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Continuous monitoring of changes in cerebral oxygenation during hemodialysis in a patient with acute congestive heart failure

  • Case Report
  • Artificial Kidney / Dialysis
  • Published:
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Abstract

A 71-year-old man undergoing hemodialysis (HD) was admitted to our hospital with congestive heart failure (CHF) and pneumonia. After admission, ultrafiltration with HD was urgently performed because of a lack of respiratory improvement despite the use of noninvasive positive pressure ventilation. During HD, cerebral regional saturation of oxygen (rSO2) was monitored by INVOS 5100c oxygen saturation monitor (Covidien Japan, Japan) to evaluate changes in tissue oxygenation. At HD initiation, cerebral rSO2 was very low at 34% under the fraction of inspiratory oxygen (FiO2) of 0.4. Ultrafiltration was performed at the rate of 0.5 L/h thereafter, cerebral rSO2 gradually improved even as inhaling oxygen concentration decreased. At the end of HD, cerebral rSO2 improved at 40% under a FiO2 of 0.28 as excess body fluid was removed. After pneumonia and CHF improved, he was discharged. Reports of the association between cerebral oxygenation and acute CHF status in patients undergoing HD are limited; therefore, in our experience with this case, cerebral oxygenation deteriorated with the CHF status but was improved by adequate body-fluid management during HD.

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Acknowledgements

We thank the patient and the clinical dialysis center staff in our hospital. This work was supported by a grant from the Japanese Association of Dialysis Physicians (JADP Grant 2017-9) and a grant from The Kidney Foundation, Japan (JKFB 17-4) to S.O.

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Authors and Affiliations

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

    Saori Minato, Susumu Ookawara, Kiyonori Ito, Mitsutoshi Shindo, Haruhisa Miyazawa, Hirofumi Shimoyama & Yoshiyuki Morishita

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

    Hideyuki Hayasaka, Masaya Kofuji & Takayuki Uchida

  3. Yuai Nisshin Clinic, Hakuyukai Medical Corporation, Saitama, Japan

    Hirofumi Shimoyama

  4. Division of Nephrology, Saitama Red Cross Hospital, Saitama, Japan

    Taro Hoshino

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  1. Saori Minato
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  2. Susumu Ookawara
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  3. Kiyonori Ito
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  4. Hideyuki Hayasaka
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  5. Masaya Kofuji
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  6. Takayuki Uchida
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  7. Mitsutoshi Shindo
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  8. Haruhisa Miyazawa
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  9. Hirofumi Shimoyama
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  10. Taro Hoshino
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  11. Yoshiyuki Morishita
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Correspondence to Kiyonori Ito.

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Minato, S., Ookawara, S., Ito, K. et al. Continuous monitoring of changes in cerebral oxygenation during hemodialysis in a patient with acute congestive heart failure. J Artif Organs 23, 292–295 (2020). https://doi.org/10.1007/s10047-019-01150-2

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  • DOI: https://doi.org/10.1007/s10047-019-01150-2

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