PMID: 6527471Oct 1, 1984

Relative contribution of intrinsic lung dysfunction and hypoventilation to hypoxemia during hemodialysis

Kidney International
F BlanchetC Amiel

Abstract

Two mechanisms have been proposed to explain hemodialysis (HD)-induced hypoxemia: reversible lung damage due to intrapulmonary leukostasis as a consequence of the contact of blood with the dialyzer membrane, or alveolar hypoventilation due to the loss of carbon dioxide through the dialyzer. To assess the role of these factors, seven chronically uremic patients were studied before and during 4-hr HD sessions using a cuprophane membrane and either acetate (AHD) or bicarbonate (BHD) dialysate. In AHD only we observed, by comparison with predialysis values, a significant hypoxemia, and a decrease of alveolar ventilation (VA), lung carbon dioxide output, and respiratory exchange ratio. In both the AHD hypoxemic group and BHD nonhypoxemic group, there was a similar decrease in lung carbon dioxide diffusing capacity (DLCO) and of white blood cells (WBC), and a positive correlation between arterial oxygen pressure and VA without modification of alveolo arterial PO2 difference, an argument against the existence of ventilation-perfusion or ventilation-diffusion mismatching. We conclude that, although WBC sequestration induced a lung damage evidenced by DLCO impairment, the key factor of hypoxemia observed in AHD was the hypoventilation.

References

Feb 1, 1977·Anesthesiology·T KolobowJ E Pierce
Oct 20, 1977·The New England Journal of Medicine·N M AurigemmaE G Lowrie
Jan 1, 1979·Nephron·A Blumberg, G Keller
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Citations

Oct 1, 1987·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·D M FordG M Lum
Jan 1, 1992·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·J U Leititis, M Brandis
Jan 1, 1990·Respiratory Medicine·A Davenport, A J Williams
Feb 1, 1986·Artificial Organs·S M Ringoir, R C Vanholder
Dec 1, 1986·Kidney International·Y BouffardJ Motin
Jul 1, 1987·Kidney International·R C VanholderS M Ringoir
Apr 1, 1988·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M CardosoL Lapierre

Related Concepts

Cuprammonium cellulose
Acetic Acids
Anoxemia
Carbonic Acid Ions
Sulfite Cellulose
Hemodialysis
Eryhem
Hypoventilation
Kidney Failure, Chronic
Differential White Blood Cell Count Procedure

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