血液透析滤过联合罗匹尼罗对尿毒症患者不宁腿综合症的临床疗效观察

目的探讨血液透析滤过联合罗匹尼罗对尿毒症患者不宁腿综合征的疗效。方法将50例行血液透析的不宁腿综合征患者采用简单随机方法分成对照组和观察组。对照组予以常规血液透析治疗,每周3次,每次4 h,联合罗匹尼罗(0.25 mg/d)口服,观察组予以血液透析滤过治疗,每周3次,每次4 h,联合罗匹尼罗(0.25 mg/d)口服,疗程为12周。观察治疗前后患者精神卫生相关指标(包括不宁腿严重程度评分,抑郁、睡眠质量及生活质量评分)和临床检验指标(血清中全段甲状旁腺素、β_2-微球蛋白、血肌酐、血红蛋白含量)。结果治疗12周后,对照组和观察组患者不宁腿严重程度评分、抑郁评分、睡眠质量评分都较治疗前明显降低(P 0.05),观察组较对照组降低更为明显(P 0.05)。透析后对照组和观察组生活质量评分都明显增加,观察组较对照组增加更为明显(P 0.05)。透析后血清中全段甲状旁腺素及β2-微球蛋白含量观察组较对照组明显降低(P 0.05)。透析前后2组血肌酐和血红蛋白水平无明显差别(P 0.05)。结论血液透析滤过联合罗匹尼罗对血液透析患者不宁腿综合征疗效明显。     

艾司氯胺酮术后静脉镇痛对乳腺癌患者疼痛及焦虑、抑郁的影响

目的探讨艾司氯胺酮术后静脉镇痛对乳腺癌患者疼痛和情绪的影响。方法采用随机数字表法将择期行乳腺癌手术的60例患者分为艾司氯胺酮组和对照组(每组30例)。手术结束后连接静脉镇痛泵, 艾司氯胺酮组给予艾司氯胺酮复合舒芬太尼静脉泵注, 对照组给予舒芬太尼泵注, 其余配方相同。记录两组患者术前1 d和术后3 d的焦虑自评量表(Self-Rating Anxiety Scale, SAS)评分、抑郁自评量表(Self-Rating Depression Scale, SDS)评分, 术后1 d和术后2 d的VAS疼痛评分、Ramsay镇静评分, 记录两组患者不良反应、辅助镇痛药使用情况、镇痛满意度。结果两组患者术前1 d SAS及SDS评分差异无统计学意义(P>0.05);术后3 d艾司氯胺酮组SAS及SDS评分较对照组降低(P<0.05);艾司氯胺酮组术后3 d SAS及SDS评分较术前1 d下降(P<0.05), 而对照组患者术后3 d SAS及SDS评分较术前1 d升高(P<0.05)。两组患者术后1 d及术后2 d Ramsay镇静评分差异无统计学意义(P>0...     

急性心肌梗死患者PCI术前后心理护理及生活质量的研究

目的:研究急性心肌梗死(AMI)患者冠状动脉介入术前后的抑郁障碍情况、心理干预的效果以及对生活质量的影响.方法:选择2008年1月至2010年1月于我科接受PCI治疗的AMI患者,随机分为对照组和心理干预组,两组均在患者手术前1～2d和手术后7～10d分别进行两次行汉密尔顿抑郁量表(HAMD)评分和生活质量(MIDAS)评分.结果:PCI术前两组患者抑郁发生率、HAMD评分、MIDAS评分无显著差异(P＞0.05).术后心理干预组的抑郁障碍较对照组有明显改善(P＜0.05),HAMD评分明显降低(P＜0.05);手术前后对照组抑郁发生率无明显变化(P＞0.05),HAMD评分无显著差异(P＞0.05);手术前后干预组抑郁发生率有明显变化,HAMD评分有显著差异(P＜0.05);手术前后两组患者的生活质量均有显著差异(P＜0.05),且干预组较对照组改善更明显(P＜0.05).结论:PCI术后患者抑郁发生率较高,因此有必要对PCI术后的患者进行联合心理干预的治疗,PCI术可以明显改善患者的生活质量,且PCI术后抑郁情绪与术后生活质量的改善呈负相关.     

