Acetate-free Biofiltration for the Prevention of Intradialytic Hypеrcapnia in a Patient with Limited Pulmonary Reserve
DOI:
https://doi.org/10.22141/2307-1257.0.4.14.2015.74906Keywords:
respiratory acidosis, hypercapnia, bicarbonate hemodialysis, acetate-free biofiltrationAbstract
A case of acute hypercapnia occurring during a session of bicarbonate hemodialysis is reported. The 82-year old female patient was affected by cardiac insufficiency, pulmonary hypertension and chronic obstructive lung disease. She developed acute symptomatic respiratory acidosis immediately after the beginning of a bicarbonate hemodialysis session, with arterial pH of 7.25 and paCO2 of 48.1 mmHg. This was related to the well known, but frequently forgotten, CO2 load from bicarbonate-based dialysate.
We treated her with acetate-free biofiltration, with stable paCO2 throughout the session. Physiopathology of blood gas dynamics during hemodialysis is reviewed.
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Copyright (c) 2015 Laura Di Leo, Maria Luisa Querques, Chiara Brunati, Mara Cabibbe, Alberto Menegotto, Alberto Montoli, Giacomo Colussi
This work is licensed under a Creative Commons Attribution 4.0 International License.
ISSN 2307-1257
ISSN 2307-1265
