Document Detail


Cold as cardiovascular stabilizing factor in hemodialysis: hemodynamic evaluation.
MedLine Citation:
PMID:  6673315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vascular instability represents the most frequent intradialytic complication of uremic patients. Catecholamine impairment, changes in plasma sodium or osmolality and, more recently, temperature (T) of dialysate have been proposed to explain this phenomenon. In order to evaluate the role of T in hemodynamic stability, we studied the effect of cooling dialysate in 5 patients (3 m, 2 f), who often experienced hypotension during dialytic sessions. Dialysate T was lowered, leading to a body T decrease of 1.5 degrees C, measured by a thermistor in the pulmonary artery. Ultrafiltration was kept constant during both "warm" (W) and "cold" (C) hemodialysis (HD). Systemic and pulmonary hemodynamic parameters were studied by thermodilution technique. The evaluation was performed in the same patients during W-HD and C-HD with the same dialysate composition. MAP showed a significant reduction during the first hour under both dialysis conditions. Subsequently a further decrease of MAP was observed in W-HD, while it remained stable in C-HD. CI and SI demonstrated similar trends, whereas HR showed no major changes. TPRI appeared significantly higher during C-HD compared to W-HD, with no clinical symptoms of hypotension. Similarly pulmonary parameters resulted in a better cardiovascular stability during C-HD. Our hemodynamic study confirms the important role played by T on intradialytic vascular stability and may explain the better control observed during hemofiltration compared to standard W-HD.
Authors:
U Coli; S Landini; S Lucatello; A Fracasso; P Morachiello; F Righetto; F Scanferla; G Onesti; G Bazzato
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Transactions - American Society for Artificial Internal Organs     Volume:  29     ISSN:  0066-0078     ISO Abbreviation:  Trans Am Soc Artif Intern Organs     Publication Date:  1983  
Date Detail:
Created Date:  1984-05-24     Completed Date:  1984-05-24     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7506088     Medline TA:  Trans Am Soc Artif Intern Organs     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  71-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure
Cardiac Output
Cold Temperature
Female
Heart Rate
Hemodynamics*
Humans
Male
Middle Aged
Renal Dialysis*
Stroke Volume
Vascular Resistance

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


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