1. Association of haemodynamic changes measured by serial central venous saturation during ultrafiltration for acutely decompensated heart failure with diuretic resistance and change in renal function
- Author
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Andrew Ludman, Arshad Ghori, Philip Marino, Peter D. Alexander, Guido Tavazzi, Victoria L. Simpkin, Winston Banya, Ali Vazir, Anthony J. Bastin, Mark J.D. Griffiths, Martin R. Cowie, Rakesh Sharma, Susanna Price, Sarah Trenfield, and Imperial College Trust
- Subjects
Male ,Cardiac output ,Cardiac & Cardiovascular Systems ,Acute decompensated heart failure ,Drug Resistance ,Worsening renal function ,Ultrafiltration ,Hemodynamics ,030204 cardiovascular system & hematology ,Cohort Studies ,chemistry.chemical_compound ,0302 clinical medicine ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Diuretics ,Middle Aged ,Treatment Outcome ,Acute Disease ,Cardiology ,Female ,TRIAL ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,Catheterization, Central Venous ,medicine.medical_specialty ,Central Venous Pressure ,Renal function ,Heart failure ,1102 Cardiovascular Medicine And Haematology ,03 medical and health sciences ,Internal medicine ,Heart rate ,Humans ,Aged ,Retrospective Studies ,Creatinine ,Science & Technology ,business.industry ,MORTALITY ,medicine.disease ,OXYGEN-SATURATION ,Blood pressure ,Endocrinology ,Cardiovascular System & Hematology ,chemistry ,Cardiovascular System & Cardiology ,Central venous saturation ,business ,Follow-Up Studies - Abstract
BACKGROUND: Patients with acute decompensated heart failure with diuretic resistance (ADHF-DR) have a poor prognosis. The aim of this study was to assess in patients with ADHF-DR, whether haemodynamic changes during ultrafiltration (UF) are associated with changes in renal function (Δcreatinine) and whether Δcreatinine post UF is associated with mortality. METHODS: Seventeen patients with ADHF-DR underwent 20 treatments with UF. Serial bloods (4-6 hourly) from the onset of UF treatment were measured for renal function, electrolytes and central venous saturation (CVO2). Univariate and multivariate analysis were performed to assess the relationship between changes in markers of haemodynamics [heart rate (HR), systolic blood pressure (SBP), packed cell volume (PCV) and CVO2] and Δcreatinine. Patients were followed up and mortality recorded. Cox-regression survival analysis was performed to determine covariates associated with mortality. RESULTS: Renal function worsened after UF in 17 of the 20 UF treatments (baseline vs. post UF creatinine: 164±58 vs. 185±69μmol/l, P
- Published
- 2016
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