Outcome Predictors of Ultrafiltration in Patients with Refractory Congestive Heart Failure and Renal Failure

This study is an attempt to identify predictors of outcome from the use of ultrafiltration (UF) in patients with refractory congestive heart failure (CHF) and renal failure. The authors studied 30 patients in NYHA functional class IV in whom UF was utilized in the management of refractory CHF. Patie...

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Veröffentlicht in:Angiology 1996-05, Vol.47 (5), p.447-454
Hauptverfasser: Ramos, Roque, Salem, Bakr I., DePawlikowski, Maria P., Tariq, Manzoor, Haikal, Maged, Pohlman, Thomas, Mennes, Paul
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container_end_page 454
container_issue 5
container_start_page 447
container_title Angiology
container_volume 47
creator Ramos, Roque
Salem, Bakr I.
DePawlikowski, Maria P.
Tariq, Manzoor
Haikal, Maged
Pohlman, Thomas
Mennes, Paul
description This study is an attempt to identify predictors of outcome from the use of ultrafiltration (UF) in patients with refractory congestive heart failure (CHF) and renal failure. The authors studied 30 patients in NYHA functional class IV in whom UF was utilized in the management of refractory CHF. Patients were retrospectively divided into two groups according to their outcome. Group A included 12 patients who improved and survived hospital admission, and group B included 18 patients who did not respond and died shortly after UF. Clinical, hemodynamic, and laboratory data before UF were fairly comparable between both groups. Renal function and hemodynamic parameters were compared and analyzed within the same group and between both groups before and after UF. The mean age in group A was sixty-three ±thirteen years while in group B it was seventy ±eleven years (P < 0.005). A mean of 9.6 liters of fluid were removed from group A and 3.2 liters from group B (P < 0.001). Group A showed greater reduction in the mean values of right atrial pressure (P < 0.005) and pulmonary capillary wedge pressure (P < 0.05) after UF. Additionally, group A showed a significant decrease in their blood urea nitrogen (P < 0.05) and serum creatinine values (P < 0.05), in contradistinction to group B patients who showed a major increase in those values after UF. There was no significant change in the mean values of cardiac index, systemic vascular resistance, and pulmonary vascular resistance after UF. (continued on next page) These findings suggest that younger age groups, greater fluid removal, as well as significant decreases in blood urea nitrogen, serum creatinine, and right atrial and pulmonary wedge pressures after UF, are associated with favorable outcome. Conversely, older age groups, less fluid removal, and rising blood urea nitrogen and serum creatinine levels after UF were associated with poor outcome.
doi_str_mv 10.1177/000331979604700503
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The authors studied 30 patients in NYHA functional class IV in whom UF was utilized in the management of refractory CHF. Patients were retrospectively divided into two groups according to their outcome. Group A included 12 patients who improved and survived hospital admission, and group B included 18 patients who did not respond and died shortly after UF. Clinical, hemodynamic, and laboratory data before UF were fairly comparable between both groups. Renal function and hemodynamic parameters were compared and analyzed within the same group and between both groups before and after UF. The mean age in group A was sixty-three ±thirteen years while in group B it was seventy ±eleven years (P < 0.005). A mean of 9.6 liters of fluid were removed from group A and 3.2 liters from group B (P < 0.001). Group A showed greater reduction in the mean values of right atrial pressure (P < 0.005) and pulmonary capillary wedge pressure (P < 0.05) after UF. 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Dialysis management</subject><subject>Female</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Hemodynamics - physiology</subject><subject>Hemofiltration</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Renal Insufficiency - blood</subject><subject>Renal Insufficiency - etiology</subject><subject>Renal Insufficiency - physiopathology</subject><subject>Renal Insufficiency - therapy</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0003-3197</issn><issn>1940-1574</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kFFLwzAQgIMoOqd_QBDyIL5VkyZrmkcZToXBRPS5JOl1ZnTNTFLFf2_K5l4EX-4uue8u4UPogpIbSoW4JYQwRqWQBeGCkAlhB2hEJScZnQh-iEYDkA3ECToNYZWOE0qKY3RcFpxLTkeoXfTRuDXgZw-1NdH5gF2D39roVWOHGK3rsO3wc6qgiwF_2fiOX6DxasC_8dR1SwjRfgJ-BOUjninb9h6w6urEdar9vTlDR41qA5zv8hi9ze5fp4_ZfPHwNL2bZ4YVImZSTKTmtdSSQQGl0dow0FrkpZIyFbViWhIBTQ1aqjJvtKgl47nKNS8oJWyMrrd7N9599Olv1doGA22rOnB9qERJmCwoS2C-BY13IXhoqo23a-W_K0qqQXH1V3Eautxt7_Ua6v3IzmnqX-36KhjVJk-dsWGPMVLKnOQJu91iQS2hWrneJ1Phv4d_AInuknk</recordid><startdate>19960501</startdate><enddate>19960501</enddate><creator>Ramos, Roque</creator><creator>Salem, Bakr I.