7. Depending upon the level of contamination and the
specific contaminant, patients may have acute onset of
symptoms at the time of exposure or develop
symptoms over time, reflecting chronic exposure
Handbook of dialysis, Daugirdas, 5th edition, 2015
19. Early symptoms include:
headache, nausea,
disorientation, restlessness,
blurred vision, asterixis.
However, may progress to
confusion, seizures, coma, and
even death.
2008 Sep-Oct;21(5):493-8
20. 2016 Jan-Dec; 5: 2048004016677687
There is no diagnostic test
for DDS, and the diagnosis
is one of exclusion
CNS imaging
Electrolytes and Glucose
assessment
21. • Symptomatic R + Dialysis should be stopped if the
patient develops seizures, coma, and/or obtundation
• Patency of the airway should also be ensured
• Hypertonic solution !!
2017 Feb 7;12(2):357-369
22. For high risk: Slow urea removal
• Therapy can be initiated with two ho of dialysis
• Low blood flow ra 150 to 250 mL/min
• URR: 40%
• (0.9 to 1.2 m2)
• Hypertonic solution !!
2017 Feb 7;12(2):357-369
27. pp 151-158
• Nasal oxygen
• If the anginal episode is associated with
hypotension: elevating the feet and
cautiously administering saline
• Sublingual nitroglycerin can be given if
the blood pressure has increased to a
clinically acceptable value
• Blood flow rate should be reduced and
UF should be stopped until the anginal
episode subsides
• ECG
37. • Treatment of suspected air embolism includes clamping
the venous line and stopping the blood pump.
• The patient should be positioned on the left side, in a
supine position, with the chest and head tilted
downward.
• Cardiorespiratory support.
• Administration of 100 percent oxygen by either mask or
endotracheal tube.
• Attempted percutaneous aspiration of air from the
ventricle may be required.
50. The treatment of arrhythmias that occur in dialysis
patients, either during or between dialysis sessions,
is similar to their treatment in the nondialysis patient
However, appropriate dosing of medications based
upon the absence of renal function is always
required