Hemolysis in a Patient during Hemodialysis
We report a case of hemolysis during a hemodialysis (HD) session in a 71-year-old man. His end-stage kidney disease is secondary to light-chain amyloidosis with renal involvement. Despite immunosuppressive treatment, his renal function continued to decline, and dialysis had to be initiated. Peritone...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2021-11-01
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| Series: | Case Reports in Nephrology and Dialysis |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/520559 |
| _version_ | 1818971174054395904 |
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| author | Maxime Taghavi Lucas Jacobs Saleh Kaysi Maria do Carmo Filomena Mesquita |
| author_facet | Maxime Taghavi Lucas Jacobs Saleh Kaysi Maria do Carmo Filomena Mesquita |
| author_sort | Maxime Taghavi |
| collection | DOAJ |
| description | We report a case of hemolysis during a hemodialysis (HD) session in a 71-year-old man. His end-stage kidney disease is secondary to light-chain amyloidosis with renal involvement. Despite immunosuppressive treatment, his renal function continued to decline, and dialysis had to be initiated. Peritoneal dialysis (PD) was started but that had to be converted to HD because of pleural effusion due to PD fluid leakage. On the event day, the patient presented a respiratory distress 2 h after the initiation of HD. He developed a sudden onset of dyspnea with hypoxemia, associated with abdominal pain, nausea, and vomiting. He also presented chest pain with arterial hypertension. The pre-pump arterial and post-pump pressures were, respectively, 40 and 100 mm Hg, with no machine alarm. The blood color in the circuit changed and became darker, so HD was stopped immediately without blood restitution, and then a blood workup was obtained, and the patient was treated with oxygen therapy, IV methylprednisolone 40 mg, and IV furosemide 100 mg. Tubing checkup performed after the incident showed a kinked arterial tube which led to the suspicion of acute hemolysis. Blood transfusion was therefore urgently ordered, and the patient was immediately transferred to the intensive care unit (ICU). Artificial ventilation was required for 4 days, with initial massive blood transfusion. A 24-h treatment with extracorporeal cytokine adsorber CytoSorb® was also performed, followed by the regular HD sessions thrice weekly. Evolution was favorable, and the patient was discharged from the ICU 18 days later. |
| first_indexed | 2024-12-20T14:48:10Z |
| format | Article |
| id | doaj.art-a3cbbb31ba7e46b8912344dd75c29fbb |
| institution | Directory Open Access Journal |
| issn | 2296-9705 |
| language | English |
| last_indexed | 2024-12-20T14:48:10Z |
| publishDate | 2021-11-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Nephrology and Dialysis |
| spelling | doaj.art-a3cbbb31ba7e46b8912344dd75c29fbb2022-12-21T19:37:04ZengKarger PublishersCase Reports in Nephrology and Dialysis2296-97052021-11-0111334835410.1159/000520559520559Hemolysis in a Patient during HemodialysisMaxime TaghaviLucas Jacobshttps://orcid.org/0000-0001-8148-0349Saleh KaysiMaria do Carmo Filomena MesquitaWe report a case of hemolysis during a hemodialysis (HD) session in a 71-year-old man. His end-stage kidney disease is secondary to light-chain amyloidosis with renal involvement. Despite immunosuppressive treatment, his renal function continued to decline, and dialysis had to be initiated. Peritoneal dialysis (PD) was started but that had to be converted to HD because of pleural effusion due to PD fluid leakage. On the event day, the patient presented a respiratory distress 2 h after the initiation of HD. He developed a sudden onset of dyspnea with hypoxemia, associated with abdominal pain, nausea, and vomiting. He also presented chest pain with arterial hypertension. The pre-pump arterial and post-pump pressures were, respectively, 40 and 100 mm Hg, with no machine alarm. The blood color in the circuit changed and became darker, so HD was stopped immediately without blood restitution, and then a blood workup was obtained, and the patient was treated with oxygen therapy, IV methylprednisolone 40 mg, and IV furosemide 100 mg. Tubing checkup performed after the incident showed a kinked arterial tube which led to the suspicion of acute hemolysis. Blood transfusion was therefore urgently ordered, and the patient was immediately transferred to the intensive care unit (ICU). Artificial ventilation was required for 4 days, with initial massive blood transfusion. A 24-h treatment with extracorporeal cytokine adsorber CytoSorb® was also performed, followed by the regular HD sessions thrice weekly. Evolution was favorable, and the patient was discharged from the ICU 18 days later.https://www.karger.com/Article/FullText/520559hemolysishemodialysisfaulty blood tubing setskinking of bloodlines |
| spellingShingle | Maxime Taghavi Lucas Jacobs Saleh Kaysi Maria do Carmo Filomena Mesquita Hemolysis in a Patient during Hemodialysis Case Reports in Nephrology and Dialysis hemolysis hemodialysis faulty blood tubing sets kinking of bloodlines |
| title | Hemolysis in a Patient during Hemodialysis |
| title_full | Hemolysis in a Patient during Hemodialysis |
| title_fullStr | Hemolysis in a Patient during Hemodialysis |
| title_full_unstemmed | Hemolysis in a Patient during Hemodialysis |
| title_short | Hemolysis in a Patient during Hemodialysis |
| title_sort | hemolysis in a patient during hemodialysis |
| topic | hemolysis hemodialysis faulty blood tubing sets kinking of bloodlines |
| url | https://www.karger.com/Article/FullText/520559 |
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