Assessment of Pulmonary Capillary Wedge Pressure Using Pulse Wave Doppler in Hemodialysis Patient- Prospective Observational Study

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Abishkauf jenish beautlin, Divyalakshmi, Roshan Vaasan, Uma maheswari, and Ashok Govindaraj, “Assessment of Pulmonary Capillary Wedge Pressure Using Pulse Wave Doppler in Hemodialysis Patient- Prospective Observational Study”, ijmhs, vol. 13, no. 05, pp. 2077–2080, May 2023.
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Abstract

Background: We aimed to identify the clinical utility of a simple echocardiography approach for estimating the pulmonary capillary wedge pressure (PCWP) on the basis of pulse wave doppler in pre and post hemodialysis patient.

Method: A prospective observational study was done in 50 patient’s attending their Hemodialysis session at Chettinad Hospital with the age limit <70 years. From the total subjects 30 were males and 20 were females. In this present study we analyzed the pre and post dialysis volume changes using Estimated PCWP and correlate it with other volume markers. To determine that estimated PCWP might be one of the diagnostic accuracy to detect volume load in the patient undergoing Hemodialysis.

Result: In this study, it was found that patients who had very low Estimated PCWPs (PCWP-less than 4mmHg) after a dialysis session started to experience wooziness, cramping, etc. The patient's hemodynamic state in the post-dialysis period is significantly impacted by intra-dialytic weight gain. The changes in Pulmonary Capillary wedge pressure in Post Dialysis session is well correlated with the other volumetric markers like Systemic blood pressure, LA Diameter, Creatinine and BUN levels.

Conclusion: Echocardiography plays an important role in day-to-day clinical diagnosis. In this study, patients with chronic kidney disease underwent haemodialysis. In Post dialysis period the intra dialytic weight gain play a major impact on the patient hemodynamic status. To overcome this various volume markers were used. At this point, the estimated pulmonary capillary wedge pressure can be used as one of the most specific volume load markers in patients undergoing Hemodialysis and it is well correlated with other volume markers too.

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