Yoowannakul, S;
Leung, TS;
Davenport, A;
(2020)
Pilot Study to Detect Changes in Blood Flow in the External Auditory Meatus During Hemodialysis.
Therapeutic Apheresis and Dialysis
, 24
(3)
, Article e13433. 10.1111/1744-9987.13433.
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Abstract
Blood flow to internal organs is reported to fall during haemodialysis (HD). As such, there non‐invasive monitoring devices are required to detect changes in perfusion, which could then be used for therapeutic interventions. We report on a pilot study monitoring blood flow in the outer auditory meatus. We measured the maximum pulse wave amplitude and indicators of blood flow by analysing red and green colour changes in the outer auditory meatus from video recordings made using an otoscope fitted with a digital camera during haemodialysis treatments. We studied 61 patients, 43 (71.5%) male, mean age 64.9 ± 12.7 years. Weight fell from 72.8 ± 22.5 pre‐dialysis to 71.5 ± 22.1 kg post‐dialysis (p < 0.001). Blood pressure did not significantly change (pre‐dialysis 142 ± 29/ 67 ± 18 to 143 ± 25/68 ± 17 mmHg post‐dialysis). The maximum pulse wave amplitude in the external auditory meatus fell from 0.21 (0.1–0.55) to 0.14 (0.04–0.4) after 90 min, p < 0.001, and remained low thereafter, and the change at the end of the dialysis session was associated with percentage weight loss (r = −0.37, p = 0.003). Green and red pixel values did not change (pre‐dialysis 0.339 (0.333–0.345) to 0.302 (0.291–0.33) post, and 0.301 (0.293–0.328) pre‐dialysis to 0.339 (0.334–0.347), respectively). This pilot study showed that the maximum pulse wave amplitude measured in the external auditory meatus fell during the dialysis session, and that the fall was associated with fluid removal. This could potentially lead to the development of a monitoring device which could fit in the ear and record during the dialysis session.
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