Kr. Burgess et al., IMPAIRED VENTILATORY RESPONSE TO CARBON-DIOXIDE IN PATIENTS WITH CHRONIC-RENAL-FAILURE - IMPLICATIONS FOR THE INTENSIVE-CARE UNIT, Critical care medicine, 22(3), 1994, pp. 413-419
Objectives: To compare aspects of ventilatory control and the suscepti
bility to depressant drugs between patients with chronic renal failure
and normal volunteers. Design: Prospective, controlled study. Setting
: Pulmonary function laboratory of a university hospital. Patients: Si
x patients with chronic renal failure requiring hemodialysis and ten n
ormal, control subjects. Interventions: Ventilatory responses to breat
hing CO2 were studied using a rebreathing method The effects of triazo
lam (0.5 mg orally) and meperidine (1 mg/kg, subcutaneously) on these
measurements were also studied. Measurements and Main Results: Dialysi
s patients showed definite impairment in the ventilatory response to C
O2, which could not be accounted for by differences in respiratory mec
hanics, muscle strength, or acid-base status. Meperidine impaired vent
ilatory responses in control subjects and in renal patients, while tri
azolam had little effect on either group. The effect of the drugs was
not proportionately greater in dialysis patients than in control subje
cts. Conclusions: Chronic renal failure results in a poorly responsive
ventilatory control system, which may make renal failure patients mor
e difficult to wean from mechanical ventilation. Theoretically, these
patients may be more vulnerable to disturbances in blood gas homeostas
is and subsequent respiratory arrest than other patients in an unmonit
ored environment.