Haemodialysis in paracetamol self-poisoning.
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Biomedical subjects
Publications and source records attributed to D N Kerr.
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The use of a presterilized, disposable, mesh-supported membrane envelope in the Watson Marlow Kiil dialyser results in a 12% improvement in urea and creatinine clearance. Priming volume, uptake volume, and ultrafiltration rate are unchanged. Residual blood volume remains small. Blood flow resistance is increased. The envelope therefore offers considerable advantages over conventional assembly for dialysis with a blood pump.
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Two fatal and five non-fatal episodes of air embolism occurred in the course of 14,000 haemodialyses. Air entered the circuit through the infusion bottle, the heparin syringe or line, or the blood pump insert. Emergency treatment with posture, oxygen, dextran infusion, and dexamethasone was apparently successful in reversing some of the manifestations. Prevention depends partly on better design of equipment and partly on the incorporation in the haemodialysis circuit of devices which detect air and prevent it from reaching the patient. Such monitors are not in general use in the United Kingdom and those currently available are far from infallible. We describe an alternative system incorporating a floating valve in the bubble trap.
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