透析技術教育用シミュレータのためのplasma refilling rate 簡易推定法の検討

概要

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Because the numbers of hemodialysis patients are increasing, it is important to establish the educational procedure for clinical engineers to keep the safety of hemodialysis procedure. Therefore the development of the high-fidelity hemodialysis simulation system which can use for education of hemodialysis techniques is expected. To simulate the hemodynamic response of patients, it is necessary to develop the numerical model of patient's condition during the hemodialysis. However, since the change of plasma refilling rate (PRR) and baroreflex control of the cardiovascular system affect the hemodynamics under dialysis intricately, construction of a correctly reproducible scientific model is very difficult. In this study, we investigated the simple estimation method to define the PRR from the patient's initial conditions. We evaluated the PRR and circulating blood volume change during hemodialysis using CRIT-LINE in 17 patients under the constant ultrafiltration rate (UFR). Time-averaged PRR/UFR value was obtained as 0.8215±0.10 under the different total amount of ultra-filtration rate(UFR) and total blood volume. Hence we found the PRR value can estimate from UFR directly by using the proper PRR/UFR coefficient. This simple estimation method seems to be effective to construct the practical model which can simulate the hemodynamic response under hemodialysis.
広島国際大学大学院総合人間科学研究科医療工学専攻の論文