Each dialysis or hemodialysis process occurred within a few hours after the end of dialysis itself with related complications.
1. Disequilibrium syndrome
Common in blood urea nitrogen and high levels of muscle liver, symptoms of uremia Obviously patients, especially common in dialysis and dialysis initial induction period. The main reason is mainly through urea after some of the substances in the blood and brain tissue between the distribution is uneven, unbalanced PH value plus cause cerebral edema and cerebral anoxia, performance and transparency through the headache, fatigue, malaise , nausea, vomiting, increased blood pressure, sleep disorders, severe cases may have psychosis, epileptic seizures, coma and even death.
2. Hypotension
The most common complication of hemodialysis. Causes including effective hypovolemia, ultrafiltration too much too fast, autonomic neuropathy, vasoconstriction decreases atrial natriuretic peptide levels are too high and the impact of antihypertensive drugs. Manifested as dizziness, pale, sweating, amaurosis, nausea, vomiting, muscle cramps and even loss of consciousness. Treatment is quick to add volume, while slowing blood flow, reduce or suspend ultrafiltration. Preventive measures include pre-filled dialyzer, blood flow gradually from small to large, using sequential dialysis or high sodium dialysis and instruct patient to control the increase in body weight between dialysis to reduce the amount of ultrafiltration.
3.Hypoxemia
More common in acetate dialysis, its causes and acetate metabolism in the body and lower blood CO2 and HCO3-concentration. Dialysis membrane biocompatibility differences can lead to pulmonary capillary leukocyte aggregation affect ventilatory function, but also produces an important cause of hypoxemia. Clinical manifestations are not obvious, the original heart and lung disease patients or the elderly may be symptoms of hypoxia, or even induced angina and myocardial infarction. Nasal cannula treatment I can. Preventive measures include: Use dialysate bicarbonate dialysis using good biocompatibility.
4. Arrhythmia
Often caused by a hypokalemia, hypokalemia mostly because of relapse or non-use of potassium potassium dialysate. Hemolysis can produce hyperkalemia and induce arrhythmia, but quite rare. Predialysis patients with digitalis drugs in serum potassium concentrations decreased as dialysis and pH fluctuations can occur digitalis intoxication induced arrhythmias. Prevention measures include: potassium diet foods to avoid predialysis hyperkalemia, severe restrictions dialysis patients digitalis drug use, and the use of potassium> 3.0 mm ol / L dialysate. Arrhythmia may be used when antiarrhythmic drugs, but need to adjust the dose according to the situation of drug metabolism.
5. Pericardial tamponade
Hemodialysis and shortly after penetration occurs mostly hemorrhagic pericardial tamponade, often on the basis of the original uremic pericarditis caused due to the application of heparin pericardial bleeding. Clinical manifestations: ① blood pressure were decreased, with signs of shock; ② jugular vein distention, hepatomegaly, odd pulse, central venous pressure increased; ③ heart community to expand, distant heart sounds; ④ B-see large amounts of pericardial effusions. Treatment measures: dialysis occurred should immediately stop dialysis to protamine and heparin, and closely observed fluctuations. Tamponade severe symptoms may be pericardiocentesis direct surgical decompression or drainage decompression. Preventive measures uremic pericarditis is suspected patients, especially precordial pericardial friction sound heard and patients, the use of low molecular weight heparin or no heparin dialysis.
6. Hemolysis
More from dialysate disorders and dialysis machine malfunction caused if the dialysate permeability, temperature, chlorine and chloramines or nitrate content is too high, the other also found abnormal blood transfusion, disinfectant residues. Acute hemolysis occurs when the patient back to the blood vein pain, chest tightness, palpitations, shortness of breath, irritability, may be associated with severe back pain and abdominal cramps, severe chills, chills, decreased blood pressure, cardiac arrhythmia, blood-red urine protein and even coma. Hypotonic dialysate caused by water intoxication can occur simultaneously or cerebral edema. Small and slow performance of hemolytic anemia will only increase.
7. Air Embolism
Due to the dialysis machine has perfect control measures, air embolism rarely occurs, and more from operational errors or pipeline damage caused.
Over time into 5ml air embolism can cause obvious symptoms, the main cause of cerebral embolism when sitting, lying is a major cause of pulmonary hypertension and acute left ventricular failure, also can occur coronary thrombosis or cerebral embolism, physical examination, smell and heart stirring sounds.
