Resting energy expenditure and thermal balance during isothermic and thermoneutral haemodialysis—heat production does not explain increased body temperature during haemodialysis
Background. During routine haemodialysis (HD) body temperature increases, which contributes to haemodynamic instability. The relative roles of increased heat production and/or incomplete heat transfer are not fully elucidated. Concomitant measurement of heat production and heat transfer may help to...
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| creator | Horáček, Jiří Sulková, Sylvie Dusilová Fořtová, Magdalena Lopot, František Kalousová, Marta Sobotka, Luboš Chaloupka, Jiří Tesař, Vladimír Žák, Aleš Zima, Tomáš |
| description | Background. During routine haemodialysis (HD) body temperature increases, which contributes to haemodynamic instability. The relative roles of increased heat production and/or incomplete heat transfer are not fully elucidated. Concomitant measurement of heat production and heat transfer may help to assess the factors determining thermal balance during HD. Methods. Thirteen stable non-diabetic maintenance HD patients were investigated during two HD procedures (isothermic, dT = 0, no change of body temperature; thermoneutral, dE = 0, no energy transfer between blood and dialysate), using a blood temperature monitor (BTM) in active mode. Energy transfer, blood and dialysate temperature, and relative blood volume change (dBV) were continuously recorded, and resting energy expenditure (REE; Deltatrac Datex) was measured repeatedly during each procedure. Fourteen healthy persons served as controls for REE comparison. Results. In isothermic HD, median energy removal was 218 kJ/4 h HD (= heat flow −15.1 W). This cooling correlated with dBV induced by ultrafiltration (ρ = 0.731, P < 0.01). There was no difference in dBV between isothermic (7.7%) and thermoneutral (8.1%) HD. Predialysis REE was 82.8 W/1.73 m2, not different from controls. No variation in REE during HD was observed, except a small and transient increase after a light meal (5 and 4%). In the time course of REE, no difference between the procedures was found. Conclusions. Our findings suggest that stable maintenance HD patients have REE not different from healthy controls, that HD procedure per se does not significantly increase REE and that neither isothermic nor thermoneutral regimen has any influence on metabolic rate. Therefore, body temperature elevation during routine HD may rather be due to decreased heat removal. With the use of BTM in active mode, body temperature can be kept stable (isothermic HD), which requires active cooling. This negative energy transfer is proportional to decrease in blood volume induced by ultrafiltration. |
| doi_str_mv | 10.1093/ndt/gfm436 |
| format | Article |
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During routine haemodialysis (HD) body temperature increases, which contributes to haemodynamic instability. The relative roles of increased heat production and/or incomplete heat transfer are not fully elucidated. Concomitant measurement of heat production and heat transfer may help to assess the factors determining thermal balance during HD. Methods. Thirteen stable non-diabetic maintenance HD patients were investigated during two HD procedures (isothermic, dT = 0, no change of body temperature; thermoneutral, dE = 0, no energy transfer between blood and dialysate), using a blood temperature monitor (BTM) in active mode. Energy transfer, blood and dialysate temperature, and relative blood volume change (dBV) were continuously recorded, and resting energy expenditure (REE; Deltatrac Datex) was measured repeatedly during each procedure. Fourteen healthy persons served as controls for REE comparison. Results. In isothermic HD, median energy removal was 218 kJ/4 h HD (= heat flow −15.1 W). This cooling correlated with dBV induced by ultrafiltration (ρ = 0.731, P < 0.01). There was no difference in dBV between isothermic (7.7%) and thermoneutral (8.1%) HD. Predialysis REE was 82.8 W/1.73 m2, not different from controls. No variation in REE during HD was observed, except a small and transient increase after a light meal (5 and 4%). In the time course of REE, no difference between the procedures was found. Conclusions. Our findings suggest that stable maintenance HD patients have REE not different from healthy controls, that HD procedure per se does not significantly increase REE and that neither isothermic nor thermoneutral regimen has any influence on metabolic rate. Therefore, body temperature elevation during routine HD may rather be due to decreased heat removal. With the use of BTM in active mode, body temperature can be kept stable (isothermic HD), which requires active cooling. This negative energy transfer is proportional to decrease in blood volume induced by ultrafiltration.