MO771: Haemodialysis Access Flow Measurement: Comparison of Ultrasound Dilution and Ultrafiltration Method on Nikisso DBB-EXA™ Dialysis Machine. (3rd May 2022) - Kosmadakis, Georgios
Abstract: BACKGROUND AND AIMS: The regular measurement of the haemodialysis vascular access (VA) flow demonstrates a protective effect over thrombotic complications [1 ]. Transonic ® Ultrasound dilution technique was first introduced in 1995 and progressively became a method of reference for recirculation and blood flow measurement on haemodialysis VA [2 ]. It is based on the technique of haemodilution with a certain volume of 0.9% NaCl and the measure of recirculation with inversed lines using the ultrasound technique. Consecutively the VA flow is estimated with a certain formula. Nikisso DBB-EXA™ dialysis machine has the capacity to measure the VA recirculation rate by photometry performing a controlled rise on ultrafiltration rate. The aim of the present study is to compare the VA flow rate between the Transonic ® Ultrasound dilution technique and the Nikisso DBB-EXA™ Ultrafiltration method. METHOD: The primary outcome of the study is the association of VA flow measured by Transonic ® and the Nikisso DBB-EXA™. During the first half of the same dialysis session, we measured the VA recirculation and flow rate twice with the two methods under a constant dialysis blood pump flow of 250–300 mL/min with the ultrafiltration and haemodiafiltration interrupted during the procedure after having reversed the dialysis lines. RESULTS: The values are represented as mean ± SD. A total of 18 chronic haemodialysis patients (13 male: 5 female, mean age: 70 ± 14 years) participated in the study. They were haemodynamically stable without acute clinical conditions and were dialysed with a well-functioning arteriovenous fistula for at least 6 months. The mean value of recirculation with inverted dialysis lines for the Transonic ® method was 20.79 ± 7.58% and for the Nikisso DBB-EXA™ was 24.43 ± 7.77. The mean values of VA blood flow with the Transonic ® method were 1229 ± 588 mL/min and for the Nikisso DBB-EXA™ 1096 ± 490 mL/min. The measured values of the two methods presented a significant positive correlation (by Pearson) ( R = 0.920, P < 0.001) (Figure). CONCLUSION: There is a significantly positive correlation concerning the VA flow measurement between the reference method of Transonic ® and the Ultrafiltration method offered by the Nikisso DBB-EXA™. Larger studies are needed to confirm this correlation with an additional comparative analysis of the reproducibility of measurements.