Acute Effects of Intermittent Hemodialysis and Sustained Low-Efficiency Hemodialysis (SLED) on the Pulmonary Function of Patients under Mechanical Ventilation

• Published in: Renal failure Vol. 29; no. 3; pp. 341 - 345
• Main Authors: Steinhorst, Renata Campos, Vieira, José Mauro, Abdulkader, Regina C.R.M.
• Format: Journal Article
• Language: English
• Published: Colchester Informa UK Ltd 2007; Taylor & Francis
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - physiopathology; Acute Kidney Injury - therapy; Adolescent; Adult; Aged; Airway Resistance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; APACHE; Biological and medical sciences; Biomarkers - blood; Emergency and intensive care: renal failure. Dialysis management; Female; Humans; ICU; Intensive care medicine; Intensive Care Units; intermittent hemodialysis; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Lung - physiopathology; Lung Compliance; Male; mechanical ventilation; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Prospective Studies; pulmonary function; Pulmonary Ventilation; Renal Dialysis - adverse effects; Renal Dialysis - instrumentation; Renal Dialysis - methods; Renal failure; Respiration, Artificial; Respiratory Physiological Phenomena; sustained low efficiency dialysis; Time Factors; Treatment Outcome; Kidney disease; Human; Nephrology; Urinary system disease; sustained low efficiency dialysis; Hemodialysis; Acute; pulmonary function; Intensive care unit; Extrarenal dialysis; intermittent hemodialysis; Lung function; Efficiency; Low; Intermittent; Renal failure; Anesthesia; Dialysis; ICU; Mechanical ventilation; Resuscitation
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/08860220701389922

The effects of hemodialysis (HD) on pulmonary function are still controversial. The objective of this study was to evaluate the effect of intermittent hemodialysis (IHD) and sustained low-efficiency dialysis (SLED) on the respiratory mechanics of ICU patients under invasive mechanical ventilation. We prospectively studied 31 patients. Laboratory and respiratory evaluation (static and dynamic compliance and resistance) was performed pre- and post-HD. Forty HD sessions were studied and grouped in: SLED (n = 17; Qa = 200-250 mL min, Qd = 300 mL min) and IHD (n = 23; Qa = 250-300 mL min, Qd = 500 mL min). There was no difference between the groups according to age, gender, comorbidities, APACHE II, and cause of mechanical ventilation, but pre-HD, patients in the IHD group had higher levels of plasma creatinine (5.4 ± 2.0 vs. 4.2 ± 1.3 mg dL, p = 0.048) and platelets (286 ± 186 vs. 174 ± 95 103 mm2, p = 0.032) and lower arterial pH (7.37 ± 0.07 vs. 7.42 ± 0.05, p = 0.02). The efficiency of the treatment was similar (p > 0.05) with both types of HD regarding fluid removal, urea reduction rate, and decrease in plasma creatinine. Pre-HD, the ventilatory conditions of both groups were similar (p > 0.05) except for pressure support ventilation and airflow resistance. There were no changes (pre- versus post-HD p > 0.05) induced either by IHD or SLED in the ratio PaO2 FiO2 or in any measured ventilatory parameter. In conclusion, neither IHD nor SLED modifies the pulmonary function of patients under mechanical ventilation.