Epistemic_Statements  

CORD-19:0431b8b024ad140517707f8828cd7dfcc560da4b JSONTXT 9 Projects

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Id Subject Object Predicate Lexical cue
T1 169-289 Epistemic_statement denotes Using isotope red cell tagging, it has been shown that red cell life span averages about 1/2 to 1/3 of normal in uremia.
T2 568-672 Epistemic_statement denotes On the other hand, normal erythrocytes transfused into a uremic individual will have shortened survival.
T3 673-801 Epistemic_statement denotes In the past, chronic hemolysis in maintenance dialysis patients may have manifested as increased blood transfusion requirements.
T4 802-980 Epistemic_statement denotes However, these days such hemolysis probably more often presents itself as erythropoietin resistance (larger erythropoietin doses being required for a given therapeutic response).
T5 981-1239 Epistemic_statement denotes A variety of abnormalities (such as impairment of red cell enzymatic activities and reduced synthesis of Na + -K + pump units by uremic reticulocytes) have been suggested to be the causes for the heightened predisposition of uremic erythrocytes to hemolysis.
T6 1240-1327 Epistemic_statement denotes Uncommonly, patients on dialysis can have severe (at times life-threatening) hemolysis.
T7 1328-1792 Epistemic_statement denotes These patients fi t into either of two categories, depending on whether hemolysis involves all or the majority of the patients being dialyzed under similar circumstances in a given dialysis center or whether the hemolysis is patient specifi c. Hemolysis in the former is often the result of water-borne toxins, centralized dialysis equipment failure, or blood tubing defects-whereas in the latter it results from medication or possibly inadequate dialytic therapy.
T8 1975-2074 Epistemic_statement denotes The signs and symptoms of hemolysis are largely nonspecifi c, but certain fi ndings are suggestive.
T9 2075-2168 Epistemic_statement denotes Blood undergoing intravascular hemolysis can show color changes from cherry red to port wine.
T10 2169-2302 Epistemic_statement denotes A sudden deepening of skin pigmentation during or shortly after dialysis can also be a consequence of severe intravascular hemolysis.
T11 2303-2532 Epistemic_statement denotes It is highly likely that these blood and skin color changes are all related to the release of hemoglobin and methemoglobin from erythrocytes, as well as the generation of methemalbumin and a complex containing hemopexin and heme.
T12 2533-2612 Epistemic_statement denotes In slowly developing hemolysis, the patient may not notice any symptoms at all.
T13 2761-2981 Epistemic_statement denotes Patients with hemolysis can also present with headache, lethargy, malaise, chills, diaphoresis, hypotension, hypertension, dyspnea, chest pain, palpitation, leg cramps, cyanosis, dark urine (and death can be associated).
T14 2982-3010 Epistemic_statement denotes Pancreatitis can also occur.
T15 4207-4364 Epistemic_statement denotes Despite being much less reactive than chlorine, chloramine has been found to cause hemolysis outbreaks among dialysis patients in various parts of the world.
T16 4554-4705 Epistemic_statement denotes Deionization tanks can only remove undesirable ions in exchange for hydrogen or hydroxyl ones but cannot remove nonionic substances such as chloramine.
T17 4993-5254 Epistemic_statement denotes However, if the chloramine-contaminated water is pumped through a carbon fi lter too forcefully the elevated water pressure generated can create artifi cial channels within the device-thus allowing the passage of chloraminecontaminated water into the dialysate.
T18 5255-5435 Epistemic_statement denotes In addition, traditional carbon fi lters may not have enough capacity to prevent hemolysis when tap water chloramine concentrations are inordinately high-as in the case of drought.
T19 5540-5654 Epistemic_statement denotes However, serum ascorbic acid levels should be monitored to prevent hypervitaminosis C and secondary hyperoxalosis.
T20 5655-5711 Epistemic_statement denotes This ascorbic acid approach has not been widely adopted.
T21 6155-6315 Epistemic_statement denotes Chloramine-induced hemolysis can present as methemoglobinemia, Heinz body anemia, or acute intravascular hemolysis (if chloramine levels are markedly elevated).
T22 7220-7383 Epistemic_statement denotes If faulty rinsing procedures are employed or formaldehyde-tainted water fi ltration fi lters are used, formaldehyde can inadvertently be introduced into the blood.
T23 7384-7545 Epistemic_statement denotes Formaldehyde in the blood may lead to the development of auto-antibodies against erythrocytes in the form of anti-N-like antibodies that can result in hemolysis.
T24 7953-8060 Epistemic_statement denotes This reduction in ATP availability (as well as the sterilant's other harmful effects) can foster hemolysis.
T25 8501-8607 Epistemic_statement denotes A reduction of serum osmolality to 260 mmoles/kg does not seem to affect erythrocyte mechanical fragility.
T26 8608-8695 Epistemic_statement denotes However, if osmolality is lowered further a signifi cant degree of hemolysis may occur.
T27 8696-8792 Epistemic_statement denotes Hemodilution can be caused by misadventures such as administering hypo-osmolal plasma expanders.
