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      Beneficial Effect of Cold Dialysate for the Prevention of Hemodialysis-lnduced Hypoxia

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          Abstract

          Hypoxia occurs frequently during routine hemodialysis (HD). In this study the effect of dialysate temperature on arterial blood gas parameters was investigated. Ten stable HD patients (2 smokers) were dialyzed for 240 min with each of three different dialysate temperatures: 36.5°C (normal temperature HD; NHD), 38.5 °C (warm HD; WHD) and 34.5 °C (cold HD; CHD). A cuprophane plate dialyzer was used. The ultrafiltration volume was identical in each patient. Arterial blood gas samples were frequently (-10 times/treatment) taken during the dialysis and immediately analyzed.The dialysate temperature significantly affected PaO<sub>2</sub> (p < 0.001) but not PaCO<sub>2</sub>. We also compared the effect of NHD with that of WHD and CHD, respectively, as regards PaO<sub>2</sub>. NHD and WHD differed significantly (p < 0.01), whereas NHD and CHD were not significantly different. However, the relative PaO<sub>2</sub> value (% of the baseline value) at the end of CHD(105 ± 5%) was significantly higher than after both NHD (96 ± 4%, p < 0.01) and WHD (91 ± 3%, p < 0.01). In the case of NHD and WHD the fraction of time during which the patients had a PaO<sub>2 </sub>value below 80 mm Hg was 62 and 64%, respectively. The corresponding figure for CHD was 44%. Arterial oxygen saturation (SaO<sub>2</sub>) increased during CHD from 95.2 ± 0.6 to 96.7 ± 0.6% (p < 0.05), while SaO<sub>2</sub> was unchanged during NHD and WHD. The positive effect of CHD was evident in 7 patients. In 1 patient PaO<sub>2</sub> was not affected by the dialysate temperature, while in the remaining 2 patients (smokers) a decrease in PaO<sub>2</sub> was induced by WHD as well as CHD. A separate statistical analysis with the 2 smokers excluded was performed, which showed that the dialysate temperature significantly affected PaO<sub>2</sub> (p < 0.001). A comparison between NHD and CHD showed a significant difference (p < 0.001), whereas NHD and WHD did not differ significantly. When the 2 smokers were excluded from the analysis the fraction of time with a PaO<sub>2</sub> value below 80 mm Hg was 60% during NHD and 56% during WHD, but it was reduced to 31 % during CHD. In conclusion, despite the existence of interindividual variations most patients seemed to benefit from cold dialysate for the prevention of dialysis-induced hypoxia.

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          Author and article information

          Journal
          BPU
          Blood Purif
          10.1159/issn.0253-5068
          Blood Purification
          S. Karger AG
          0253-5068
          1421-9735
          1997
          1997
          30 October 2008
          : 15
          : 1
          : 15-24
          Affiliations
          Departments of aNephrology, and b Anesthesiology and Intensive Care, University Hospital, and cDepartment of Medical Research, Gambro AB, and d Perstorp Pharma, Ideon, Lund, Sweden, eDepartment of Nephrology, University Hospital, Hvidovre, Denmark
          Article
          170313 Blood Purif 1997;15:15–24
          10.1159/000170313
          9096903
          b8701236-97f8-4851-8466-0081a43fb501
          © 1997 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 18 December 1995
          Page count
          Pages: 10
          Categories
          Original Paper

          Cardiovascular Medicine,Nephrology
          Dialysate temperature,Cold dialysate,Hypoxia,Oxygen tension,Hemodialysis

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