The effect of acetate on ventilation in haemodialysis patients.
This study evaluates the direct effect of acetate upon ventilation during acetate-haemodialysis. Eight patients with end-stage renal failure who were receiving chronic haemodialysis treatment underwent acetate infusion for 1 h on a day outside a haemodialysis session. Ventilation was continuously measured using respiratory inductance plethysmography, starting 20 min before the infusion. Arterial blood samples were drawn and expired gases were analysed at regular intervals. After 1 h of acetate infusion, arterial pH increased rapidly and significantly from 7.38 +/- 0.01 to 7.49 +/- 0.01, the VCO2 and VO2 slightly decreased and increased respectively, resulting in a reduced respiratory exchange ratio from 0.81 +/- 0.04 to 0.69 +/- 0.05. Ventilation slightly decreased only after 60 min, whereas the breathing pattern remained normal; neither apnoea periods nor periodic breathing were observed. We conclude that the hypoventilation and irregular breathing encountered in acetate-cuprophane haemodialysis is related to CO2/HCO3- unloading and the occurrence of complement-activation-induced hypoxaemia rather than to the small changes in VCO2, VO2 during metabolism of acetate.
Heyrman
R M
RM
Department of Pulmonary Medicine, University Hospital Antwerp, Belgium.
De Backer
W A
WA
Van Waeleghem
J P
JP
De Broe
M E
ME
D000085:Acetates / Q000494:pharmacology*; D000328:Adult; D001784:Blood Gas Analysis; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D006435:Renal Dialysis; D012119:Respiration / Q000187:drug effects*; D012129:Respiratory Function Tests
D000085:Acetates