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfm436</identifier><identifier>PMID: 17717032</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Basal Metabolism ; Biological and medical sciences ; blood temperature monitor ; Body Temperature - physiology ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Humans ; Intensive care medicine ; isothermic haemodialysis ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Renal Dialysis - methods ; Renal failure ; resting energy expenditure ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; thermal balance ; thermoneutral haemodialysis ; ultrafiltration</subject><ispartof>Nephrology, dialysis, transplantation, 2007-12, Vol.22 (12), p.3553-3560</ispartof><rights>The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org 2007</rights><rights>2008 INIST-CNRS</rights><rights>The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-d2c3fcb10b1786bbf71526fa7f5d5c3e77f5f9e2b31d64e7e20839afeaea29483</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19961275$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17717032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horáček, Jiří</creatorcontrib><creatorcontrib>Sulková, Sylvie Dusilová</creatorcontrib><creatorcontrib>Fořtová, Magdalena</creatorcontrib><creatorcontrib>Lopot, František</creatorcontrib><creatorcontrib>Kalousová, Marta</creatorcontrib><creatorcontrib>Sobotka, Luboš</creatorcontrib><creatorcontrib>Chaloupka, Jiří</creatorcontrib><creatorcontrib>Tesař, Vladimír</creatorcontrib><creatorcontrib>Žák, Aleš</creatorcontrib><creatorcontrib>Zima, Tomáš</creatorcontrib><title>Resting energy expenditure and thermal balance during isothermic and thermoneutral haemodialysis—heat production does not explain increased body temperature during haemodialysis</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>Background. During routine haemodialysis (HD) body temperature increases, which contributes to haemodynamic instability. The relative roles of increased heat production and/or incomplete heat transfer are not fully elucidated. Concomitant measurement of heat production and heat transfer may help to assess the factors determining thermal balance during HD. Methods. Thirteen stable non-diabetic maintenance HD patients were investigated during two HD procedures (isothermic, dT = 0, no change of body temperature; thermoneutral, dE = 0, no energy transfer between blood and dialysate), using a blood temperature monitor (BTM) in active mode. Energy transfer, blood and dialysate temperature, and relative blood volume change (dBV) were continuously recorded, and resting energy expenditure (REE; Deltatrac Datex) was measured repeatedly during each procedure. Fourteen healthy persons served as controls for REE comparison. Results. In isothermic HD, median energy removal was 218 kJ/4 h HD (= heat flow −15.1 W). This cooling correlated with dBV induced by ultrafiltration (ρ = 0.731, P < 0.01). There was no difference in dBV between isothermic (7.7%) and thermoneutral (8.1%) HD. Predialysis REE was 82.8 W/1.73 m2, not different from controls. No variation in REE during HD was observed, except a small and transient increase after a light meal (5 and 4%). In the time course of REE, no difference between the procedures was found. Conclusions. Our findings suggest that stable maintenance HD patients have REE not different from healthy controls, that HD procedure per se does not significantly increase REE and that neither isothermic nor thermoneutral regimen has any influence on metabolic rate. Therefore, body temperature elevation during routine HD may rather be due to decreased heat removal. With the use of BTM in active mode, body temperature can be kept stable (isothermic HD), which requires active cooling. This negative energy transfer is proportional to decrease in blood volume induced by ultrafiltration.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Basal Metabolism</subject><subject>Biological and medical sciences</subject><subject>blood temperature monitor</subject><subject>Body Temperature - physiology</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>isothermic haemodialysis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Renal Dialysis - methods</subject><subject>Renal failure</subject><subject>resting energy expenditure</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>thermal balance</subject><subject>thermoneutral haemodialysis</subject><subject>ultrafiltration</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90c2KFDEQB_BGFHdcvfgAEgQ9CO3mozvpPsqis8KCIIqyl5BOqmeydie9SRp2bj6Eb-Ib-SRmdhoHPXhKoH5UFfUviqcEvya4ZWfOpLNNP1aM3ytWpOK4pKyp7xerXCQlrnF7UjyK8Rpj3FIhHhYnRAgiMKOr4udHiMm6DQIHYbNDcDuBMzbNAZByBqUthFENqFODchqQmcNe2-jvKlYflXcwp5DtVsHojVXDLtr46_uPLaiEpuDNrJP1DhkPETmf9sMGZR2yTgdQEQzqvNmhBOMEQd3tsMz7q-Xj4kGvhghPlve0-Pzu7afzi_Lyw_r9-ZvLUlcVT6WhmvW6I7gjouFd1wtSU94r0dem1gxE_vQt0I4RwysQQHHDWtWDAkXbqmGnxctD37z7zZzvJEcbNQz5EuDnKHlT1zifO8Pn_8BrPweXd5OUNIRjQffo1QHp4GMM0Msp2FGFnSRY7nOUOUd5yDHjZ0vHuRvBHOkSXAYvFqCiVkMfcjo2Hl3bckJFfXR-nv4_sDw4GxPc_pEqfJNcMFHLi69Xcn21_tIwvpYV-w1llsmz</recordid><startdate>20071201</startdate><enddate>20071201</enddate><creator>Horáček, Jiří</creator><creator>Sulková, Sylvie Dusilová</creator><creator>Fořtová, Magdalena</creator><creator>Lopot, František</creator><creator>Kalousová, Marta</creator><creator>Sobotka, Luboš</creator><creator>Chaloupka, Jiří</creator><creator>Tesař, Vladimír</creator><creator>Žák, Aleš</creator><creator>Zima, Tomáš</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20071201</creationdate><title>Resting