Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Differences Between Hepatic and Cerebral Regional Tissue Oxygen Saturation at the Onset of Intradialytic Hypotension

Shohei Kaneko
ORCID logo ,
Susumu Ookawara
* ORCID logo ,
Kiyonori Ito
,
Saori Minato
,
Yuko Mutsuyoshi
,
Yuichiro Ueda
,
Keiji Hirai
ORCID logo ,
Yoshiyuki Morishita
Version 1 : Received: 21 June 2023 / Approved: 21 June 2023 / Online: 21 June 2023 (07:33:20 CEST)

A peer-reviewed article of this Preprint also exists.

Kaneko, S.; Ookawara, S.; Ito, K.; Minato, S.; Mutsuyoshi, Y.; Ueda, Y.; Hirai, K.; Morishita, Y. Differences between Hepatic and Cerebral Regional Tissue Oxygen Saturation at the Onset of Intradialytic Hypotension. J. Clin. Med. 2023, 12, 4904. Kaneko, S.; Ookawara, S.; Ito, K.; Minato, S.; Mutsuyoshi, Y.; Ueda, Y.; Hirai, K.; Morishita, Y. Differences between Hepatic and Cerebral Regional Tissue Oxygen Saturation at the Onset of Intradialytic Hypotension. J. Clin. Med. 2023, 12, 4904.

Abstract

Background: Intradialytic hypotension (IDH) is a critical pathological condition associated with all−cause mortality in patients undergoing hemodialysis (HD). However, few studies have investigated IDH-related changes in hepatic and cerebral regional tissue oxygen saturation (rSO2). This study investigated IDH-induced changes in hepatic and cerebral rSO2. Methods: Hepatic and cerebral rSO2 during HD were measured using an INVOS 5100C oxygen saturation monitor, and their percentage (%) changes during IDH development were analyzed. Ninety-one patients undergoing HD were investigated, including 20 with IDH development. Results: In patients with IDH, % changes in hepatic and cerebral rSO2 decreased at IDH onset. Additionally, the % change in hepatic rSO2 was significantly larger than those in cerebral rSO2 (P < 0.001). In patients without IDH, no significant differences were found between the % changes in hepatic and cerebral rSO2 at time of the lowest systolic blood pressure during HD. Multivariable linear regression analysis showed that the difference between the % change in cerebral and hepatic rSO2 was significantly associated with IDH development (P < 0.001) and ultrafiltration rate (P = 0.010). Conclusion: Hepatic and cerebral rSO2 significantly decreased in IDH development and hepatic rSO2 was more largely decreased than cerebral rSO2 at IDH onset.

Keywords

cerebral oxygenation; hepatic oxygenation; intradialytic hypotension; splanchnic circulation; ultrafiltration rate

Subject

Medicine and Pharmacology, Urology and Nephrology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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