Leukopenia and Hypoxemia

Dumler, Francis

doi:10.1001/archinte.1979.03630470025011

Cited by 48 publications

(2 citation statements)

References 20 publications

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“…Dumler and Levin [19] and Jacob et al [20] have disso ciated hypoxemia from leukopenia by eliminating leuko penia during hemodialysis by dialyzer reuse and by use of a polyacrylonitrile membrane. Hypoxemia occurs despite prevention of leukopenia.…”

Section: Discussionmentioning

confidence: 99%

Contrasting Alterations in Pulmonary Gas Exchange during Acetate and Bicarbonate Hemodialysis

et al. 1982

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We studied 10 patients during acetate and 10 patients during bicarbonate hemodialysis to assess changes of minute ventilation; oxygen consumption (VO₂); and carbon dioxide production (VCO₂) as well as pO₂, pCO₂ and pH. We also measured the extent of pulmonic shunting by administering 100% O2. Our studies revealed that VO₂ increased significantly during acetate dialysis, while it decreased slightly during bicarbonate dialysis. Since VCO₂decreased with both baths, the respiratory exchange ratio (R) decreased during acetate dialysis but did not change during bicarbonate dialysis. By the alveolar gas equation, these changes in R could account for a difference in alveolar PO₂ and consequently arterial pO₂ The fact that pO₂ fell during bicarbonate dialysis may relate to decreased minute ventilation paralleling decreases in VCO₂. The degree of intrapulmonic shunting was not altered during dialysis with either bath. We conclude that hypoxemia during dialysis relates to decreases in minute ventilation and that a greater decrease during acetate dialysis is a consequence of enhanced VO₂ and its effect on R. Bicarbonate dialysis does not increase VO₂.

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Section: Discussionmentioning

confidence: 99%

Contrasting Alterations in Pulmonary Gas Exchange during Acetate and Bicarbonate Hemodialysis

et al. 1982

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“…Some studies have attributed hypoxemia during HD to the type of dialysate [7], to the type of membrane used [8], or to both [9][10][11]. Acetate dialysate, for example, has been found to trigger hypoxemia by the loss of carbon dioxide (CO 2 ) across the dialyzer [12,13]. This loss in CO 2 results in alveolar hypoventilation.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Gas Exchange During Hemodialysis: A Comparison of Subjects With and Without COPD on Bicarbonate Hemodialysis

Alfakir

Moammar

Chaudry

et al. 2010

Chest

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Little is known about the effect of hemodialysis (HD) on gas exchange in subjects with chronic obstructive pulmonary disease (COPD). The purpose of this study was to examine blood gases and pH in COPD patients undergoing HD with bicarbonate dialysate. We studied thirteen subjects with COPD and thirteen controls (CON). All were dialyzed for 4 hrs against a bicarbonate HD solution. Blood gases, pH and HCO 3 were initially analyzed (t 0) and, during HD, at 30 min (t 0.5), 1 hr (t 1) and 4 hrs (t 4). At t 0 , a statistically significant difference was observed for PO 2 (CON: 84.7±3.60, COPD: 72.19±4.92; p<0.001). For the first hr, PO 2 decreased, and at t 1 , oxygen was required for 6 COPD subjects. By t 4 , there was no significant difference in PO 2 between groups. The alveolar-arterial gradient (ΔA-a) remained different between groups (P<0.001, all times), with increasing ΔA-a for both groups up to t 1 and decreasing over the remaining 3 hr. For both groups, at t 4 , ΔA-a was higher than at t 0 (p<0.001). For PCO 2 , both groups demonstrated increases from t 0 to t 1 (p=0.0004), with COPD having PCO 2 higher than CON at t 0.5 and t 1 (p<0.05 for both); by t 4 , PCO 2 levels decreased to nearly the same as at t 0. Over the 4 hr treatment, HCO 3 and pH increased significantly for both groups; however no significant difference was observed between COPD and CON. Markedly increased ΔA-a is observed during HD in some COPD patients. COPD patients retain more CO 2. However, the effect of HCO 3 leads to mild metabolic alkalosis at t 4 .

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Hypoxemia During Hemodialysis

Burns¹,

Scheinhorn²

1982

Arch Intern Med

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Leukopenia and Hypoxemia

Cited by 48 publications

References 20 publications

Contrasting Alterations in Pulmonary Gas Exchange during Acetate and Bicarbonate Hemodialysis

Contrasting Alterations in Pulmonary Gas Exchange during Acetate and Bicarbonate Hemodialysis

Pulmonary Gas Exchange During Hemodialysis: A Comparison of Subjects With and Without COPD on Bicarbonate Hemodialysis

Hypoxemia During Hemodialysis

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