Background: To date, most intradialytic hypotension (IDH) studies have proposed technologies to comprehensively predict the occurrence of IDH using the patient's baseline information and ultrafiltration (UF) information, but it is difficult to apply the technologies while identifying the patient's condition in real time.
Methods: In this study, we propose an IDH indicator that uses heart rate (HR) change information to identify the patient's condition in real time and visually shows whether IDH has occurred. The data used were collected from 40 dialysis patients in a clinical trial conducted in the Artificial Kidney Unit at Yeungnam University Medical Center, Korea, from 18 July to 29 November 2023.
Results: The IDH indicator infers changes in the patient's blood pressure during dialysis by analyzing the upper and lower maximum HRs based on the real-time average HR. Medical staff can respond to IDH in real time by looking at the IDH indicator, which visually expresses changes in the patient's HR. In addition, we propose a multilayer perceptron structure that inputs upper and lower maximum HR information based on the average HR for the time interval accumulated in real time. In learning using 40 min of data up to 5 min before IDH occurred, models using two and five layers showed excellent performance, with accuracy of 88.6% and 85.2%, respectively.
Conclusions: By combining IDH visual indicators and the multi-layer perceptron method, medical staff can effectively respond to IDH in real time.
Keywords: heart rate; hemodialysis; intradialytic hypotension; perceptron; real-time.