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Showing 2 results for Hypotension

M Ghafourifard, M Rafieian, N Shahgholian, M Mortazavi,
Volume 16, Issue 1 (5-2010)
Abstract

Background & Aim: Intradialytic hypotension is the most frequent complication in patients receiving haemodialysis (HD). This complication not only contributes to the illness of the patients, but also decreases the efficacy of the HD. So, hypotension prevention is a major challenge for medical team, especially for nurses. One of the preventive methods that have recently been presented is the use of sodium profile and ultra filtration (UF) profile. The aim of this study was to compare the effects of linear sodium + UF profile (type1) with stepwise sodium + UF profile (type3) on systolic and diastolic blood pressure in HD patients.

Methods & Materials: In this crossover design study, 26 HD patients from two dialysis centers at Esfahan University underwent three kinds of treatment: (1) control, constant dialysate sodium concentration of 138 mmol/L with constant UF (2) linear sodium profile + UF profile (type1), a linearly decreasing dialysate sodium concentration (146-138mmol/L) in combination with a linearly decreasing UF rate and (3) stepwise sodium profile + UF profile (type2), a stepwise decreasing dialysate sodium concentration (146-138 mmol/L) in combination with a stepwise decreasing UF rate. Each treatment was applied in three dialysis sessions. Data were analyzed using repeated measure ANOVA test in the SPSS.

Results: Twenty six patients participated in the study. A total of 234 dialysis sessions were analyzed. There were no significant differences in the systolic blood pressure between three groups during predialysis and first and the second hours (P>0.05). The mean of systolic blood pressures were higher in the third hour and postdialysis during two types of profiles (1&3) compared with the routine care group (P<0.05). The mean of diastolic blood pressure was also higher in postdialysis during two types of profiles (1&3) compared with the routine group (P<0.05). There was no significant difference between the profiles 1and 3 (P>0.05).

Conclusion: In conclusion, sodium profile + UF profile is a simple and cost-effective method that modulate the dialysate sodium and ultra filtration rate and preserve the homodynamic status and blood pressure of patients during dialysis. Therefore, using sodium profile + UF profile (type1 & type3) is recommended in order to prevent hypotension and reduce nursing work during hemodialysis process.

 


Khodayar Oshvandi, Armin Mohamadiparsa, Zahra Khalili, Leili Tapak, Massoud Ghiasian,
Volume 30, Issue 2 (6-2024)
Abstract

Background & Aim: Hypotension is a common complication associated with plasmapheresis. Elevating the legs and using elastic stockings are nursing interventions aimed at preventing hypotension. The objective of this study was to compare the effects of elastic stockings and leg elevation on the prevention of hypotension during plasmapheresis.
Methods & Materials: This randomized crossover clinical trial was conducted on 35 patients undergoing plasmapheresis at Beheshti Hospital in Hamadan from 2020 to 2021. Patients were selected based on convenience sampling and then allocated to four different methods in four sessions using random permuted block designs: elastic stockings (A), leg elevation (B), a combination of elastic stockings and leg elevation (C), and a control group (D). Blood pressure was monitored before, during (every half hour), and half an hour after the completion of plasmapheresis. Data analysis was performed using SPSS version 24, applying repeated measures ANOVA with a significance level of 0.05.
Results: During plasmapheresis, systolic blood pressure decreased over time in all four methods (P<0.001). Blood pressure measurements in intervention methods A, B, and C were higher than in the control group (P<0.001). Among the intervention methods, blood pressure in method C was higher than in methods A and B, while method B was higher than method A (P<0.001).
Conclusion: The use of elastic stockings in combination with leg elevation is more effective in preventing hypotension. Therefore, it is recommended as an easy and cost-effective method for preventing hypotension in patients undergoing plasmapheresis and for nursing staff to implement.
Clinical trial registry: IRCT20191020045166N1

 

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