Pediatric Dialysis Imbalance Syndrome
Introduction
Introduction to dialysis imbalance syndrome in children Dialysis disequilibrium syndrome (also known as imbalance syndrome) is a syndrome that affects cells after hemodialysis (usually only refers to artificial kidney dialysis) due to the correction of body fluid volume and chemical osmotic balance due to effective dialysis. The balance of internal and external osmotic pressure, and thus caused a series of syndromes that are not directly related to renal failure itself. basic knowledge The proportion of sickness: 0.01% Susceptible people: children Mode of infection: non-infectious Complications: coma, children's convulsions
Cause
Pediatric dialysis imbalance syndrome etiology
(1) Causes of the disease
Dialysis imbalance syndrome is a special iatrogenic disease.
(two) pathogenesis
Gililand et al. (1963) and Sitprija et al. (1964) conducted a multi-faceted study on the etiology from different perspectives such as EEG and intracranial pressure changes and animal experiments. The disease is considered to be a special iatrogenic disease. The etiology of the disease has not been finalized, and the claim that electrolyte imbalance has been induced after dialysis has not been confirmed.
Prevention
Pediatric dialysis imbalance prevention
Improve vigilance, strengthen monitoring, especially for multiple dialysis patients, it is necessary to strengthen the sense of responsibility and prevent the occurrence of this disease.
Complication
Pediatric dialysis imbalance syndrome complications Complications, coma, convulsions
During the manual dialysis correction, convulsions, coma, increased intracranial pressure, and even death occurred.
Symptom
Symptoms of dialysis imbalance syndrome in children Common symptoms Increased intracranial pressure, nausea, coma, convulsions
1. The relieved symptoms reappeared shortly after or after 48 hours of artificial kidney dialysis, and the previously relieved symptoms reappeared, which may be manifested as headache, nausea, vomiting, confusion, convulsions, coma, and even death.
2. No improvement in symptoms. Excess poison has been ruled out, but there is no corresponding improvement in clinical symptoms.
3. Pathological reflex positive and increased intracranial pressure.
Examine
Examination of dialysis imbalance syndrome in children
Serum electrolytes (usually referred to as hyperkalemia) and nitrogen-containing substances have been significantly reduced compared to pre-dialysis, while cerebrospinal fluid levels are relatively high.
Should do ECG, brain CT examination.
Diagnosis
Diagnosis and differential diagnosis of dialysis imbalance syndrome in children
1. Clinical features: Symptoms relieved after hemodialysis reappear, resulting in the above clinical symptoms.
2. Laboratory examination: blood potassium and urea nitrogen, creatinine has decreased significantly, but the clinical manifestations of cerebral edema in some cases of cerebrospinal fluid relatively high.
3. Therapeutic test: to improve the patient's plasma osmotic pressure, has a certain effect on the treatment of this disease.
With renal failure, uremia has not been effectively corrected after dialysis, and clinical manifestations and laboratory tests can help identify.
