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Printable Handouts
Navigable Slide Index
- Introduction
- Talk outline
- Oxygen saturation
- Measurement methods
- Determinants of oxygen saturation
- Hypoxemia in hemodialysis (HD) patients
- Pulmonary function in end-stage renal disease
- Nocturnal systolic blood pressure (SBP)
- Lower SaO2 & higher left ventricle wall thickness
- Nocturnal hypoxemia / cardiovascular events (1)
- Nocturnal hypoxemia / cardiovascular events (2)
- What do we know about intradialytic hypoxemia?
- Effect of dialysate and membranes on oxygen
- What causes intradialytic hypoxemia?
- Intrapulmonary leukostasis
- 2,3 DPG and rapid correction of acidosis
- Decreased respiratory drive
- Intradialytic hypoxemia and hypotension
- SaO2 variability predicts intradialytic hypotension
- Summary #1
- Crit-LineTM monitor
- Arterial oxygen saturation patient population
- Mean SaO2 time course
- Patient characteristics - PIH & non-PIH groups
- Increased mortality due to prolonged hypoxemia
- Mean SaO2 <92% and increased mortality
- Time spent with SaO2 <90% and mortality
- Summary #2
- Intradialytic central venous oxygen saturation
- Vascular access at time of HD initiation
- Catheters & monitoring intradialytic ScvO2
- ScvO2 and mortality in non-uremic populations
- Limited prior ScvO2 studies in HD patients (1)
- Limited prior ScvO2 studies in HD patients (2)
- ScvO2 patient population
- Distribution of mean intradialytic ScvO2
- Mean ScvO2 time course
- Risk of death by mean ScvO2 levels
- Summary #3
- Improving intradialytic hypoxemia
- Low bicarbonate dialysis
- Oxygen therapy
- Future directions
- Conclusions
- Acknowledgements
Topics Covered
- Oxygen saturation in hemodialysis (HD) patients
- Interdialytic and intradialytic hypoxemia in HD patients
- Central venous oxygen saturation in HD patients
- Treatment for abnormal oxygen saturation levels
Links
Series:
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Therapeutic Areas:
Talk Citation
Chan, L. (2019, February 3). Intradialytic oxygen saturation [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 6, 2024, from https://doi.org/10.69645/WMKA4034.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Lili Chan has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Other Talks in the Series: The Kidney in Health and Disease
Transcript
Please wait while the transcript is being prepared...
0:00
Hello everyone, my name is Lili Chan and
I'm currently faculty at the Icahn School
of Medicine at Mount Sinai.
I'm glad you have chosen to learn more
about oxygen saturation in hemodialysis
patients.
I think it is interesting that while
we routinely measure blood pressure and
heart rate during hemodialysis, we neglect
the other vital sign of oxygen saturation.
That leads us to our topic of
intradialytic oxygen supplementation,
what does it mean and
should we care about it?
0:28
The outline of today's talk will be to
first review what oxygen saturation is and
what we currently know about
hypoxemia in hemodialysis patients,
then we will discuss specifically
intradialytic hypoxemia.
Next we will review what we know about
intradialytic central venous oxygen
saturation, and we will finish with
a discussion on what has been done and
what we can do for
abnormal oxygen saturation levels.
Let's start with what
oxygen saturation is and
what we know about hypoxemia
in hemodialysis patients.
0:59
Oxygen saturation is the fraction of
hemoglobin with oxygen bound to it over
the total hemoglobin in blood.
As displayed in the graph,
normal oxygen saturation levels
are more than 93% in humans.
1:13
There are many different ways that
oxygen saturation can be measured,
displayed here are two of
the most common methods.
On the left is a person obtaining
an arterial blood sample where oxygen
saturation levels can
be directly measured.
On the right is a commercially available
pulse oximeter which measures oxygen
saturation indirectly.
Pulse oximeters measure oxygen saturation
by detecting the differences in absorption
of red and infrared lights between
oxygenated and deoxygenated hemoglobin.