Real-time Noninvasive Monitoring of Intracranial Fluid Shifts During Dialysis Using Volumetric Integral Phase-Shift Spectroscopy (VIPS): A Proof-of-Concept Study
Background Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique call...
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| Veröffentlicht in: | Neurocritical care Jg. 28; H. 1; S. 117 - 126 |
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| Sprache: | Englisch |
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New York
Springer US
01.02.2018
Springer Nature B.V |
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| ISSN: | 1541-6933, 1556-0961, 1556-0961 |
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| Abstract | Background
Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called “Volumetric Integral Phase-shift Spectroscopy (VIPS)” for detecting intracranial fluid shifts during hemodialysis.
Methods
Subjects receiving scheduled hemodialysis for end-stage renal disease and without a history of major neurological conditions were enrolled. VIPS monitoring was performed during hemodialysis. Serum osmolarity, electrolytes, and cognitive function with mini-mental state examination (MMSE) were assessed.
Results
Twenty-one monitoring sessions from 14 subjects (4 women), mean group age 50 (SD 12.6), were analyzed. The serum osmolarity decreased by a mean of 6.4 mOsm/L (SD 6.6) from pre- to post-dialysis and correlated with an increase in the VIPS edema index (E-Dex) of 9.7% (SD 12.9) (Pearson’s correlation
r
= 0.46,
p
= 0.037). Of the individual determinants of serum osmolarity, changes in serum sodium level correlated best with the VIPS edema index (Pearson’s correlation,
r
= 0.46,
p
= 0.034). MMSE scores did not change from pre- to post-dialysis.
Conclusions
We detected an increase in the VIPS edema index during hemodialysis that correlated with decreased serum osmolarity, mainly reflected by changes in serum sodium suggesting shifts in intracranial fluids. |
|---|---|
| AbstractList | BackgroundCerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called “Volumetric Integral Phase-shift Spectroscopy (VIPS)” for detecting intracranial fluid shifts during hemodialysis.MethodsSubjects receiving scheduled hemodialysis for end-stage renal disease and without a history of major neurological conditions were enrolled. VIPS monitoring was performed during hemodialysis. Serum osmolarity, electrolytes, and cognitive function with mini-mental state examination (MMSE) were assessed.ResultsTwenty-one monitoring sessions from 14 subjects (4 women), mean group age 50 (SD 12.6), were analyzed. The serum osmolarity decreased by a mean of 6.4 mOsm/L (SD 6.6) from pre- to post-dialysis and correlated with an increase in the VIPS edema index (E-Dex) of 9.7% (SD 12.9) (Pearson’s correlation r = 0.46, p = 0.037). Of the individual determinants of serum osmolarity, changes in serum sodium level correlated best with the VIPS edema index (Pearson’s correlation, r = 0.46, p = 0.034). MMSE scores did not change from pre- to post-dialysis.ConclusionsWe detected an increase in the VIPS edema index during hemodialysis that correlated with decreased serum osmolarity, mainly reflected by changes in serum sodium suggesting shifts in intracranial fluids. Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called "Volumetric Integral Phase-shift Spectroscopy (VIPS)" for detecting intracranial fluid shifts during hemodialysis.BACKGROUNDCerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called "Volumetric Integral Phase-shift Spectroscopy (VIPS)" for detecting intracranial fluid shifts during hemodialysis.Subjects receiving scheduled hemodialysis for end-stage renal disease and without a history of major neurological conditions were enrolled. VIPS monitoring was performed during hemodialysis. Serum osmolarity, electrolytes, and cognitive function with mini-mental state examination (MMSE) were assessed.METHODSSubjects receiving scheduled hemodialysis for end-stage renal disease and without a history of major neurological conditions were enrolled. VIPS monitoring was performed during hemodialysis. Serum osmolarity, electrolytes, and cognitive function with mini-mental state examination (MMSE) were assessed.Twenty-one monitoring sessions from 14 subjects (4 women), mean group age 50 (SD 12.6), were analyzed. The serum osmolarity decreased by a mean of 6.4 mOsm/L (SD 6.6) from pre- to post-dialysis and correlated with an increase in the VIPS edema index (E-Dex) of 9.7% (SD 12.9) (Pearson's correlation r = 0.46, p = 0.037). Of the individual determinants of serum osmolarity, changes in serum sodium level correlated best with the VIPS edema index (Pearson's correlation, r = 0.46, p = 0.034). MMSE scores did not change from pre- to post-dialysis.RESULTSTwenty-one monitoring sessions from 14 subjects (4 women), mean group age 50 (SD 12.6), were analyzed. The serum osmolarity decreased by a mean of 6.4 mOsm/L (SD 6.6) from pre- to post-dialysis and correlated with an increase in the VIPS edema index (E-Dex) of 9.7% (SD 12.9) (Pearson's correlation r = 0.46, p = 0.037). Of the individual determinants of serum osmolarity, changes in serum sodium level correlated best with the VIPS edema index (Pearson's correlation, r = 0.46, p = 0.034). MMSE scores did not change from pre- to post-dialysis.We detected an increase in the VIPS edema index during hemodialysis that correlated with decreased serum osmolarity, mainly reflected by changes in serum sodium suggesting shifts in intracranial fluids.CONCLUSIONSWe detected an increase in the VIPS edema index during hemodialysis that correlated with decreased serum osmolarity, mainly reflected by changes in serum sodium suggesting shifts in intracranial fluids. Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called "Volumetric Integral Phase-shift Spectroscopy (VIPS)" for detecting intracranial fluid shifts during hemodialysis. Subjects receiving scheduled hemodialysis for end-stage renal disease and without a history of major neurological conditions were enrolled. VIPS monitoring was performed during hemodialysis. Serum osmolarity, electrolytes, and cognitive function with mini-mental state examination (MMSE) were assessed. Twenty-one monitoring sessions from 14 subjects (4 women), mean group age 50 (SD 12.6), were analyzed. The serum osmolarity decreased by a mean of 6.4 mOsm/L (SD 6.6) from pre- to post-dialysis and correlated with an increase in the VIPS edema index (E-Dex) of 9.7% (SD 12.9) (Pearson's correlation r = 0.46, p = 0.037). Of the individual determinants of serum osmolarity, changes in serum sodium level correlated best with the VIPS edema index (Pearson's correlation, r = 0.46, p = 0.034). MMSE scores did not change from pre- to post-dialysis. We detected an increase in the VIPS edema index during hemodialysis that correlated with decreased serum osmolarity, mainly reflected by changes in serum sodium suggesting shifts in intracranial fluids. Background Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called “Volumetric Integral Phase-shift Spectroscopy (VIPS)” for detecting intracranial fluid shifts during hemodialysis. Methods Subjects receiving scheduled hemodialysis for end-stage renal disease and without a history of major neurological conditions were enrolled. VIPS monitoring was performed during hemodialysis. Serum osmolarity, electrolytes, and cognitive function with mini-mental state examination (MMSE) were assessed. Results Twenty-one monitoring sessions from 14 subjects (4 women), mean group age 50 (SD 12.6), were analyzed. The serum osmolarity decreased by a mean of 6.4 mOsm/L (SD 6.6) from pre- to post-dialysis and correlated with an increase in the VIPS edema index (E-Dex) of 9.7% (SD 12.9) (Pearson’s correlation r = 0.46, p = 0.037). Of the individual determinants of serum osmolarity, changes in serum sodium level correlated best with the VIPS edema index (Pearson’s correlation, r = 0.46, p = 0.034). MMSE scores did not change from pre- to post-dialysis. Conclusions We detected an increase in the VIPS edema index during hemodialysis that correlated with decreased serum osmolarity, mainly reflected by changes in serum sodium suggesting shifts in intracranial fluids. |
| Author | Maldonado, Nelson Damani, Rahul Mandayam, Sreedhar Venkatasubba Rao, Chethan P. Bershad, Eric M. Calvillo, Eusebia Suarez, Jose I. |
| Author_xml | – sequence: 1 givenname: Chethan P. surname: Venkatasubba Rao fullname: Venkatasubba Rao, Chethan P. email: cprao@bcm.edu organization: Department of Neurology, Section of Vascular Neurology and Neurocritical Care, Baylor College of Medicine – sequence: 2 givenname: Eric M. surname: Bershad fullname: Bershad, Eric M. organization: Department of Neurology, Section of Vascular Neurology and Neurocritical Care, Baylor College of Medicine – sequence: 3 givenname: Eusebia surname: Calvillo fullname: Calvillo, Eusebia organization: Department of Neurology, Section of Vascular Neurology and Neurocritical Care, Baylor College of Medicine – sequence: 4 givenname: Nelson surname: Maldonado fullname: Maldonado, Nelson organization: Department of Neurology, Section of Vascular Neurology and Neurocritical Care, Baylor College of Medicine – sequence: 5 givenname: Rahul surname: Damani fullname: Damani, Rahul organization: Department of Neurology, Section of Vascular Neurology and Neurocritical Care, Baylor College of Medicine – sequence: 6 givenname: Sreedhar surname: Mandayam fullname: Mandayam, Sreedhar organization: Department of Nephrology, Baylor College of Medicine – sequence: 7 givenname: Jose I. surname: Suarez fullname: Suarez, Jose I. organization: Department of Neurology, Section of Vascular Neurology and Neurocritical Care, Baylor College of Medicine |
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| CitedBy_id | crossref_primary_10_1002_bem_22230 crossref_primary_10_7717_peerj_10416 crossref_primary_10_7717_peerj_12877 crossref_primary_10_1007_s11255_022_03389_w crossref_primary_10_1038_s41581_025_00960_3 crossref_primary_10_1109_TBME_2018_2872851 crossref_primary_10_1186_s12883_021_02049_3 crossref_primary_10_7717_peerj_10079 crossref_primary_10_1007_s11154_019_09483_2 crossref_primary_10_1097_MAT_0000000000001100 |
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| Keywords | ESRD Noninvasive monitoring Cerebral edema VIPS Intracranial fluid shifts Dialysis dysequillibrium |
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Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is... Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no... BackgroundCerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is... |
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| SubjectTerms | Critical Care Medicine Cytotoxicity Edema Hemodialysis Hemorrhage Hypertension Intensive Internal Medicine Ischemia Medicine Medicine & Public Health Monitoring systems Neurology Original Article Patients Spectrum analysis Stroke Traumatic brain injury Vital signs |
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| Title | Real-time Noninvasive Monitoring of Intracranial Fluid Shifts During Dialysis Using Volumetric Integral Phase-Shift Spectroscopy (VIPS): A Proof-of-Concept Study |
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