</creator><creator>DePawlikowski, Maria P.</creator><creator>Tariq, Manzoor</creator><creator>Haikal, Maged</creator><creator>Pohlman, Thomas</creator><creator>Mennes, Paul</creator><general>SAGE Publications</general><general>Westminster</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19960501</creationdate><title>Outcome Predictors of Ultrafiltration in Patients with Refractory Congestive Heart Failure and Renal Failure</title><author>Ramos, Roque ; Salem, Bakr I. ; DePawlikowski, Maria P. ; Tariq, Manzoor ; Haikal, Maged ; Pohlman, Thomas ; Mennes, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c367t-9759b4d9b93e6e8cbbc3ebb728a99ebbda3b907efdeb9a82fb7d9342a2b461103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Hemodynamics - physiology</topic><topic>Hemofiltration</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Renal Insufficiency - blood</topic><topic>Renal Insufficiency - etiology</topic><topic>Renal Insufficiency - physiopathology</topic><topic>Renal Insufficiency - therapy</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ramos, Roque</creatorcontrib><creatorcontrib>Salem, Bakr I.</creatorcontrib><creatorcontrib>DePawlikowski, Maria P.</creatorcontrib><creatorcontrib>Tariq, Manzoor</creatorcontrib><creatorcontrib>Haikal, Maged</creatorcontrib><creatorcontrib>Pohlman, Thomas</creatorcontrib><creatorcontrib>Mennes, Paul</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Angiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ramos, Roque</au><au>Salem, Bakr I.</au><au>DePawlikowski, Maria P.</au><au>Tariq, Manzoor</au><au>Haikal, Maged</au><au>Pohlman, Thomas</au><au>Mennes, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome Predictors of Ultrafiltration in Patients with Refractory Congestive Heart Failure and Renal Failure</atitle><jtitle>Angiology</jtitle><addtitle>Angiology</addtitle><date>1996-05-01</date><risdate>1996</risdate><volume>47</volume><issue>5</issue><spage>447</spage><epage>454</epage><pages>447-454</pages><issn>0003-3197</issn><eissn>1940-1574</eissn><coden>ANGIAB</coden><abstract><![CDATA[This study is an attempt to identify predictors of outcome from the use of ultrafiltration (UF) in patients with refractory congestive heart failure (CHF) and renal failure. The authors studied 30 patients in NYHA functional class IV in whom UF was utilized in the management of refractory CHF. Patients were retrospectively divided into two groups according to their outcome. Group A included 12 patients who improved and survived hospital admission, and group B included 18 patients who did not respond and died shortly after UF. Clinical, hemodynamic, and laboratory data before UF were fairly comparable between both groups. Renal function and hemodynamic parameters were compared and analyzed within the same group and between both groups before and after UF. The mean age in group A was sixty-three ±thirteen years while in group B it was seventy ±eleven years (P < 0.005). A mean of 9.6 liters of fluid were removed from group A and 3.2 liters from group B (P < 0.001). Group A showed greater reduction in the mean values of right atrial pressure (P < 0.005) and pulmonary capillary wedge pressure (P < 0.05) after UF. Additionally, group A showed a significant decrease in their blood urea nitrogen (P < 0.05) and serum creatinine values (P < 0.05), in contradistinction to group B patients who showed a major increase in those values after UF. There was no significant change in the mean values of cardiac index, systemic vascular resistance, and pulmonary vascular resistance after UF. (continued on next page) These findings suggest that younger age groups, greater fluid removal, as well as significant decreases in blood urea nitrogen, serum creatinine, and right atrial and pulmonary wedge pressures after UF, are associated with favorable outcome. Conversely, older age groups, less fluid removal, and rising blood urea nitrogen and serum creatinine levels after UF were associated with poor outcome.]]></abstract><cop>Thousand Oaks, CA</cop><pub>SAGE Publications</pub><pmid>8644941</pmid><doi>10.1177/000331979604700503</doi><tpages>8</tpages></addata></record>
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subjects Age Factors
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Emergency and intensive care: renal failure. Dialysis management
Female
Heart Failure - blood
Heart Failure - complications
Heart Failure - physiopathology
Heart Failure - therapy
Hemodynamics - physiology
Hemofiltration
Humans
Intensive care medicine
Male
Medical sciences
Middle Aged
Renal Insufficiency - blood
Renal Insufficiency - etiology
Renal Insufficiency - physiopathology
Renal Insufficiency - therapy
Retrospective Studies
Survival Rate
Treatment Outcome
title Outcome Predictors of Ultrafiltration in Patients with Refractory Congestive Heart Failure and Renal Failure
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