n this work a pulsatile model of the cardiovascular system was developed to simulate the hemodynamic effects of the hemodialysis treatment. The model comprises the dialysis-relevant autonomic regulatory mechanisms, the arterial baroreflex and the cardiopulmonary reflex, as well as possible treatment-related, patient-related and pathological factors that are causally linked to the development of dialysis hypotension, e.g. fluid withdrawal, postural changes, left ventricular hypertrophy, autonomic impairment. The sensitivity analysis of the model yields feasible results and corresponds with data on the efficacy of the autonomic reflex mechanisms reported in literature. Furthermore, individually identification of model parameters can be performed on the basis of intradialytic measurement data. Digital signal processing techniques were applied to analyse electrocardiograms that were recorded during 26 dialysis sessions within the scope of clinical investigations. The objective was the calculation of spectral parameters of heart rate variability (HRV) as well as the development and implementation of reliable methods for the detection and classification of premature heartbeats depending on their origin. HRV-analysis revealed significant differences between hypotension-resistant and hypotension-prone dialysis patients. The results of the clinical investigations emphasize the importance of the applied techniques for the risk-monitoring during hemodialysis treatment.
|Titel in Übersetzung||System analysis of the heart and circulatory system during hemodialysis treatment|
|Qualifikation||Doktor der Technik|
|Betreuer/-in / Berater/-in|
|Publikationsstatus||Veröffentlicht - 27 Feb 2001|