Respiratory gas exchange by high-efficiency hemodialyzers

N TolchinE J Lewis


The effects of respiratory gas mass-transfer by high-efficiency hemodialyzers with regard to respiratory status and acid-base balance were studied in three groups of patients. Patients dialyzed with acetate dialysate and a single pass delivery system (group I) and those dialyzed with the same dialysate and a recirculating single pass system (group II) had significant intradialytic decreases in PCO2 (p is less than 0.05), while patients hemodialyzed aginst a carbon dioxide/bicarbonate dialysate (group III) had no significant alterations in arterial PCO2. The massfransfer rate of carbon dioxide was 0.3 mM/min in group I and 0.2 mM/min in group II. The hypocapnia caused by dialyzer mass-transfer of carbon dioxide was associated with a significant drop in minute ventilation volume and a decrease in PO2 which was significant in group I (p is less than 0.05). Although bicarbonate mass-transfer reduced serum bicarbonate levels, the loss of carbon dioxide to the dialysate resulted in an increased arterial pH during dialysis.


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Related Concepts

Acetic Acids
Anion Gap
Carbonic Acid Ions
Blood Gas Analysis
Carbon Dioxide
Kidney Failure, Chronic

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