Abstract

SANCHEZ VILLAR, Isidro et al. Hypotension in unstable patients: predictive factors and preventive measures. Rev Soc Esp Enferm Nefrol [online]. 2005, vol.8, n.3, pp.17-21. ISSN 1139-1375.

Hypotension continues to be the most frequent complication occurring during haemodialysis. Of the 81 patients at risk in the chronic haemodialysis programme in the Satellite Unite of the HUC (Hospital Universitario de Canarias) in 2003, 25% showed particular fragility with more than 30% hypotensive events. Accordingly, we have set as our objectives the definition of the traits shown by labile patients, hypotension predictive events, and the proven preventive measures possible. A prospective, interventionist, randomised and controlled study was designed. Hypotension preventive intervention protocols were applied based on maximum hourly ultrafiltration (UF) control, axillar temperature of 36º, and different UF and conductivity profiles. Age, together with the associated comorbility, and sex were predictors. In fact, 79% of the unstable patients included in the hypotension protocol were over 75 years of age, and 81.9 % were women. All the protocols reduced the incidence of hypotension, but a spectacularly reduction down to 17.2%, when the basal period had a result of 41.1%, was found in the period in which the protocol with lineal profiles was used. We think that Nursing staff can apply simple, proven measures that can significantly improve comfort during haemodialysis sessions in the more unstable patients.

Keywords : Haemodialysis; Hypotension; Conductivity; Ultrafiltration.

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