PMID: 2120511Aug 17, 1990Paper

Modification of gas exchange and metabolism by various hemodialysis procedures

Klinische Wochenschrift
S GrosserH Greten


We compared the effects of various dialysate composition on pulmonary and transdialyzer gas exchange in patients during hemodialysis. Under acetate hemodialysis there was a permanent loss of CO2 (45-68 ml/min) into the dialysate resulting in a significant decrease of arterial pO2, which can be explained by a reduced alveolar ventilation. The pulmonary oxygen uptake increased up to +20% during treatment, reflecting rising energy metabolism and possibly increased cardiopulmonary instability. Using different concentrates for bicarbonatehemodialysis we saw a moderate to clinical relevant uptake of CO2 (40-60 ml/min) from the dialysate into the blood of the patients, cause the pCO2 in the dialysate varied between 45 and 115 mmHg. Bicarbonate hemodialysis with high pCO2-levels in the dialysate led to hyperventilation and markedly increased oxygen consumption. In critically ill hemodialysis patients the pathophysiologic effects on pulmonary gas exchange of either acetatehemodialysis and bicarbonatehemodialysis with high pCO2 can explain the higher incidence of severe complications.


Oct 20, 1977·The New England Journal of Medicine·N M AurigemmaE G Lowrie
Mar 1, 1978·Annals of Internal Medicine·U GraefeB H Scribner
Jan 1, 1979·Nephron·A Blumberg, G Keller
Mar 1, 1975·Chest·M D BischelJ G Mohler
Apr 1, 1975·Journal of Applied Physiology·K WassermanR Lugliani
Jan 1, 1977·Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology·S BurszteinR Nedey
Apr 7, 1977·The New England Journal of Medicine·P R CraddockH S Jacob
May 1, 1977·Kidney International·N TolchinE J Lewis
Apr 1, 1984·Critical Care Medicine·E J QuebbemanW F Piering
Feb 1, 1981·Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology·R W PattersonS F Sullivan
May 1, 1980·Kidney International·L W Henderson
Dec 1, 1982·Kidney International·J L VincentR J Kahn

Related Concepts

Acetic Acids
Carbonic Acid Ions
Carbon Dioxide
Glucose, (beta-D)-Isomer
Membranes, Artificial
Pulmonary Gas Exchange
Dialysis Solutions

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