Wolff J, Pedersen T, Rossen M, Rasmussen K
Department of Nephrology, Herlev Hospital, University of Copenhagen, Denmark.
Life Support Syst. 1985;3 Suppl 1:32-5.
The object of the present study was to assess the haemodynamic changes measured by impedance cardiography during acetate and bicarbonate dialysis in uraemic patients without cardiovascular diseases. It was demonstrated that the cardiac output increased significantly after 60 minutes during acetate dialysis compared with bicarbonate dialysis while the peripheral resistance decreased significantly during acetate dialysis. As estimated by the diastolic systolic pressure time index ratio myocardial perfusion fell significantly following acetate dialysis as compared to bicarbonate dialysis. It is concluded that the work of the heart increases during acetate dialysis. This involves risk of myocardial hypoperfusion. It is therefore recommended that bicarbonate dialysis is the choice for patients with unstable circulation and/or ischaemic heart disease.
本研究的目的是评估在无心血管疾病的尿毒症患者中，通过阻抗心动描记法测量的醋酸盐和碳酸氢盐透析期间的血流动力学变化。结果表明，与碳酸氢盐透析相比，醋酸盐透析60分钟后心输出量显著增加，而醋酸盐透析期间外周阻力显著降低。根据舒张期收缩压时间指数比值估计，与碳酸氢盐透析相比，醋酸盐透析后心肌灌注显著下降。得出的结论是，醋酸盐透析期间心脏的工作负荷增加。这涉及心肌灌注不足的风险。因此，建议对于循环不稳定和/或患有缺血性心脏病的患者，选择碳酸氢盐透析。
