Risk Factors of Bitker et al for Preload Dependent Hypotension in a Patient Undergoing Intermittent Hemodialysis in the Intensive Care Unit (ICU)

 

Patient selection: ICU patient undergoing intermittent hemodialysis

 

Hypotnesion was defined as the mean arterial pressure < 65 mm Hg.

 

Preload dependence was present if the systolic ejection volume increased >= 10% during passive leg raising.

 

Risk factors for preload dependent hypotension:

(1) pulmonary vascular permeability index >= 1.6 at start of session

(2) mechanical ventilation

 

A patient at risk for preload dependent hypotension may benefit from:

(1) longer session duration

(2) reduction in planned fluid removal

 

Most episodes of hypotension during hemodialysis are not preload dependent and so a reduction in planned fluid removal is not necessary.