Observational studyBMC nephrology2020
Non-invasive venous waveform analysis (NIVA) for volume assessment in patients undergoing hemodialysis: an observational study.
Observational study in BMC nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The trial behind it
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Who cites it
9 citing papers in PubMed.
- The Importance of a Continuously Changing Heart Rate in Venous and Arterial Pressure Analysis.Medical research archives · 2025Article
- A prospective, observational study of non-invasive venous waveform analysis (NIVA) for the detection of acute low volume blood loss in humans.Journal of clinical anesthesia · 2025Observational
- Signal quality assessment of peripheral venous pressure.Journal of clinical monitoring and computing · 2024Article
- Article
- Noninvasive Venous Waveform Analysis Correlates With Pulmonary Capillary Wedge Pressure and Predicts 30-Day Admission in Patients With Heart Failure Undergoing Right Heart Catheterization.Journal of cardiac failure · 2022Article
- Contemporary Review of Hemodynamic Monitoring in the Critical Care Setting.US cardiology · 2022Review
- Respiratory Non-Invasive Venous Waveform Analysis for Assessment of Respiratory Distress in Coronavirus Disease 2019 Patients: An Observational Study.Critical care explorations · 2021Article
- Physiology and clinical utility of the peripheral venous waveform.JRSM cardiovascular diseaseReview
- A brief report on the effects of vasoactive agents on peripheral venous waveforms in a porcine model.JRSM cardiovascular diseaseArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundAccurate assessment of volume status to direct dialysis remains a clinical challenge. Despite current attempts at volume-directed dialysis, inadequate dialysis and intradialytic hypotension (IDH) are common occurrences. Peripheral venous waveform analysis has recently been developed as a method to accurately determine intravascular volume status through algorithmic quantification of changes in the waveform that occur at different volume states. A noninvasive method to capture peripheral venous signals is described (Non-Invasive Venous waveform Analysis, NIVA). The objective of this proof-of-concept study was to characterize changes in NIVA signal with dialysis. We hypothesized that there would be a change in signal after dialysis and that the rate of intradialytic change in signal would be predictive of IDH.
methodsFifty subjects undergoing inpatient hemodialysis were enrolled. A 10-mm piezoelectric sensor was secured to the middle volar aspect of the wrist on the extremity opposite to the access site. Signals were obtained fifteen minutes before, throughout, and up to fifteen minutes after hemodialysis. Waveforms were analyzed after a fast Fourier transformation and identification of the frequencies corresponding to the cardiac rate, with a NIVA value generated based on the weighted powers of these frequencies.
resultsAdequate quality (signal to noise ratio > 20) signals pre- and post- dialysis were obtained in 38 patients (76%). NIVA values were significantly lower at the end of dialysis compared to pre-dialysis levels (1.203 vs 0.868, p < 0.05, n = 38). Only 16 patients had adequate signals for analysis throughout dialysis, but in this small cohort the rate of change in NIVA value was predictive of IDH with a sensitivity of 80% and specificity of 100%.
conclusionsThis observational, proof-of-concept study using a NIVA prototype device suggests that NIVA represents a novel and non-invasive technique that with further development and improvements in signal quality may provide static and continuous measures of volume status to assist with volume directed dialysis and prevent intradialytic hypotension.
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