Estimating and Predicting Hemodynamic Changes During Hemodialysis

Study Overview
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Brief Summary
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Machine learning techniques and algorithms originally developed for use in the field of robotics can be applied to continuous, noninvasive physiological waveform data to discover hidden, hemodynamic relationships. Newly developed algorithms can, in real-time: 1) estimate acute blood loss volume, 2) monitor and estimate fluid resuscitation needs, 3) predict cardiovascular collapse well ahead of any clinically significant changes in standard vital signs, and 4) estimate intracranial pressure. We hypothesize that these same methods can be used to monitor volume loss during hemodialysis, as well as predict intradialytic hypotension, well before it occurs.

Detailed Description
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Collect physiological waveform data from patients undergoing hemodialysis at the University of Colorado Hospital, Children's Hospital Colorado, and Fresenius Medical Centers using non-invasive monitoring techniques. Combine the physiological data from patient monitors with clinical and demographic data, including age, gender, race, problem list, reason for dialysis, estimated dry weight, volume removed, arterial and venous pressures, etc. for use in developing mathematical models of hemodialysis. Develop robust, real-time, computational models for: estimating acute intravascular volume loss during hemodialysis predicting an optimal, individual specific, intravascular volume to be removed during a hemodialysis session predicting intradialytic hypotension Determine: which non-invasive signals are relevant to each model type which features extracted from these signals are relevant which algorithms are capable of using the extracted features for each decision type

Official Title
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Estimating and Predicting Hemodynamic Changes During Hemodialysis

Conditions
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Hemodialysis

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age: 2 - 89 years Undergoing hemodialysis at the Fresenius Medical Centers, University of Colorado Hospital or Children's Hospital Colorado Exclusion Criteria: Pregnant Incarcerated Decisionally challenged Positive for hepatitis B surface antigen Limited access to or compromised monitoring sites for non-invasive finger and ear or forehead sensors

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 89 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Hemodialysis<br>Patients undergoing hemodialysis | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute intravascular volume loss during hemodialysis | development of algorithm to estimate acute intravascular volume loss during hemodialysis | one hemodialysis session (approx 3-4 hours) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hemodialysis, Hemodynamics