Determinants of Oxygenation during Hemodialysis and Related Procedures

Sherlock, Julian; Ledwith, James W.; Letteri, Joseph M.

doi:10.1159/000429308

Cited by 2 publications

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“…In uremic patients a decrease in both variables has been reported [24,25], but unchanged [26] and increased [27] oxy gen tensions have also been found. Conflict ing and variable results have been reported concerning pulmonary function in uremia during different extracorporeal treatments.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Function and Arterial Blood Gases during Isolated Ultrafiltration in Healthy Man

Freyschuss¹,

Danielsson²,

Bergström³

1988

Blood Purif

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In order to recognize possible cardiovascular signs of underhydration during isolated ultrafiltration (IUF), we have studied the physiological hemodynamic adaptation to IUF in healthy man both above and below normohydration. In 7 subjects IUF was performed with the subjects in a normohydrated state at the start of IUF. In 8 subjects the IUF was preceded by a 1-hour infusion of Ringer solution equal to 3% of body weight. By invasive techniques, cardiac index (thermodilution), stroke index, heart rate, brachial and pulmonary arterial blood pressures, systemic vascular resistance index, central blood temperature, P_aO₂ and P_aCO₂ were measured. Calf vascular resistance was assessed by venous occlusion plethysmography. A recirculation period of 30 min was followed by IUF in both study groups. During IUF with overhydration and normohydration at the start of IUF, cardiac output fell because of a decline in stroke volume and an unchanged heart rate. Blood pressure remained constant because of systemic vascular constriction. P_aO₂ and P_aCO₂ remained unchanged. IUF in healthy man is mainly characterized by vascular constriction and an unchanged heart rate. Thus, the cardiovascular adaptation to ultrafiltration was the same whether or not ultrafiltration was performed at overhydration or normohydration at the start of ultrafiltration. Therefore, it is unlikely that monitoring of heart rate or noninvasive recording of blood pressure can predict whether a subject is becoming underhydrated during isolated ultrafiltration. The adaptation to IUF is similar to that observed during the treatment of uremic patients without complications.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular Function and Arterial Blood Gases during Isolated Ultrafiltration in Healthy Man

Freyschuss¹,

Danielsson²,

Bergström³

1988

Blood Purif

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“…Supporting evidence for changes in pulmonary circulation are the decrease in carbon monoxide diffu sion during dialysis [1,17] and a decrease in pulmonary capillary blood flow after dialysis [18]. An alternate mech anism including correction of metabolic acidosis leading to hypoventilation, does not appear to be important in reducing P a02 [12], During bicarbonate dialysis Pa02 has varied from no change to a minor decrease [1,3,7,8,17], These differ ences have been explained as depending on the bicarbo nate concentration and C 0 2 bubbling into the dialysate [ …”

Section: Discussionmentioning

confidence: 99%

Hypoxemia during Hemodialysis in Patients with Impairment in Pulmonary Function

Serrano¹,

Vega²,

Grande³

1986

Nephron

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In order to examine the effect of different dialysates on hemodialysis-induced hypoxemia, 6 stable patients with chronic pulmonary disease (CPD) were compared with 8 control subjets using, alternately, acetate and bicarbonate in the dialysate. These patients were also studied during acetate dialysis and 2 liters/min of nasally administered oxygen. In the control group the presence of hypoxemia with acetate and its absence with bicarbonate suggests that the major mechanism responsible for hypoxemia is hypoventilation. In CPD patients the higher hypoxemia with acetate which bicarbonate analysis did not prevent suggests that a superimposed mechanism may be an important factor in hypoxia aggravation. In these patients hypoxemia can be prevented easily by increasing the inspired oxygen concentration.

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Determinants of Oxygenation during Hemodialysis and Related Procedures

Cited by 2 publications

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Cardiovascular Function and Arterial Blood Gases during Isolated Ultrafiltration in Healthy Man

Cardiovascular Function and Arterial Blood Gases during Isolated Ultrafiltration in Healthy Man

Hypoxemia during Hemodialysis in Patients with Impairment in Pulmonary Function

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