الفهرس | Only 14 pages are availabe for public view |
Abstract Intradialytic hypotension continues to be a leading problem, especially in the elderly and cardiovascular compromised patients. Intradialytic hypotension does not only cause discomfort, but also increases mortality, according to recent data in which a low post dialytic blood pressure was associated with a significantly increased risk for mortality . The present study was prospective cross over study conducted upon 40 ESRD patient on regular hemodialysis session 3 times per week 4 hour each session on dialysate bicarbonate on Fresenius 4008 machine in AL-Agoza hospital . .Patients were divided into two groups ( A and B) every group consists of 20 patients . Group A: subjected to Two weeks ( six sessions) of hemodialysis with lowering the dialysate temperature to 35° c with measurement of BP every hour during session . Two weeks with midodrine supplementation of 5 mg 30 minutes before each session with measurement of BP every hour during session . Group B: subjected at the same time to Two weeks with midodrine supplementation of 5 mg 30 minutes before each session with measurement of BP every hour during session Two weeks ( six sessions) of hemodialysis with lowering the dialysate temperature to 35° c with measurement of BP every hour during session . Mean blood pressure of each group was calculated before and after each trial , average mean blood pressure was calculated during the trial as well . We found the following After administration of midodrine as an alpha adrenergic agonist mean arterial blood pressure (MAP) in patients with intra dialytic hypotension in our research elevated which reveals that midodrine improves MAP markedly in intra dialytic hypotension. After applying low dialysate temperature mean arterial blood pressure in patients with intra dialytic hypotension in our research elevated which reveals that lowering dialysate temperature improves MAP in intra dialytic hypotension. Although both midodrine administration and low dialysate temperature are effective in improving and preserving arterial blood pressure in patients with intra dialytic hypotention . but midodrine is mildly more effective in improving and preserving arterial blood pressure in patients with intra dialytic hypotention but without statistical significant difference |