Document Detail


Approach to intradialytic hypotension in intensive care unit patients with acute renal failure.
MedLine Citation:
PMID:  12940898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The increasing prevalence of acute renal failure (ARF) patients with hemodynamic intolerance of intermittent hemodialysis (HD), generally because of septic vasoparesis or severe cardiac dysfunction, has led to the development of several strategies to improve the delivery of renal replacement therapy (RRT) in ARF patients. Intradialytic hypotension (IDH) is caused by the interaction of dialysis-dependent and dialysis-independent factors. Dialysis-dependent factors include the prescriptions for fluid removal, solute removal, and dialysate components such as sodium, buffer, and calcium. Dialysis-independent factors include hemodynamic compromise caused by hypovolemic, cardiogenic, vasodilatory, and mixed mechanisms. We propose an approach to the prevention and management of IDH in critically ill ARF patients, which minimizes hypovolemic, cardiogenic, and vasodilatory insults by optimizing fluid removal, cardiac function, and vascular contractility.
Authors:
Mona Doshi; Patrick T Murray
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Artificial organs     Volume:  27     ISSN:  0160-564X     ISO Abbreviation:  Artif Organs     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-27     Completed Date:  2004-02-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  772-80     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Chicago, Chicago, IL, USA.
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MeSH Terms
Descriptor/Qualifier:
Humans
Hypotension / etiology*,  therapy*
Intensive Care*
Kidney Failure, Acute / therapy
Renal Dialysis / adverse effects*
Risk Factors
Grant Support
ID/Acronym/Agency:
1K23GM00713-01A1/GM/NIGMS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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