[Behavior of ventilation parameters, gas exchange and blood gases during hemodialysis (HD), in a traction during which the bicarbonate concentration in dialysis fluid is raised to a level of 60 m Eq/l].
In 9 patients with chronic renal failure treated by HD with bicarbonate-35 mEq/l containing fluid, investigations of minute ventilation, breathing patterns and blood gases were done during 5 sequential HD. During the standard HD-bicarbonate 35 mEq/l, the disturbances of minute ventilation, breathing patterns and blood gases did not appeared. During the standard HD session, between 60 to 75 minute of HD, the concentration of bicarbonate was increased to 60 mEq/l. Increased VCO2, PaCO2 and PvCO2 was observed during this 15 minutes in 45 HD sessions. Analysis of each HD in 9 patients showed that during 22 HD the values of VE, VA, VCO2 and PvCO2 were increased in 75 minute of HD compared to values obtained in 60 minute of HD. This group of HD we called responders. The different situation was during the 23 HD-non-responders. The values of PaCO2 and PvCO2 were increased in 75 minute of HD and VE and VA were decreased in this time. We conclude, that in the group of responders the increase of VE, VA, VCO2 and PvCO2 was the positive reaction of the breathing center to high values of PaCO2 and PvCO2. Decrease of VE observed in 23 HD-non-responders suggest the depressive influence of CO2 on respiratory muscles in patients with uremia.
Wanic-Kossowska
M
M
Kliniki Nefrologii Instytutu Chorób Wewnetrznych AM im. K. Marcinkowskiego w Poznaniu.
D000328:Adult; D001639:Bicarbonates / Q000008:administration & dosage* / Q000032:analysis; D001784:Blood Gas Analysis; D005260:Female; D015312:Hemodialysis Solutions / Q000008:administration & dosage* / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012119:Respiration / Q000187:drug effects*
D001639:Bicarbonates; D015312:Hemodialysis Solutions