[Arterio-venous fistula of the Brescii type as a cause of circulatory failure in hemodialysed and dialysed patients with chronic renal failure].
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Biomedical subjects
Publications and source records attributed to M Wanic-Kossowska.
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In the uraemic patient regularly treated with peritoneal dialyses occurring peritonitis caused a decrease of ultrafiltration and transfer abilities of the peritoneum. Other symptoms dangerous for life also appeared: uraemic pericarditis and significant overhydration. Peritoneal dialyses lost its effectiveness. Therefore they were supplemented by arterio-venous haemofiltration. Haemofiltration was also conducted at the beginning of haemodialysis treatment, which was initially unregular. Application of haemofiltration enabled the patient to survive during the time of waiting for regular haemodialyses. It may be useful to consider such a treatment, when the adequacy of proper renal substitutive management of uraemia by other methods is impossible to obtain.
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In 20 patients with chronic renal failure on a hemodialysis (HD) programme with a cuprophane membrane and acetate-containing dialysis fluid, gasometric parameters, ventilation disturbances and peripheral blood leucocyte count were determined. A significant fall was observed of the arterial blood oxygen pressure persisting during the first hour of HD, which was parallelled by a fall of the leucocyte count. The loss of CO2 in the dialysate is attributed the major cause of hypoxemia due to alveolar hypoventilation. In 18 patients we observed a ventilation disturbances of restrictive type which were demonstrated with decreased vital capacity (VC), reduced maximal breathing capacity (MBC), increased residual volume (RV) and lower one-second forced expiratory volume (FEV1).