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Phlebotomy for pulmonary edema in dialysis patients
A R Eiser1, J J Lieber, M S Neff
1Department of Ambulatory Care, Elmhurst Hospital Center, NY, USA.
Clinical Nephrology
|January 1, 1997
Summary
Phlebotomy effectively treated pulmonary edema in hemodialysis patients, often preventing intubation or emergent dialysis. This intervention improved clinical status and allowed for delayed subsequent dialysis treatments.
Area of Science:
- Nephrology
- Critical Care Medicine
- Cardiology
Background:
- Pulmonary edema is a serious complication in patients undergoing maintenance hemodialysis.
- End-stage renal disease (ESRD) patients are at high risk for fluid overload and associated respiratory distress.
Purpose of the Study:
- To evaluate the effectiveness of phlebotomy as a treatment for pulmonary edema in hemodialysis patients.
- To determine if phlebotomy can reduce the need for intubation or emergent dialysis.
Main Methods:
- A cohort of maintenance hemodialysis patients presenting with respiratory distress due to pulmonary edema was studied.
- Patients underwent phlebotomy, and outcomes including clinical response, blood pressure, hematocrit, and time to next dialysis were assessed.
Main Results:
- Seventeen out of twenty-one patients (81%) showed marked improvement after phlebotomy, avoiding intubation or emergent dialysis.
- The average time to the next hemodialysis treatment was significantly delayed.
- Hypertension was common at presentation, with blood pressure tending to normalize post-phlebotomy; transient hypotension occurred in a minority without lasting effects.
- All patients survived to hospital discharge.
Conclusions:
- Phlebotomy is a valuable therapeutic option for hemodialysis patients experiencing pulmonary edema.
- This procedure can frequently obviate the need for more invasive interventions like intubation or emergent dialysis.
- Phlebotomy offers a safe and effective means to manage fluid overload in ESRD patients with pulmonary edema.
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