Hirszel P, Maher J F, Tempel G E, Mengel C E
Nephron. 1975;15(6):438-43. doi: 10.1159/000180527.
To determine the effect of changing concentrations of uremic metabolites on factors affecting oxygen transport, without the effects of extracorporeal blood pumping, we studied five patients before, during and after peritoneal dialysis. Significant decreases in serum urea, creatinine and phosphate and increase in serum bicarbonate were not associated with changes in P50, a reflection of hemoglobin-oxygen affinity. High erythrocyte 2,3-DPG concentrations decreased only slightly. Arterial pO2 increased slightly as negative fluid balance was achieved. The slight changes in oxygen transport parameters with dialysis suggest an interplay of compensatory factors and do not warrant modifying dialysis to limit the correction on acidosis or hyperphosphatemia. Effects on hemoglobin and pO2 resulting from fluid loss can be the dominant influence of peritoneal dialysis on tissue oxygenation.
为了在不考虑体外血液泵影响的情况下，确定尿毒症代谢产物浓度变化对影响氧运输的因素的作用，我们研究了5例患者在腹膜透析前、透析期间和透析后的情况。血清尿素、肌酐和磷酸盐显著降低，血清碳酸氢盐升高，但这与反映血红蛋白-氧亲和力的P50变化无关。高浓度的红细胞2,3-二磷酸甘油酸（2,3-DPG）仅略有下降。随着负液体平衡的实现，动脉血氧分压（pO2）略有升高。透析时氧运输参数的轻微变化提示了代偿因素的相互作用，因此没有必要调整透析以限制对酸中毒或高磷血症的纠正。液体丢失对血红蛋白和pO2的影响可能是腹膜透析对组织氧合的主要影响。
