Is there a way the blood pressure can be raised on a dialysis patient?
I have my grandmother in ICU and they told us that the fluid that they take out of her body is being put back in with a medication that is keeping her blood pressure high so they can give her the dialysis treatment.
Is there anything else that can be done besides pumping her with fluid that can keep her blood pressure stable during the treatment? They are giving her two different types of medication through an IV to keep it from dropping.
Any advice would help. Thank you
Tagged with: blood pressure • dialysis treatment • grandmother • medication • stable
Filed under: blood pressure treatment
You need to talk to the doctors who are treating your grandmother (assuming that she has given them permission to do so). They will explain why the medications they have chosen are necessary.
Basically, the two ways of raising blood pressure are to increase fluid load (the total volume of blood) or to increase the resistance of the blood vessels themselves. Part of the point of dialysis is to REDUCE fluid load, so that is not a good solution for dialysis patients (this would take longer than an answer I can post here to fully explain, but part of the reason that her blood pressure drops is because they are removing fluid that is there because her kidneys are not functioning, and pressure drops as a result). Increasing the resistance (the push-back-against-ive-ness, if you will) of the blood vessels is done with medication, and that is what they’re doing with your grandmother.
In a patient whose blood pressure drops because of another reason, like blood loss, pushing fluids is exactly what we do to raise blood pressure. It’s just not appropriate in this case. Once your grandmother is more stable, they may not need to give as much medication to control the pressures because the changes in hemostasis (the balance of control of her blood pressure and vital signs) may not be as great as they are now.
Make sense?
Dialysis is used to remove excess fluid and toxins that cannot be excreted by the kidneys due to kidney failure (either chronic or acute failure). This removal of fluid can cause a drop in blood pressure. If her pressure is low to start with the dialysis can cause it to drop even more. The doctors are probably giving her pressors which are meds that increase the blood pressure by causing constriction of the vessels. The other option is to perform a different type of hemodialysis called SLED which causes less of a BP drop and lasts longer than HD. Sounds like the doctors are doing what needs to be done. It is a difficult dilemma when a patient needs dialysis and has low BP. Hope your grandma gets better.