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      Intradialytic Hypercapnic Respiratory Failure Managed by Noninvasive Assisted Ventilation

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          We report a hemodialysis patient with acute hypercapnic respiratory failure managed on noninvasive intermittent positive pressure ventilation and progressive metabolic acidosis. Dialysate bicarbonate concentration of 25 mEq/l was associated with exacerbation of metabolic acidosis, while higher dialysate bicarbonate concentration of 30 mEq/l induced a dangerous increase in PCO<sub>2</sub> level. Excessive bicarbonate buffering and CO<sub>2</sub> production induced by severe metabolic acidosis, malnourishment and tissue hypoxia, could explain inadequate correction of metabolic acidosis and worsening of hypercapnia in this patient. Our findings suggest the need for close monitoring of blood gases and cautious modulation of dialysate bicarbonate concentration in the presence of progressive metabolic acidosis in hypercapnic hemodialysis patients.

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          Effect of oxygen on breathing irregularities during haemodialysis in patients with chronic uraemia


            Author and article information

            Am J Nephrol
            American Journal of Nephrology
            S. Karger AG
            October 2001
            19 October 2001
            : 21
            : 5
            : 383-385
            Departments of aNephrology, bInternal Medicine, cUrology and dPulmonology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
            46279 Am J Nephrol 2001;21:383–385
            © 2001 S. Karger AG, Basel

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            Figures: 1, References: 15, Pages: 3
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            Clinical Study


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