Progressive loss in circulating volume during haemodialysis can be monitored by time voltage integral area of QRS complex: pilot study

Introduction: Time voltage area of QRS is a parameter that showed a close association with modifications in endoventricular volume. The aim of the study was to investigate the efficacy of this parameter in identifying progressive reduction in circulating blood volume (BV) during haemodialytic treatment (HT). Material and methods: Thirteen uraemic patients were studied. XYX like leads were monitored before, during and after HT. Summation of areas of each QRS complex was named QRS total area (TA). Results: Increase in QRS TA and decrease in BV were found after vs. before HT. Progressive increase in QRS TA is strongly linked to a progressive reduction of BV during HT. Conclusions: These findings encourage use of ECG monitoring during HT with a dual purpose: rhythm and haemodynamic control. In fact, excessive or insufficient subtractions of water, with consequent hypotensive or cardiorespiratory crisis, are the most frequent complications in these patients.