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- Title
Ventilatory and metabolic changes during high efficiency hemodialysis.
- Authors
Symreng, Tommy; Flanigan, Michael J.; Lim, Victoria S.
- Abstract
Ventilatory and metabolic changes were measured in seven patients undergoing high efficiency hemodialysis using a cuprophane dialyzer and bicarbonate-containing dialysate. At an HCO3 concentration of 35 mEq/liter and a mean in vivo urea clearance of 3.6 ml/kg/min, hypoxemia was not detected during dialysis (PaO2 was 14.00 and 13.60 kPa before and during dialysis). The new findings, related lo high efficiency bicarbonate dialysis, include a sustained rise in minute ventilation (&Vdot;E, 6.1 to 6.8 liter/min, P < 0.01), an increase in CO2 excretion (&Vdot;CO2, 194 to 2l4 ml/min, P < 0.05), and O2 consumption (&Vdot;O2, 215 to 246 ml/min, P < 0.05). The increment in &Vdot;E and &Vdot;CO2, was attributed to the high flux rate of bicarbonate while the rise in &Vdot;O2 is likely the result of metabolic alkatosis. Arterial pH rose from 7.40 to 7.49 mm Hg and serum HCO3 increased from 23.8 to 29.2 mEq/liter, while pCO2 remained normal at 5.07 kPa throughout the study. The acid-base status of the blood changed from that of a metabolic acidosis to that of a respiratory acidosis across the dialyzer where the pH decreased from 7.47 to 7.41 and pCO2 rose from 5.31 to 7.72 kPa. These data indicate that a healthy ventilatory response is needed to excrete the excess CO2 generated during high efficiency bicarbonate hemodialysis. The significance and etiology of the elevated O2 consumption is undetermined.
- Subjects
HEMODIALYSIS; HYDROGEN-ion concentration; HYPOXEMIA; ACIDITY function; THERAPEUTICS; URINALYSIS; METABOLISM
- Publication
Kidney International, 1992, Vol 41, Issue 4, p1064
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1992.162