Respiratory Drive and Pulmonary Mechanics During Haemodialysis with Ultrafiltration in Ventilated Patients

SUMMARY The improvements of respiratory drive and pulmonary mechanics which follow haemodialysis with ultrafiltration inmechanically ventilated renal failure patients seem predictable but have not been studied before. In this study, 14 renal failure patients with stable haemodynamics mechanically ventilated with pressure supportventilation (PSV) were enrolled. Respiratory drive (represented as P0.1), pulmonary mechanics, breathing pattern,arterial blood gas and haemodynamics were measured according to the time schedule: pre-dialysis (Time 0), and at60, 120, 180, 240 minutes thereafter. Following the removal of excess lung water during haemodialysis, auto-PEEP and patient’s work of breathing(WOBp) decreased gradually. P0.1 lessened progressively along with the improvement in pulmonary mechanics. Thechanges in auto-PEEP and WOBp correlated closely to the pre- and post-dialysis decline of P0.1 ( ∆ P0.1). There wasa negative, moderately significant correlation between the amount of fluid ultrafiltrated during dialysis (