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Red Blood Cell Damage from Extracorporeal Circulation in Hemodialysis
Author(s) -
Polaschegg HansDietrich
Publication year - 2009
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2009.00616.x
Subject(s) - medicine , hemolysis , extracorporeal circulation , hematocrit , cannula , extracorporeal , hemodialysis , dialysis , catheter , erythropoietin , surgery , anesthesia , intensive care medicine
Abstract Blood damage is an unavoidable side effect of extracorporeal circulation. The effects of blood damage on patients’ hematocrit and erythropoietin requirement as well as other potential side effects have not been studied for uneventful treatments. Comparing long nocturnal dialysis with regular 4‐hour, three times per week dialysis allows for the conclusion that the influence of blood damage caused by extracorporeal circulation is small compared with biochemical effects. Acute hemolysis is one of the few remaining mechanical problems of dialysis. Acute hemolysis is caused by obstructions within the extracorporeal circuit caused by manufacturing errors, kinking of blood tubing or user errors, or by a combination of excessive flow and improper cannula or catheter dimensions. The risk of acute hemolysis can be further reduced by industrial quality control, better design of dialysis equipment, and hemodialysis machine control. Adverse effects caused by chronic mechanical hemolysis need to be studied.