T28 8793-8920 Epistemic_statement denotes It can also result from dialyzing against hypo-osmolal dialysates, as a result of using a faulty conductivity-measuring device.
T29 9341-9455 Epistemic_statement denotes A dialysate temperature in excess of 42ºC has been associated with hemolysis that may last for days or even weeks.
T30 10259-10875 Epistemic_statement denotes Other causes of obstruction in the vascular circuit that can foster hemolysis include partial occlusion of a vascular catheter (e.g., at its tip, by a thrombus, development of a thrombus at a dialyzer blood port, wide disproportion between the caliber of a dialysis needle or of a cannula (both being too small) and the blood fl ow rate (being too high), malocclusion of a roller pump with its consequent constricting effect on the blood path within the pump segment of an "arterial" blood tubing, impingement of the bevel of an "arterial" needle against the wall of a vascular access, and kinking of a blood tubing.
T31 10876-11024 Epistemic_statement denotes The abutting of an "arterial" needle against the wall of a vascular access can obstruct the needle's bevel and reduce the caliber of the blood path.
T32 11025-11247 Epistemic_statement denotes If the blood pump now keeps on pumping at the original speed, a vacuum can be created that can lead to "arterial" tubing collapse as well as a highly turbulent and often to-and-fro movement of the blood within that tubing.
T33 11387-11548 Epistemic_statement denotes Kinking can be the result of the improper manner in which blood tubing is routed over a hard and narrow support, especially if easily collapsible tubing is used.
T34 11549-11629 Epistemic_statement denotes Hemolysis associated with blood path problems is mainly intravascular in nature.
T35 11630-11810 Epistemic_statement denotes However, milder stimuli may lead to less signifi cant damage to red blood cells-causing them to be removed subsequently by the reticuloendothelial system (extravascular hemolysis).
T36 12182-12260 Epistemic_statement denotes Thus, when high blood fl ows are required larger-size cannulas should be used.
T37 12321-12395 Epistemic_statement denotes Whether a high ultrafi ltraion rate can foster hemolysis is controversial.
T38 12608-12798 Epistemic_statement denotes However, one study found that during ultrafi ltration even at negative pressures as high as -710 mmHg on the blood side of the ultrafi ltering membrane no measurable hemolysis was discerned.
T39 13422-13591 Epistemic_statement denotes It has been suggested that there may be an increased susceptibility of uremic erythrocytes to lysis as a result of the presence of noxious agents or of oxidative stress.
T40 13592-13966 Epistemic_statement denotes Lipid peroxidation of the red blood cell membrane (caused by increased free radical formation that occurs in uremia alone and by exposure of polymorphonuclear leucocytes to artifi cial materials in the extracorporeal circuit during hemodialysis), along with the consequent lack of cell deformability and the presence of splenic sequestration, may be an underlying mechanism.
T41 13967-14099 Epistemic_statement denotes Whether antioxidants that reduce free radical production can prevent red blood cell damage in uremic patients is at present unknown.
T42 14289-14414 Epistemic_statement denotes Although most studies have found a benefi t, the fi ndings were not yet extensive enough to warrant universal implementation.
T43 14415-14737 Epistemic_statement denotes Recently, the use of electrolyzed-reduced water that contains active hydrogen and possesses a lower redox potential (to prepare dialysates for hemodialysis) has been suggested to reduce hemodialysis-enhanced production of reactive oxygen species and proinfl ammatory cytokines, peroxidation of erythrocytes, and hemolysis.
T44 14738-15014 Epistemic_statement denotes The benefi cial effects on erythrocytes (including that of the reduction of erythropoietin dosage because of the amelioration of hemolysis) are believed to be related to the scavenging of reactive oxygen species by the electrolyzed-reduced water used to prepare the dialysate.
T45 15144-15260 Epistemic_statement denotes Treatment with erythropoietin may not only augment red cell generation but reduce hemolysis in patients with uremia.
T46 15378-15489 Epistemic_statement denotes Insuffi cient dialysis may also lead to hemolysis, as revealed by the U.S. National Cooperative Dialysis Study.
T47 15704-15924 Epistemic_statement denotes Although this difference in hematocrit may partly be due to reduced red cell production or more occult bleeding, some investigators have observed an inverse relationship between BUN concentrations and red cell life span.
T48 17208-17302 Epistemic_statement denotes A low serum phosphorus concentration from any cause may lead to a predisposition to hemolysis.
T49 17303-17390 Epistemic_statement denotes With severe hemolysis, a profound anemia may occur that may require blood transfusions.
T50 17391-17486 Epistemic_statement denotes However, the more immediate danger in end-stage renal disease patients is that of hyperkalemia.
T51 17487-17579 Epistemic_statement denotes This problem is exacerbated if hemolysis occurs after blood has passed through the dialyzer.
T52 17773-17927 Epistemic_statement denotes The blood present in the dialyzer and in the blood tubing should not be returned to the patient, as this blood may contain excessive amounts of potassium.
T53 17928-18066 Epistemic_statement denotes In addition, it is imperative to monitor the electrocardiogram frequently in these patients so that hyperkalemia can be detected promptly.