Document Detail


Microemboli, developed during haemodialysis, pass the lung barrier and may cause ischaemic lesions in organs such as the brain.
MedLine Citation:
PMID:  20305135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic haemodialysis (HD) may relieve some medical problems of terminal uraemia, but the life expectancy of patients is still significantly shortened, and there is a greatly increased morbidity. This includes pulmonary morbidity and chronic central nervous system (CNS) abnormalities. Previous studies have shown that a considerable amount of air microbubbles emanate within the blood lines of the dialysis device and pass the air detector without sounding an alarm. The aim of this study was to investigate whether microemboli can pass to the patient and whether they could be detected in the carotid artery. METHODS: A total of 54 patients on chronic HD (16 with central dialysis catheter) were investigated with an ultrasound detector (Hatteland, Røyken, Norway) for the presence of microemboli at the arteriovenous (AV) fistula/graft and at the common carotid artery before and during HD. Measurements were taken for 2 and 5 min, respectively. Non-parametric paired statistics were used (Wilcoxon). RESULTS: The median number (range) and mean +/- SD of microembolic signals detected at the AV access site before commencing dialysis and during HD were 0 (0-3) and 0.2+/- 0.5 versus 4 (0-85) and 13.5 +/- 20 (P = 0.000); at the carotid artery, 1 (0-14) and 1.7 +/- 2.9 versus 2 (0-36) and 3.5 +/- 5.8 (P = 0.008). CONCLUSIONS: The infused and returning fluid from HD devices contains air microbubbles that enter the patient without triggering any alarms. These small emboli pass the lung and may cause ischaemic lesions in organs supported by the arterial circuit, such as the brain.
Authors:
Ulf Forsberg; Per Jonsson; Christofer Stegmayr; Bernd Stegmayr
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-19
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2691-5     Citation Subset:  IM    
Affiliation:
Medicin-Geriatriska Kliniken, Skelleftea lasarett, Lasarettsvagen 29, Skelleftea, Sweden. ulf.forsberg@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arteriovenous Shunt, Surgical
Brain Ischemia / epidemiology*
Carotid Arteries / physiology,  ultrasonography
Chronic Disease
Embolism, Air / complications*,  etiology
Female
Humans
Kidney Diseases / therapy*
Lung / blood supply*
Male
Microbubbles / adverse effects*
Middle Aged
Regional Blood Flow / physiology
Renal Dialysis / adverse effects*
Retrospective Studies
Risk Factors

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


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