Prevention of hemodialysis associated hypoxemia by use of low-concentration bicarbonate dialysate.
Hypoxemia during acetate dialysis is caused by hypoventilation due to bicarbonate loss across the dialyzer and its regeneration from acetate by a CO2 consuming process. Loss of bicarbonate is prevented by using a bicarbonate containing dialysate, but hypoxemia is still found by many authors. In the current study, ten patients were dialyzed twice against acetate dialysate, high concentration bicarbonate (36 mmol/L), and low concentration bicarbonate (29 mmol/L) dialysates. A significant decrease in PO2 was found during both acetate and high concentration bicarbonate dialysis. Hypoxemia was prevented by low concentration bicarbonate dialysate. A possible explanation for the hypoxemia in high concentration bicarbonate dialysis may be hypoventilation induced by alkalosis. It was concluded that low concentration bicarbonate dialysate prevents hypoxemia during hemodialysis.
Ganss
R
R
Department of Internal Medicine, Ullevaal Hospital, University of Oslo, Norway.
Aarseth
H P
HP
Nordby
G
G
D001639:Bicarbonates / Q000097:blood*; D002245:Carbon Dioxide / Q000097:blood; D015314:Dialysis Solutions; D006801:Humans; D006863:Hydrogen-Ion Concentration; D000860:Hypoxia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D010100:Oxygen / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*
D001639:Bicarbonates; D015314:Dialysis Solutions; D002245:Carbon Dioxide; D010100:Oxygen