Temperature control by the blood temperature monitor.

Abstract:

:The rationale of temperature control during hemodialysis (HD) is to prevent heat accumulation, which increases body temperature and enhances hypotensive susceptibility. Treatments where thermal energy is neither delivered nor removed from the patient through the extracorporeal circulation (so-called extracorporeal thermoneutral treatments) lead to a marked increase in body temperature and to considerable heat accumulation during HD. Since this accumulation of heat cannot be explained by increased heat production, it must be related to reduced heat dissipation through the body surface. Peripheral vasoconstriction, and cutaneous vasoconstriction in particular, compensating for the ultrafiltration-induced decrease in blood volume is considered an important component in this setting. Therefore, to maintain temperature homeostasis, thermal energy has to be cleared from the patient by the extracorporeal system because cutaneous clearance of thermal energy is compromised intradialytically. The focus on dialysate temperature alone does not properly address the problem of controlled extracorporeal heat removal because dialysate temperature is only one of the variables involved in that process. These difficulties can be addressed by changing from the control of dialysate temperature to control of body temperature. Control of body temperature and temperature homeostasis is achievable by the physiologic feedback control system realized in the temperature control mode (T-mode) of the blood temperature monitor (BTM). The delivery of isothermic dialysis, that is, dialysis where body temperature is controlled to remain constant during the treatment, has impressively improved hemodynamic stability in hypotension prone patients.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Schneditz D,Ronco C,Levin N

doi

10.1046/j.1525-139x.2003.16103.x

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

477-82

issue

6

eissn

0894-0959

issn

1525-139X

pii

16103

journal_volume

16

pub_type

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