Blood volume monitoring tied to shorter hospital stays, fewer readmissions for some adults
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Key takeaways:
- Blood volume monitoring-guided hemodialysis decreased hospital stay by 2 days.
- Patients treated with the therapy had significantly fewer readmissions.
SAN DIEGO — Blood volume monitoring may lead to shorter hospital stays and fewer readmissions for adults with end-stage kidney disease and heart failure, data show.
Patients at Massachusetts General Hospital in Boston typically “get dialysis via Crit-Line [IV Monitor, Fresenius] whenever they are admitted to the inpatient dialysis unit,” Christopher El Mouhayyar, MD, a nephology fellow the hospital, told Healio. “We rely on [data] like, ‘What is their blood pressure?’ ‘How is their heart rate doing?’ ‘How is their volume and everything?’ We wanted to see if the Crit-Line actually helps,” he said.
Mouhayyar and colleagues performed a multicenter cohort study from 2017 and 2020 with 278 hospitalized patients on hemodialysis with heart failure or heart failure exacerbation. Demographic, comorbidity and clinical data were gathered from electronic health records.
Mean age was 70 years, 58% were men and 62% were white adults. Average index hospitalization was 7 days. Overall, 168 patients were dialyzed with blood volume monitoring during hospitalization and 118 patients were dialyzed without it.
Blood volume monitoring-guided hemodialysis was associated with a decrease in hospital length of stay by an average 2 days (95% CI, -3.9 to -0.13), according to the study results.
Mouhayyar and colleagues found patients treated with blood volume monitoring had significantly fewer readmissions between 90 days and 180 days after discharge vs. patients not on the treatment, with adjusted beta coefficients of 0.27 (95% CI, -0.48 to -0.06) and 0.47 (95% CI, -0.48 to -0.06), respectively.
Blood volume monitoring was not used at two included hospitals during 2015 and 2017 for 100 patients, according to the researchers, who found no differences in clinical endpoints.
Overall, the “Crit-Line [IV Monitor] is a useful measure for patients with heart failure,” Mouhayyar said. “Do not rely only on physical exams because it [may] miss [important data].”
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Mouhayyar CE, et al. TH-PO318. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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