#6463 IMPLEMENTATION OF CLINICAL ALARM SYSTEM IS ASSOCIATED WITH REDUCTION OF THE RISK OF INTRADIALYTIC HYPOTENSION

Abstract

Abstract Background and Aims Intradialytic hypotension (IDH) plays an essential role in hemodialysis. IDH prevalence can be up to 8% to 40% [1], according to research. Furthermore, research shows that IDH positively correlates with severe complications such as non-occlusive mesenteric ischemia[2], critical limb ischemia[3] and tissue ischemia, which leads to irreversible damage, even increasing the chance of infection. Many causes and risk factors result in IDH, such as excessive weight gain during dialysis, cardiovascular dysfunction, and improper use of blood pressure-lowering drugs[1]. Therefore, it still relies on experienced medical professionals to monitor patients’ blood pressure to beware of the risk of developing IDH. However, this increases the workload on medical professionals and does not provide standard or more objective early warning indicators of hypotension for new medical professionals. Method Selection of experimental and control group: In this study, we included 81 subjects that received hemodialysis in Tainan City Municipal Annan Hospital from January 2021 to August 2022. The control group was retrospective data collected from January 2021 to August 2021. Then, from January 2022 to August 2022, we implemented our IDH predicting system and took subjects’ data from this interval as the experimental group to compare the incidence of IDH with the control group. IDH prediction system monitoring interface: After integrating with the hemodialysis dataset, our prediction system will predict patients’ systolic pressure and the likelihood of IDH in the next 30 minutes. As soon as the system detects that the patient will encounter hypotension, it sends warning signals, blood pressure and IDH incidence probability predictions to the monitoring interface to alert medical professionals. Furthermore, our system also supports multi-bed monitoring, which can significantly increase the efficiency of monitoring during hemodialysis. Results After implementing the IDH prediction system, the outcome yielded an IDH incidence of 6.12% in August 2022. Compared to the control group, when the IDH system was not yet implemented, which yielded an IDH incidence of 9.34%, it showed a reduction of 34.5% in IDH cases. Furthermore, the average reduction in IDH rate each month was 12%. Conclusion The present study demonstrated that implementing the IDH predicting model may efficiently reduce the incidence of IDH. However, along with the IDH warning multi-bed monitoring interface, medical professionals must develop a standard procedure to deploy when noticing the warning signals. As a result, this may further reduce the incidence of IDH during hemodialysis sessions.