Hypoxemia in patients undergoing first hemodialysis procedure with respect to different clinical and biochemical parameters

Abstract

Introduction: During hemodialysis, PaO₂ falls about 10-20 mmHg. In seriously ill patients with pre-dialysis hypoxemia, the drop in PaO₂ can be catastrophic. Hypoxemia and fall in PaO₂ do occur during hemodialysis and hence we looked to ascertain the clinical, physiological and biochemical parameters which predisposes such events. Secondly, does it develop post hemodialysis and finally its outcome in patients with hypoxemia? Methods: A hospital based study was conducted on 120 patients undergoing hemodialysis for first time to know the incidence of hypoxia and its correlation with physiological and biochemical parameters, during and six hours post hemodialysis and their clinical significance in terms of morbidity and mortality. Patients with SpO₂ >95% and not on oxygen support were enrolled in the study. Clinical status of patients general condition and biochemical parameters were measured as outcome. Results: Study showed that hypoxia (SpO₂ 90%) was the most common complication (22.5%) occurring during and post hemodialysis period of which 55% occurred post hemodialysis in a patient undergoing first dialysis. 27.5% patients had significant fall in PaO₂>25% following hemodialysis. Hypoxia during hemodialysis (especially post dialysis period) was associated with unfavorable outcome mainly due to increased cardiovascular risk in diabetic nephropathy patients and due to multiple organ failure in septicemic patients.