Maggiore Q, Pizzarelli F, Zoccali C, Sisca S, Nicolò F
Int J Artif Organs. 1985 Jul;8(4):175-8.
We tested the hypothesis that differing temperature (T) changes in extracorporeal blood circuit might partly account for the difference in vascular stability (VS) between isolated ultrafiltration (UF) and simultaneous UF-hemodialysis (HD). The study was carried out in 6 patients who presented frequent episodes of symptomatic hypotension during the routine dialytic sessions. During simultaneous UF-HD with dialysate T set at 37.5 degrees C (standard HD), blood reentered the patients with a T of about 2 degrees C higher, whereas during isolated UF (standard UF) 2 degrees C lower, than at its exit. These extracorporeal blood T changes were reciprocated by warming the venous line in isolated UF (warm UF) and by setting the dialysate at 34.5 degrees C in simultaneous UF-HD (cold HD). During warm UF mean arterial pressure (MAP) fell and heart rate (HR) increased nearly as much as during standard HD. Vice versa, during cold HD MAP and HR remained nearly as stable as during standard UF. It is concluded that the T changes in blood flowing through the extracorporeal circuit largely account for the differing VS between isolated UF and simultaneous UF-HD.
我们检验了这样一个假设，即体外血液回路中不同的温度（T）变化可能部分解释了单纯超滤（UF）和同步超滤-血液透析（HD）之间血管稳定性（VS）的差异。该研究在6例在常规透析期间频繁出现症状性低血压发作的患者中进行。在将透析液温度设定为37.5摄氏度的同步UF-HD（标准HD）过程中，血液回流到患者体内时的温度比其流出时高约2摄氏度，而在单纯超滤（标准UF）过程中则低2摄氏度。通过在单纯超滤（温热UF）中加热静脉管路以及在同步UF-HD中将透析液温度设定为34.5摄氏度（低温HD），体外血液温度的这些变化得以逆转。在温热UF期间，平均动脉压（MAP）下降，心率（HR）升高，幅度几乎与标准HD期间相同。反之，在低温HD期间，MAP和HR与标准UF期间一样几乎保持稳定。得出的结论是，流经体外回路的血液温度变化在很大程度上解释了单纯超滤和同步UF-HD之间不同的VS。
