Robinson P J, Rosen S M
Br Med J. 1971 Mar 6;1(5748):528-30. doi: 10.1136/bmj.1.5748.528.
The characteristics, circumstances, and treatment of 450 pyrexial reactions occurring in 468 patient-months over a period of two and a half years, using a warm single-pass Kiil system, were studied. There is a wide variation in severity of symptoms and morbidity. The incidence of pyrexial reactions has an epidemic pattern within the hospital unit. Patients on dialysis at home have reactions much less often than patients in hospital.Blood cultures taken from patients during each of the 450 reactions showed a growth on 38 occasions, but this was not significantly different from the incidence of positive cultures taken simultaneously from control patients during haemodialysis. Reactions were not correlated with bacterial growth from the blood compartment of the kidney before dialysis. There was no difference in incidence of reactions when using different types of equipment which were either a central tank distribution system with bedside monitors or chemically- or heat-sterilized individual proportioning pump systems. Reactions were also noted with the disposable coil kidney and recirculating single-pass (R.S.P.) system, but presented different features from those of the Kiil kidney.The incidence of reactions was not related to the albuminoid nitrogen content of the water supply. Reactions were not abolished by deionization of the tap-water.
对在两年半时间内使用温暖的单程基尔系统的468个患者月中发生的450次发热反应的特征、情况及治疗进行了研究。症状严重程度和发病率差异很大。发热反应的发生率在医院病房内呈流行模式。在家透析的患者比住院患者发生反应的频率低得多。在450次反应中的每次反应期间从患者身上采集的血培养物有38次显示有细菌生长，但这与血液透析期间同时从对照患者身上采集的阳性培养物的发生率没有显著差异。反应与透析前肾脏血液腔室中的细菌生长无关。使用不同类型设备时反应发生率没有差异，这些设备包括带有床边监测器的中央水箱分配系统或化学或热消毒的个体配比泵系统。使用一次性盘管肾和再循环单程（R.S.P.）系统时也观察到了反应，但呈现出与基尔肾不同的特征。反应发生率与供水的白蛋白氮含量无关。自来水去离子并不能消除反应。
