慈大式人工腎臓の研究 第5報: 人工腎臓装用時に於ける循環系変化について

三木, 信男

The author carried out a series of animal expe r iments to study influences upon the circulatory system during application of the Jikei Electro-Dialyzer. Six n ormal dogs and eleven bilaterally nephrec t omized dogs were hemodialized for two hours and changes on the electrocardiographic tracings were observed. Two n ephrectomized dogs were utilized to study cardiac outpu t and a normal dog was utilized to study cardiac out-put, pulmonary arterial pressure, pulmonary capillary pressure and right intracardiac pressure by means of the right cardiac catheterization. One normal dog and three nephrectomized dogs were sacrificed imm ediately after hemodialysis to study histopathological changes. The results obtained are summarize d as follows. 1) The changes on the EKG : The prolon g ation of R-R distance and the decrease in hight of R-spike are observed in majority of the cases in both normal and nephrectomized dogs. It is thought that these changes are most likely caused by the changes of the hemodinamics during hemodialysis. However, the changes of the T-wave are almost accorded with the changes of the serum potassium concentration and are considered to be caused by the changes of the serum electrolyte balance. The appearance and disappearance of arrhythmia are o b served to be accompanied by the changes of the serum electrolyte in some instances. However, such hemodinamic factors as increase of the blood flow or the ventricular automaty following application of hemodializer should be considered as a probable cause of the arrhythmia. 2) The right cardiac catheterization : There are no fixed tend e n cy as for the changes of the cardiac output before and after hemodialysis. In some cases it is observed to be increased but in some other cases decreased. A tendency of elevation of pulmonary arterial pressure, pulmonary capillary pressure and right intracardiac pressure are observed in the first 60 minuts of the hemodialysis. 3) Histopathological changes : A s l i ght degree of vascular dilatation and congestion are seep in the liver and spleen. There are po remarkable histological changes in the lungs and kidneys. In conc l usion, I think it is reasonable to say that the performance of hemodialysis with the Jikei Electro-Dialyzer for two hours duration with the blood flow rate of 50cci does not offer any serious changes on the circulatory system.

慈大式人工腎臓の研究第5報: 人工腎臓装用時に於ける循環系変化について

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