Emergency surgery in patients on chronic hemodialysis.

概要

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Thirty-six patients on chronic hemodialysis underwent emergency surgical operations at the Dialysis Unit, Tokai University School of Medicine, from July, 1976 to December, 1988. During 1988 there were such cases. We discuss these nine cases and the results obtained were as follows: 1. In cases requiring emergency surgery the preoperative blood urea nitrogen and creatinine levels were significantly higher and the blood HCO3- levels were significantly lower than in those cases undergoing elective surgery. 2. Postoperative complications included hyperkalemia and pulmonary edema in one case, obstruction of the A-V fistula in one case and a minor leak after gastrectomy in one case. There were no deaths. 3. During surgery, Solita T1® was infused and postoperatively the intravenous infusions were mainly glucose solutions. Five of the nine cases had intravenous hyperalimentation. Measurments of central venous pressure were performed in five cases during surgery and in three cases postoperatively. 4. In eight of the nine cases, hemodialysis was performed the day after surgery. No heparin was used in three cases, and low dose heparin was used in five cases. There was no incidence of postoperative hemorrhage.The results of the present study indicate that emergency surgery can be safely performed in patients on chronic hemodialysis.
社団法人日本透析医学会の論文