Morris AT, Schneditz D, Fan Z, Kaufman AM, Levin NW
Dialysate temperature is not the sole determinant of
extracorporeal blood cooling during hemodialysis
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1414 1996
It is now well established that changes in blood temperature in the
extracorporeal circuit during dialysis contributes to hemodynamic
stability. Last year at ASN, important new information was added, in
that hemodynamic benefits conferred were shown by Fine et al to
depend on the patient's predialysis body temperature. Now in this
abstract, Morris et al show that the thermal effects of a given
dialysate temperature depend to a large extent on the blood flow rate.
Other factors known to be important are environmental temperature, and
the insulating properties of the dialysis blood lines.
This abstract was simply a mathemical analysis of these effects, which
showed that using a 37 degree dialysate temperature with low blood
flow rate could lead to some degree of cooling, whereas the same
temperature can lead to warming at high blood flow rates.
Comment: What is interesting is the blood temperature control
module that will soon be available in Fresenius machines. This module
can be used to adjust heat balance in patients during dialysis, and
will theoretically compensate for many of the factors identified
above. The extent to which use of such new technology will
meaningfully improve hemodynamic stability and limit side effects
(shivering, discomfort, etc.) remains to be determined. (John T.
Daugirdas, M.D., University of IL at Chicago)
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Am Soc Nephrol
Basic hemodialysis :
Complications (acute)
Basic hemodialysis :
Dialysis machines