energy expenditure and thermal balance during isothermic and thermoneutral haemodialysis—heat production does not explain increased body temperature during haemodialysis</title><author>Horáček, Jiří ; Sulková, Sylvie Dusilová ; Fořtová, Magdalena ; Lopot, František ; Kalousová, Marta ; Sobotka, Luboš ; Chaloupka, Jiří ; Tesař, Vladimír ; Žák, Aleš ; Zima, Tomáš</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-d2c3fcb10b1786bbf71526fa7f5d5c3e77f5f9e2b31d64e7e20839afeaea29483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Basal Metabolism</topic><topic>Biological and medical sciences</topic><topic>blood temperature monitor</topic><topic>Body Temperature - physiology</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>isothermic haemodialysis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Renal Dialysis - methods</topic><topic>Renal failure</topic><topic>resting energy expenditure</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>thermal balance</topic><topic>thermoneutral haemodialysis</topic><topic>ultrafiltration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horáček, Jiří</creatorcontrib><creatorcontrib>Sulková, Sylvie Dusilová</creatorcontrib><creatorcontrib>Fořtová, Magdalena</creatorcontrib><creatorcontrib>Lopot, František</creatorcontrib><creatorcontrib>Kalousová, Marta</creatorcontrib><creatorcontrib>Sobotka, Luboš</creatorcontrib><creatorcontrib>Chaloupka, Jiří</creatorcontrib><creatorcontrib>Tesař, Vladimír</creatorcontrib><creatorcontrib>Žák, Aleš</creatorcontrib><creatorcontrib>Zima, Tomáš</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horáček, Jiří</au><au>Sulková, Sylvie Dusilová</au><au>Fořtová, Magdalena</au><au>Lopot, František</au><au>Kalousová, Marta</au><au>Sobotka, Luboš</au><au>Chaloupka, Jiří</au><au>Tesař, Vladimír</au><au>Žák, Aleš</au><au>Zima, Tomáš</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Resting energy expenditure and thermal balance during isothermic and thermoneutral haemodialysis—heat production does not explain increased body temperature during haemodialysis</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2007-12-01</date><risdate>2007</risdate><volume>22</volume><issue>12</issue><spage>3553</spage><epage>3560</epage><pages>3553-3560</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background. During routine haemodialysis (HD) body temperature increases, which contributes to haemodynamic instability. The relative roles of increased heat production and/or incomplete heat transfer are not fully elucidated. Concomitant measurement of heat production and heat transfer may help to assess the factors determining thermal balance during HD. Methods. Thirteen stable non-diabetic maintenance HD patients were investigated during two HD procedures (isothermic, dT = 0, no change of body temperature; thermoneutral, dE = 0, no energy transfer between blood and dialysate), using a blood temperature monitor (BTM) in active mode. Energy transfer, blood and dialysate temperature, and relative blood volume change (dBV) were continuously recorded, and resting energy expenditure (REE; Deltatrac Datex) was measured repeatedly during each procedure. Fourteen healthy persons served as controls for REE comparison. Results. In isothermic HD, median energy removal was 218 kJ/4 h HD (= heat flow −15.1 W). This cooling correlated with dBV induced by ultrafiltration (ρ = 0.731, P < 0.01). There was no difference in dBV between isothermic (7.7%) and thermoneutral (8.1%) HD. Predialysis REE was 82.8 W/1.73 m2, not different from controls. No variation in REE during HD was observed, except a small and transient increase after a light meal (5 and 4%). In the time course of REE, no difference between the procedures was found. Conclusions. Our findings suggest that stable maintenance HD patients have REE not different from healthy controls, that HD procedure per se does not significantly increase REE and that neither isothermic nor thermoneutral regimen has any influence on metabolic rate. Therefore, body temperature elevation during routine HD may rather be due to decreased heat removal. With the use of BTM in active mode, body temperature can be kept stable (isothermic HD), which requires active cooling. This negative energy transfer is proportional to decrease in blood volume induced by ultrafiltration.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>17717032</pmid><doi>10.1093/ndt/gfm436</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Basal Metabolism Biological and medical sciences blood temperature monitor Body Temperature - physiology Emergency and intensive care: renal failure. Dialysis management Female Humans Intensive care medicine isothermic haemodialysis Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Renal Dialysis - methods Renal failure resting energy expenditure Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system thermal balance thermoneutral haemodialysis ultrafiltration |
| title | Resting energy expenditure and thermal balance during isothermic and thermoneutral haemodialysis—heat production does not explain increased body temperature during haemodialysis |
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