Hypopnea Associated with Acetate Hemodialysis: Carbon Dioxide-Flow-Dependent Ventilation

Abstract

IN patients with chronic renal failure who are undergoing hemodialysis, arterial oxygen tension (PaO2) falls when a dialysis solution containing acetate is used.1 2 3 4 It has been suggested that hypoxemia results from altered pulmonary ventilation-perfusion ratios in the lung that are consequent to pulmonary sequestration of neutrophils.3 4 5 However, Aurigemma1 and Tolchin2 and their colleagues have proposed that the major cause of the reduced PaO2 is a reduction in carbon dioxide output at the lungs, as a consequence of the carbon dioxide loss through the dialysis bath that leads to reduced ventilation. Such a reduction in ventilation has been . . .