[Neurosurgical management of dialyzed patients]
| Autor: | Ryoichi Ohtsuka, Yasushi Itoh, Yasuo Suzuki, Kazuhiro Hirano, Ryoji Ishii, Hiroshi Hirano, Masahisa Kikuoka, Gengo Ohsawa |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Adult
Glycerol Male medicine.medical_specialty medicine.medical_treatment Peritonitis Ultrafiltration Extracorporeal Peritoneal dialysis Peritoneal Dialysis Continuous Ambulatory Renal Dialysis medicine Humans Dialysis Intracranial pressure Aged business.industry Continuous ambulatory peritoneal dialysis Osmolar Concentration Middle Aged medicine.disease Surgery Cerebrovascular Disorders Kidney Failure Chronic Neurology (clinical) Hemodialysis business Complication |
| Zdroj: | Neurologia medico-chirurgica. 31(13) |
| ISSN: | 0470-8105 |
| Popis: | Cerebrovascular disease is a lethal complication for patients with renal failure because of the hemostatic disturbance and equivocality about management of the central nervous system. Appropriate management of the renal failure in neurosurgical patients was considered on the basis of experience. Hemodialysis (HD), which is the most common dialysis method, has a serious disadvantage: the elevation of intracranial pressure during dialysis due to the “disequilibrium syndrome.” It is important to stabilize the serum osmolarity during dialysis in order to prevent the disequilibrium syndrome. From this point of view, continuous ambulatory peritoneal dialysis (CAPD) has great advantages; serum osmolarity is not rapidly changed and no anticoagulants are required during dialysis. CAPD is recommended as the first method of choice in neurosurgical management of renal failure patients. However, if a patient has to be maintained with HD because of a history of laparotomy or peritonitis, it is essential to keep the serum osmolarity as stable as possible using the extracorporeal ultrafiltration method, hypernatremic HD, bicarbonate HD, and intravenous administration of glycerol. |
| Databáze: | OpenAIRE |
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