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Differences in tissue oxygenation and changes in total hemoglobin signal strength in the brain, liver, and lower-limb muscle during hemodialysis

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  • Artificial Kidney / Dialysis
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Abstract

Near-infrared spectroscopy has been used to measure regional saturation of oxygen (rSO2) based on the total hemoglobin (t-Hb) signal strength. To date, few studies have investigated the changes of systemic oxygenation and t-Hb signal strength during hemodialysis (HD). This study aimed to (1) monitor rSO2 and t-Hb signal strength in the brain, liver, and lower-limb muscle during HD and (2) clarify the differences in rSO2 and t-Hb signal strength in each compartment. Fifty-three patients receiving 4-h HD were included and divided into three groups according to the compartments in which tissue oxygenation was measured as follows: brain (n = 44), liver (n = 42), and lower-limb muscle (n = 40). The rSO2 and t-Hb signal strength was monitored using an INVOS 5100c (Covidien Japan, Tokyo, Japan). The rSO2 levels were significantly lower in the brain than in the liver from HD initiation to the end (HD initiation: rSO2 in the brain and liver, 46.5 ± 1.3 and 52.4 ± 1.7%, respectively, p = 0.031). Furthermore, compared to the t-Hb signal strength ratio [value at t (min) during HD/initial value before HD] in the brain during HD, there were significant increases in the liver and lower-limb muscle, respectively. In conclusion, deterioration of cerebral oxygenation was remarkable compared to the hepatic oxygenation in HD patients. Our results, which revealed significant differences among the t-Hb signal strength ratios in the brain, liver, and lower-limb muscle during HD, might reflect the non-uniform body-fluid reduction within systemic tissues induced by ultrafiltration.

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Acknowledgements

We thank the study participants and our hospital’s clinical dialysis center staff.

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Authors and Affiliations

  1. Division of Nephrology, Department of First Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan

    Susumu Ookawara, Kiyonori Ito, Yuichiro Ueda, Haruhisa Miyazawa, Hiroki Ishii, Mitsutoshi Shindo, Taisuke Kitano, Akinori Aomatsu, Keiji Hirai, Yoshio Kaku, Taro Hoshino & Yoshiyuki Morishita

  2. Department of Clinical Engineering, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Hideyuki Hayasaka, Masaya Kofuji & Takayuki Uchida

  3. Minami-Uonuma City Hospital, Niigata, Japan

    Kaoru Tabei

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  1. Susumu Ookawara
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Correspondence to Susumu Ookawara or Kiyonori Ito.

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Ookawara, S., Ito, K., Ueda, Y. et al. Differences in tissue oxygenation and changes in total hemoglobin signal strength in the brain, liver, and lower-limb muscle during hemodialysis. J Artif Organs 21, 86–93 (2018). https://doi.org/10.1007/s10047-017-0978-1

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  • DOI: https://doi.org/10.1007/s10047-017-0978-1

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