Issue |
J Extra Corpor Technol
Volume 14, Number 5, October 1982
|
|
---|---|---|
Page(s) | 424 - 427 | |
DOI | https://doi.org/10.1051/ject/1982145424 | |
Published online | 19 September 2023 |
Case report
Renal Dialysis during Coronary Artery Revascularization: A Case Study
The Tucson Heart Institute School of Perfusion, Tucson, Arizona 85712
* Address communications and requests for reprints to: Daryl Kirby, S,C,P, Tucson Heart Institute, 5200 E. Grant Road, Suite 612, Tucson, AZ 85712
Received:
1
May
1982
Revised:
August
1982
Accepted:
5
September
1982
A diabetic, uremic patient maintained on chronic hemodialysis underwent coronary artery revascularization with successful intraoperative dialysis. A portable sorbent dialyzer and hollow fiber artificial kidney were used in conjunction with the extracorporeal heart pump and oxygenator to dialyze the patient's blood during cardiopulmonary bypass. Conservative fluid management and use of isotonic solution with dialyzable solutes prevented fluid imbalances. Cold cardioplegia without potassium combined with core hypothermia (26°C) protected the myocardium while minimizing the risk of hyperkalemia. Alterations in the serum potassium level were adjusted with changes in the infusate bath of the dialyzer during bypass-dialysis. Intraoperative dialysis in this case optimized chemistries and fluid balance and prevented the hazards of hemodialysis during the immediate post-operative period when bleeding and hypotension could limit effectiveness and jeopardize the patient's condition.
© 1982 AMSECT
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