Abstract
As a method of managing blood pressure during hemodialysis (HD), we developed a pressure monitoring catheter which made it possible to preform continuous direct measurement of pressure within a shunt and a conducted preliminary study to determine whether or not this new catheter could be appled to the establisment of a new monitoring system of arterial blood pressure during HD.
The catheter was composed of two parts, i.e., a 12G double lumen catheter (Biocathera) for dialysis, modified by changing the connection site between the dialysis circuit and the pressure monitoring circuit to a Luer type, and a 21G elaster needle for pressure monitoring. The pressure monitoring catheter was protected by a catheter guard so that the pressure measuring point could be operated freely without contamination.
We found that pressures measured at the sites within the peripheral 1cm of the arterio-venous anastomosis were barely affected by the blood flow rate and were very similar to the blood pressure measured on the contralateral arm by the cuff method. However, pressures obtained from peripheral sites more than 2cm from the arterio-venous anastomosis fell with increasing distance.
The results of study suggest that the pressure inside the shunt obtained at sites within 1cm penipheral from the arterio-venous anastomosis most probably reflects the arterial pressure, and that a rapid decrease in blood pressure is recognizable in real time.
Complications arising from the catheter, including unsatisfactory blood flow, were not obsarved. This study suggests that the catheter is useful in a clinical setting for long-term monitoring of blood pressure during HD.