心肌梗死患者支架术前后生活质量及心理护理的探讨

目的:研究急性心肌梗死(AMI)患者冠状动脉介入术前后的抑郁障碍情况、心理干预的效果以及对生活质量的影响.方法:选择2009年1月至2010年9月于我科接受PCI治疗的AMI患者,随机分为对照组和心理干预组,两组均在患者手术前1～2d和手术后7～10d分别进行两次行汉密尔顿抑郁量表(HAMD)评分和生活质量(MIDAS)评分.结果:PCI术前两组患者抑郁发生率、HAMD评分、MIDAS评分无显著差异(P＞0.05).手术前后对照组抑郁发生率无明显变化(P＞0.05),HAMD评分无显著差异(P＞0.05);术后心理干预组的抑郁障碍较对照组有明显改善(P＜0.05),HAMD评分明显降低(P＜0.05);手术前后干预组抑郁发生率有明显变化,HAMD评分有显著差异(P＜0.05);手术前后两组患者的生活质量均有显著差异(P＜0.05),且干预组较对照组改善更明显(P＜0.05).结论:PCI术后患者抑郁发生率较高,因此有必要对PCI术后的患者进行联合心理干预的治疗,PCI术可以明显改善患者的生活质量,且PCI术后抑郁情绪与术后生活质量的改善呈负相关.     

心理护理对出血性脑卒中后抑郁患者康复的影响

目的探讨心理护理对出血性脑卒中后抑郁患者康复的影响。方法将128例手术治疗的出血性脑卒中后抑郁患者随机分为2组,各64例。2组患者均接受常规抗抑郁治疗。对照组行常规护理,治疗组采用认知干预、心理干预等护理。采用抑郁量表(HAMD)、日常生活活动能力(ADL)测定和运动功能(FMA)评分,评价2组疗效。结果经过6周护理和治疗后,观察组各项测评指标均优于对照组,差异有统计学意义(P0.05)。结论心理护理能显著改善患者的抑郁症状和神经功能,有助于脑卒中后抑郁患者的全面康复。     

氯胺酮对疼痛抑郁共病大鼠行为学及吲哚胺2,3二加氧酶信号通路的影响

目的观察氯胺酮对疼痛抑郁共病大鼠行为学及吲哚胺2,3二加氧酶(IDO)信号通路的影响。方法健康成年雄性SD大鼠24只,2月龄,体重200~250g,随机分为三组:对照组(S组)、生理盐水组(N组)和氯胺酮组(K组),每组8只。N组及K组大鼠均接受右踝关节腔内完全弗氏佐剂(CFA)50μl注射,建立疼痛抑郁共病模型;S组大鼠则注射生理盐水50μl作为对照。CFA注射后1、7、14d分别测定机械性缩足反射阈值(MWT)及不动时间。第14天行为学测试后,N组大鼠腹腔注射生理盐水1ml,K组则注射20 mg/kg氯胺酮1 ml。三组大鼠于腹腔注射后1h测定MWT及不动时间。随后取大鼠海马、前额皮层、扣带回组织及血浆,采用ELISA法测定IL-6浓度及IDO活性。结果与S组比较,N组及K组CFA注射后1、7、14dMWT明显降低(P0.05),CFA注射后7、14d不动时间明显延长(P0.05)。与N组比较,K组MWT明显升高(P0.05),不动时间明显缩短(P0.05),大鼠海马、前额皮层、扣带回IL-6浓度和IDO活性均明显下降(P0.05)。结论氯胺酮可有效治疗疼痛抑郁共病,这可能与其抑制大鼠不同脑区IDO信号通路活性有关。     

不同剂量艾司氯胺酮对术前焦虑患者胸腔镜手术后早期情绪的影响

目的 观察不同剂量艾司氯胺酮对术前焦虑患者胸腔镜手术后早期情绪的影响。方法 选择存在术前焦虑的胸腔镜手术患者80例,男37例,女43例,年龄25～64岁,BMI 18～26 kg/m²,ASAⅠ—Ⅲ级。采用随机数字表法将患者分为四组：对照组(C组)、艾司氯胺酮0.1 mg/kg组(E1组)、艾司氯胺酮0.2 mg/kg组(E2组)和艾司氯胺酮0.3 mg/kg组(E3组),每组20例。E1组、E2组和E3组于手术结束前30 min分别静脉缓慢注射相应剂量艾司氯胺酮,C组给予等容量生理盐水10 ml。记录术前24 h、术后24、48、72、120 h的7项广泛性焦虑障碍量表(GAD-7)评分和医院焦虑抑郁量表(HADS)评分,并抽取外周静脉血5 ml,采用ELISA法检测血清脑源性神经营养因子(BDNF)浓度。记录术后12、24 h静息和活动时NRS疼痛评分。记录术后48 h内补救镇痛例数和镇痛泵有效按压次数。结果 与C组比较,E1组、E2组和E3组术后24、48、72 h的GAD-7评分和HADS评分明显降低,且E3组明显低于E1组和E2组(P<0.05);...     

