title: Impact of renal replacement therapy on the respiratory function of patients under mechanical ventilation.
abstract: OBJECTIVE
  To assess the oxygenation behavior and ventilatory mechanics after hemodialysis in patients under ventilatory support.
  
  
  METHODS
  The present study was performed in the general intensive care unit of a tertiary public hospital. Patients over 18 years of age under mechanical ventilation and in need of dialysis support were included. Each patient was submitted to 2 evaluations (pre- and post-dialysis) regarding the cardiovascular and ventilatory parameters, the ventilatory mechanics and a laboratory evaluation.
  
  
  RESULTS
  Eighty patients with acute or chronic renal failure were included. The analysis of the ventilatory mechanics revealed a reduction in the plateau pressure and an increased static compliance after dialysis that was independent of a reduction in blood volume. The patients with acute renal failure also exhibited a reduction in peak pressure (p=0.024) and an increase in the dynamic compliance (p=0.026), whereas the patients with chronic renal failure exhibited an increase in the resistive pressure (p=0.046) and in the resistance of the respiratory system (p=0.044). The group of patients with no loss of blood volume after dialysis exhibited an increase in the resistive pressure (p=0.010) and in the resistance of the respiratory system (p=0.020), whereas the group with a loss of blood volume >2,000 mL exhibited a reduction in the peak pressure (p=0.027). No changes in the partial pressure of oxygen in arterial blood (PaO2) or in the PaO2/the fraction of inspired oxygen (PaO2/FiO2) ratio were observed.
  
  
  CONCLUSIONS
  Hemodialysis was able to alter the mechanics of the respiratory system and specifically reduced the plateau pressure and increased the static compliance independent of a reduction in blood volume.
authors.affiliation: Unidade de Terapia Intensiva, Hospital Geral Roberto Santos, SalvadorBA, Brasil.
authors.forename: Fernanda Maia
authors.initials: FM
authors.lastname: Lopes
authors.forename: José Roberval
authors.initials: JR
authors.lastname: Ferreira
authors.forename: Dimitri
authors.initials: D
authors.lastname: Gusmao-Flores
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000502:physiology; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D012121:Respiration, Artificial; D015656:Respiratory Mechanics
chemical_list: D010100:Oxygen