van Kuijka WHM, Hillion D, Savoiub C, Leunissen KML
Critical role of the extracorporeal blood temperature in the
hemodynamic response during hemofiltration
33rd Congress of the Eur Dial Transplant Assoc
Nephrol Dial Transplant
(Jun) 11:A227 1996
Extracorporeal blood cooling is considered an important factor for
the better hemodynamic tolerance of hemofiltration (HF) in comparison
with HD. However in previous studies the two treatments were not
matched for dialysis membrane, small molecule clearances and dialysis
buffer.
The authors re-examined the issue in 11 uremic
patients. Hemodynamic measurements (MAP, HR, forearm vascular
resistance and venous tone) were measured during HD (Qd 500 ml/min) at
37.5 øC and pre-dilution HF (Qinf 350 ml/min) at 39.0 (warm-HF) and
36.0 øC (cold-HF). In both HD and HF sessions the AK-100 Ultra
(Gambro) was used to produce on-line, sterile bicarbonate dialysate or
infusate. The two treatments were membrane-matched (polyamide,
Gambro) and with identical Qb (300 ml/min) and UF rate (0.9 l/hr).
Venous blood temperatures were comparable in HD and warm HF (35.8Cø)
and significantly cooler during cold HF (34.6 øC). Hemodynamic
tolerance was similar during HD and warm HF (unchanged MAP, HR
forearm vascular resistance and venous tone) while MAP, venous tone
and forearm vascular resistance rose significantly during cold HF.
Comment: These data further again confirm that
disparity in vascular reactivity between HD and HF is primarily
related to differences in the extracorporeal blood temperature
(Carlo Basile, M.D., Taranta, Italy).
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33rd Congress of the Eur Dial Transplant Assoc
Basic hemodialysis :
Complications (acute)