The effect on blood pressure and mood/sensation changes caused by fostering venous return during dialysis

In maintenance hemodialysis treatment, dialysis hypotension, whereby the blood pressure suddenly drops during treatment, is a common complication at the actual treatment sites. The aim of this paper is a study on how fostering crus venous return during dialysis has an impact on blood pressure and mood/feeling changes. The subjects were 19 patients (10 males and 9 females) undergoing maintenance hemodialysis. We used crus pneumatic compression to foster venous return. Four experimental conditions were set and a comparison was done between the control condition and each of the conditions using crus pneumatic compression. The experimental conditions were as follows: condition 1 was the control condition, condition 2 used crus pneumatic compression set for 40mmHg and a 30second interval, and condition 3 used crus pneumatic compression that automatically adjusts to the venous return speed of the patient. The measurement items were blood pressure rate of change, circulator blood volume rate of change (ΔBV), sensation change (crus thermal sensing and feeling of lightness), and a mood evaluation scale (POMS). The result of our study is that only the control condition showed a significant decrease in blood pressure rate of change, during the latter half of dialysis, and the conditions fostering venous return did not show such a decrease. ΔBV also showed a slope matching that of blood pressure change but condition 3 showed a slope similar to condition 1. There was a significant improvement in the visual analogue scale values (VAS values) for thermal sensing and feeling of lightness in conditions 2 and 3 when comparing the values for before dialysis, after dialysis, and after returning home. In POMS, condition 2 showed significantly lower values compared to condition 1 in the scales of [depression-dejection (D)] and [Anger-Hostility (A-H)]. By implementing this method, it seems that a reduction in dialysis hypotension pathogenesis and comfortable mood/sensation changes can be attained.