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Digitale Medien

Sequential hypertonic haemodialysis in children (1988)

Fischbach, M. ; Tarral, E. ; Geisert, J.

Springer

Pediatric nephrology 2 (1988), S. 442-446

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ISSN: 1432-198X

Schlagwort(e): Sequential hypertonic dialysis ; Sodium-free water clearance ; Cellular compartment mobilization

Quelle: Springer Online Journal Archives 1860-2000

Thema: Medizin

Notizen: Abstract Sequential hypertonic dialysis (SHD) was studied in two binephrectomized children over a period of 6 weeks. Each dialysis session comprised four periods of 45 min. The concentration of sodium in the dialysate [Na(D)] during the first period was 190 mmol/l and during the second period 140 mmol/l. The sequence was then repeated. The sodium-free water clearance [C(ONa)] was calculated from the measurements of the ultrafiltrate clearance and of the sodium clearance. Despite the short periods of hypertonic dialysis, C(ONa) was positive, suggesting that water was removed from the intracellular compartment as well as from the extracellular fluid. The transfer of fluid from the intracellular space improved circulatory stability during rapid removal of large volumes of fluid by ultrafiltration. SHD was also associated with increased removal of potassium and phosphate. Comparison of clinical parameters before and during SHD showed a tendency towards increased sodium balance and the possibility of raised cardiovascular morbidity. SHD stabilized blood volume during ultrafiltration, encouraging removal of uraemic toxins. SHD with this levels of Na(D) is only a study dialysis method.

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1007/BF00853439

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Digitale Medien

Effect of posture on intraperitoneal pressure and peritoneal permeability in children (1998)

Fischbach, M. ; Terzic, J. ; Dangelser, C. ; [weitere]

Springer

Pediatric nephrology 12 (1998), S. 311-314

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ISSN: 1432-198X

Schlagwort(e): Key words: Posture ; Intraperitoneal pressure ; Peritoneal permeability ; Upright position ; Supine position

Quelle: Springer Online Journal Archives 1860-2000

Thema: Medizin

Notizen: Abstract. The posture of the patient influences both the intraperitoneal pressure (IPP) and the peritoneal permeability. We have studied the effects of the supine and the upright position in six children. Two peritoneal equilibration tests (PET) of 90-min dwell time each were performed consecutively, firstly in the supine position and then in the upright position. The same amount of dialysate was instilled (1,000 ml/m2; isotonic 1.36% dextrose) for each PET. Using the same filling volume, the IPP was significantly higher in the upright position (18.4±4.8 cm H2O) than in the supine position (8±2.4 cm H2O). The mean percentage IPP increase was 130%±35%. The decline in glucose resorption rate from the dialysate during the PET was significantly lower in the upright position. Despite this greater relative loss of osmotic gradient in the upright than the supine position, no significant difference in net ultrafiltration was noted after 90 min of dwell. The peritoneal equilibration ratio during the PET was lower in the upright than the supine position for urea, creatinine, and phosphate. These results favor performing peritoneal dialysis in a supine position, both to increase dialysis efficiency and to reduce patient discomfort.

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1007/s004670050460

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