To evaluate the extent and cause(s) of dialysis-related hypoxemia, we studied 10 patients, 7 days apart using acetate (AC) and bicarbonate dialysate (HCO3). We measured arterial blood gases, WBC, minute ventilation (VE) and inspired and expired gas concentrations and calculated the respiratory quotient (R) and the alveolar-arterial oxygen difference (A-a)DC·2 before and during hemodialysis. 8 patients developed hypoxemia. Arterial PO2 (PaO2) dropped similarly at 30 min from 93 ± 5 to 78 ± 6 (p 3, respectively. R and VE decreased during AC (p 2 during both AC (r = 0.68, p 3 (r = 0.76, p 2 also correlated with the fall in WBC count for both AC and HCO3 (r = 0.63, p 3 (up to 7.45 ± 0.01) was significantly greater than that during AC (up to 7.42 ± 0.01) (p E. We conclude that (1) HCO3 does not prevent hypoxemia, and (2) hypo ventilation V/Q abnormalities and increase in arterial pH, contribute variably to dialysis related hypoxemia depending on the type of dialysate and the time during d
展开▼
