Pneumatic compression devices during hemodialysis: a randomized crossover trial
Bibliographic record
Abstract
BACKGROUND: Maintenance of central blood volume (CBV) is essential for hemodynamic stability during hemodialysis (HD), though preservation of CBV is poorly understood. Pneumatic compression devices (PCDs) during HD may help maintain CBV. METHODS: We performed a randomized, crossover trial to determine the effect of PCDs on CBV during HD. Patients underwent two consecutive mid-week HD sessions, randomized to begin the first session either with or without PCDs [stratified by intradialytic hypotension (IDH)-prone status]. The primary outcome was change in CBV during HD. The secondary outcomes were change in other hemodynamic and volume status parameters. RESULTS: Fifty-one patients (median age 65 years, 75% male, 22% IDH-prone) were randomized; forty-six completed the study. During HD, the median change in CBV for PCD and control sessions was -0.08 versus -0.05 L (P = 0.62). There was no difference in the change in cardiac output (CO) (-0.63 versus -0.49 L/min, P = 0.78) or systemic vascular resistance (SVR) (+1.30 versus +1.55 mmHg/L/min, P = 0.67) for PCDs versus control. Based on the bioimpedance measurements, patients were not volume overloaded pre-dialysis. There was a greater reduction in total body water (TBW) (-2.6 versus -2.3 L, P = 0.05) and intracellular fluid (ICF) volume (-1.3 versus -1.1 L, P = 0.03), and no difference in change in the extracellular fluid (ECF) volume (1.3 versus 1.2 L, P = 0.09) with PCDs versus control. Similar results were observed in IDH-prone patients. CONCLUSIONS: Compared with standard of care, PCDs have no effect on intradialytic hemodynamic parameters, including CBV, although they may allow greater capacity for fluid removal. Further studies are required to better understand physiological and hemodynamic changes in patients during HD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".