Hemodynamic changes during acetate dialysis, bicarbonate dialysis and hemofiltration.
Twenty uremic patients submitted to three different dialytic procedures (6 patients to acetate dialysis, 8 patients to bicarbonate dialysis, 6 patients to hemofiltration) were monitored in respect to the hemodynamic parameters recorded with a thermistor Swan-Ganz catheter. During acetate dialysis there was an increment of cardiac index (CI) up to positive values (+4.8%), while resistance index (RI) decreased progressively until it reached -16.5%. During bicarbonate dialysis CI, after an initial fall, remained constant and RI increased (+8.6%). During hemofiltration CI decreased constantly throughout the entire procedure while RI increased until +12.9%. We concluded that during diffusive transport the buffer used plays an important role in determining hemodynamic responses to fluid removal; during convective transport vascular resistance increases in spite of acetate.
Vagge
R
R
Hemodialysis Service, Hospital of Lavagna, Genova, Italy.
Cavatorta
F
F
Queirolo
C
C
Rosselli
P
P
Gentile
A
A
Bertulla
A
A
D000085:Acetates; D000368:Aged; D001639:Bicarbonates; D002021:Buffers; D005260:Female; D006439:Hemodynamics; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D014655:Vascular Resistance; D014882:Water-Electrolyte Balance
D000085:Acetates; D001639:Bicarbonates; D002021:Buffers