A Thermal Energy Balance Model for Hypotension Prevention in Hemodialysis.

In the present paper, the authors propose a thermal energy balance model in order to prevent accidents in hemodialysis. Hemodialysis is the most common treatment for renal failure. It performs an extracorporeal blood wastes filtration taking the place of the malfunctioning kidney. Nevertheless this replacement therapy is cause of several side effects affecting the hemodynamic stability of patient. The authors focus attention on the hypotension accident. Thermal energy/heat exchanges between extracorporeal system and body might be cause of hypotension occurrence. Nevertheless, today poor importance is given to such aspects. A careful analysis of these issues has allowed authors to define a model for optimizing treatment procedures nowadays used in medical practice. In fact, most of the hemodialysis machines control automatically the dialysate solution temperature starting from peripheral body temperature measurements. Differently, the proposed approach is based on two control parameters: the predialysis patient core temperature and heat exchanges. Non-invasive temperature measurements of arterial and venous blood are obtained by estimating the thermal energy exchange. The aim of the present model is to guarantee a constant patient core temperature preventing intradialytic hypotension.