规范化疼痛护理管理改善人工全髋关节置换术患者不良情绪及术后疼痛的效果

目的探讨规范化疼痛护理管理改善人工全髋关节置换术患者不良情绪及术后疼痛的效果。方法依据随机表法将2017-12—2019-08间接受人工全髋关节置换术的60例患者分为2组。对照组28例行围术期常规护理,观察组32例在常规护理的基础上联合规范化疼痛护理管理。采用抑郁自评量表(SDS)和焦虑自评量表(SAS)评价2组患者护理前后抑郁、焦虑等不良情绪改善情况;应用视觉模拟评分法(VAS)评价2组患者术后24 h和48 h的疼痛程度;应用Harris髋关节功能评分比较2组患者术后4周和8周时的髋关节功能。结果 2组患者干预前SDS、SAS评分比较差异无统计学意义(P0.05)。2组干预后SDS、SAS评分较干预前均明显降低,且观察组改善程度优于对照组。观察组术后24 h和48 h的VAS评分均低于对照组,差异均有统计学意义(P0.05)。观察组术后4周及8周时Harris评分均高于对照组,差异有统计学意义(P0.05)。结论规范化疼痛护理管理,可有效改善人工全髋关节置换术患者的不良情绪和疼痛程度,为提升髋关节功能恢复效果奠定坚实基础。     

氯胺酮辅以地塞米松术前用药对腹腔镜胆囊切除术后疼痛的影响

目的:探讨氯胺酮在腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后超前镇痛作用及地塞米松对氯胺酮超前镇痛的影响。方法:将60例患者随机分为3组(每组20例):A组(氯胺酮组);B组(氯胺酮+地塞米松组);C组(对照组)生理盐水2ml。对术后1h、2h、4h、6h、12h及术后1d、2d、3d切口痛及非切口痛分别进行VAS镇痛评分和术后镇静评分,记录术后不良反应及术后止痛药的需求情况。结果:术后非切口痛及切口痛,A、B组VAS评分均较C组显著降低(P<0.05);而A组与B组相比,术后VAS评分无明显差异(P>0.05)。术后恶心、呕吐发生率B组(20%)与A组(55%)、C组(60%)相比,明显降低(P<0.05);A、C两组间无明显差异(P>0.05);术后需要止痛药的例数A组3例(15%),B组3例(15%),C组9例(45%)(P<0.05)。结论:氯胺酮辅以地塞米松在LC中能减轻术后疼痛,降低术后恶心、呕吐的发生率,具有超前镇痛作用,但地塞米松未使氯胺酮超前镇痛作用增强。     

急性心肌梗死患者支架术前术后心理护理及生活质量的研究

目的:研究急性心肌梗死(AMI)患者冠状动脉介入术前后的抑郁障碍情况、心理干预的效果以及对生活质量的影响.方法:选择2009年1月至2010年1月于我科接受PCI治疗的AMI患者,随机分为对照组和心理干预组,两组均在患者手术前1～2d和手术后7～10d分别进行两次行汉密尔顿抑郁量表(HAMD)评分和生活质量(MIDAS)评分.结果:PCI术前两组患者抑郁发生率、HAMD评分、MIDAS评分无显著差异(P>0 05).术后心理干预组的抑郁障碍较对照组有明显改善(P<0.05),HAMD评分明显降低(P<0.05);手术前后对照组抑郁发生率无明显变化(P>0.05),HAMD评分无显著差异(P>0.05);手术前后干预组抑郁发生率有明显变化,HAMD评分有显著差异(P<0.05);手术前后两组患者的生活质量均有显著差异(P<0.05),且干预组较对照组改善更明显(P<0.05).结论:PCI术后患者抑郁发生率较高,因此有必要对PCI术后的患者进行联合心理干预的治疗,PCI术可以明显改善患者的生活质量,且PCI术后抑郁情绪与术后生活质量的改善呈负相关.     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.