of Medical Sciences, Department of Ophthalmology, Kragujevac, Serbia
  • Ana Vujić University of Kragujevac, Faculty of Medical Sciences, Department of Pediatrics, Kragujevac, Serbia
  • Biljana Ljujić University of Kragujevac, Faculty of Medical Sciences, Department of Genetics, Kragujevac, Serbia
  • Maja Sazdanović University of Kragujevac, Faculty of Medical Sciences, Department of Histology with Embryology, Kragujevac, Serbia
  • Zoran Kovačević University Clinical Center of Kragujevac, Urgent Center, Department of Internal Medicine, Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP200513131L
Ključne reči: plazma, volumen, hemodijaliza, spektometrija, v. cava inferior, ultrasonografija

Sažetak


Uvod/Cilj. Hipervolemija je značajan faktor rizika od razvoja kardiovaskularnog morbiditeta i moratliteta kod bolesnika koji se leče redovnom hemodijalizom. Još uvek ne postoji suverena metoda za procenu statusa volemije kod tih bolesnika. Cilj istraživanja bio je da se merenjem parametara donje šuplje vene i merenjem bioimpedance proceni status volemije kod bolesnika koji se leče redovnom hemodijalizom. Metode. Ispitivan je uticaj tretmana hemodijalizom na ultrazvučne parametre donje šuplje vene, kao i na parametre merene spektroskopskom bioimpedancom (SB) pre i posle hemodijalize. Merene su i vrednosti N-terminalnog prohormona moždanog natriuretskog peptida (NT-proBNP) pre i posle hemodijalize. U neinterventnu studiju preseka bilo je uključeno 45 bolesnika koji se leče standardnom bikarbonatnom dijalizom. Prema intradijaliznom prinosu bolesnici su bili podeljeni u tri grupe: I (do 2 000 mL), II (2 000 – 3 000 mL), III (preko 3 000 mL). Rezultati. Vrednosti parametara donje šuplje vene i parametara izmerenih SB-om bili su značajno niži nakon tretmana hemodijalizom (p < 0.005). Treća grupa bolesnika imala je značajno veću ukupnu zapreminu tečnosti u organizmu pre hemodijalize u poređenju sa I grupom, kao i značajno veću zapreminu vanćelijske tečnosti (p < 0,005). Nakon hemodijalize detektovane su značajno niže vrednosti NT-proBNP-a u svim grupama (p < 0,005). Posle tretmana hemodijalizom, zabeležena je pozitivna korelacija između koncentracije NT-proBNP-a u serumu i odnosa ekstracelularne/intracelularne tečnosti; međutim korelacija između koncentracije NT-proBNP-a i ukupne tečnosti izmerene putem SB nije dostigla statističku značajnost. Zaključak. Merenje ultrazvučnih parametara donje šuplje vene i parametara volemije SB-om u značajnoj meri doprinosi proceni statusa volemije, ali se ne može koristiti kao odvojeni parametar, već u kombinaciji sa svim drugim metodama.

Biografija autora

Mirjana A. Janićijević Petrović, University of Kragujevac, Faculty of Medical Sciences, Department of Ophthalmology, Kragujevac, Serbia

full professor

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Objavljeno
2022/07/13
Broj časopisa
Vol. 79 Br. 5 (2022): Vojnosanitetski pregled
Rubrika
Originalni članak