Peripherally inserted veno-venous ultrafiltration for rapid treatment of volume overloaded patients

Jaski, Brian E.; Ha, Jae Seong; Denys, Bart G.; Lamba, Sumant; Trupp, Robin J.; Abraham, William T.

doi:10.1054/jcaf.2003.28

Cited by 156 publications

(111 citation statements)

References 15 publications

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“…We demonstrated significantly greater fluid and weight loss with UF than intravenous diuretics, despite a significantly lower urine output in the UF group. These results, which are comparable to those of previous studies, (16,17,19) are not unexpected, as the fluid removal rate can be adjusted using the UF device. Conversely, the urine output in the standard care group was variable and mostly non-substantial (especially since the standard care group was also made up of patients with diuretic resistance).…”

Section: Discussionsupporting

confidence: 92%

“…This observation is consistent with that of other UF trials. (16,17,26) Other than that, none of the patients who underwent UF in our study cohort experienced adverse events such as hypotension, bleeding, electrolyte imbalance, worsening renal function or line-related complications. This finding further confirms the safety of UF.…”

Section: Discussionmentioning

confidence: 89%

“…The availability of new UF devices, such as the Aquadex FlexFlow TM Fluid Removal System (Gambro, Deerfield, IL, USA), which is much smaller, more portable and requires only a peripheral venous catheter, overcomes the aforementioned limitations and elevates the potential of UF in HF treatment. (16) UF has been proven to be a safe and effective alternative to intravenous diuretics in the treatment of decompensated HF. (17,18) However, there have not been any clinical trials assessing the use of UF in decompensated HF patients with diuretic resistance.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrafiltration in patients with decompensated heart failure and diuretic resistance: an Asian centre’s experience

Teo

Lim

Neo

et al. 2016

smedj

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrafiltration in patients with decompensated heart failure and diuretic resistance: an Asian centre’s experience

Teo

Lim

Neo

et al. 2016

smedj

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“…In the early 2000s, there was a renewed interest in this therapy because of the advent of the user-friendly portable devices that are dedicated to UF, use low-blood flow rates, and do not mandate admission to higher-level care units. A number of small clinical studies further established the practical aspects of this therapy, such as feasibility of using peripheral veins and safety of higher UF rates, while also revealing some of its drawbacks (Table 2) (17,18). They set the stage for the second generation of UF studies that were mainly carried out in the United States and included large multicenter RCTs.…”

Section: Clinical Trialsmentioning

confidence: 99%

Ultrafiltration Therapy for Heart Failure: Balancing Likely Benefits against Possible Risks

Kazory

2016

CJASN

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Heart failure remains a major public health concern because of its high prevalence, morbidity, mortality, and financial burden. The poor clinical outcomes associated with acute decompensated heart failure, suboptimal efficacy and safety profile of conventional treatment regimens, and unsatisfactory experiences with the newer classes of pharmacologic therapy underlie the interest in the use of extracorporeal isolated ultrafiltration in this setting. In this article, selected mechanistic aspects of ultrafiltration therapy are briefly reviewed followed by a critical overview of the largest trials in this field. I will discuss the clinical relevance of renal dysfunction and decongestion as two commonly used end points of safety and efficacy in the ultrafiltration trials, with emphasis on the emerging pertinent notions that could challenge our conventional thinking. Finally, a number of practical recommendations (e.g., customization of ultrafiltration rates) are provided for ultrafiltration therapy in the setting of acute decompensated heart failure. Because of a paucity of evidence, universally accepted consensus guidelines cannot yet be generated. As such, when considering ultrafiltration therapy for acute decompensated heart failure, the likely benefits should be carefully balanced against the potential risks for an individual patient. A conceivable implication of the ultrafiltration trials is that collaborative heart failure programs benefiting from nephrology expertise and resources could improve the outcomes and reduce the cost.

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“…W odróżnieniu od diuretyków, hemofiltracja nie powoduje odruchowej aktywacji neurohumoralnej upośledzającej krążenie wewnątrzner-kowe. Może ona dodatkowo uwrażliwiać nefron na działania leków moczopędnych w przypadku oporności na diuretyki [67]. Niemniej jednak, zastosowanie ciągłej żylno-żylnej hemofiltracji (CVVH, continuous veno-venous hemofiltration) jest kosztowne i pociąga za sobą ryzyko ciężkich powikłań, takich jak krwawienie czy też zator powietrzny o charakterze skrzyżo-wanym w przypadku obecności drożnego otworu owalnego (PFO, patent foramen ovale).…”

Section: Metody Niefarmakologiczneunclassified

Postępowanie w okresie okołooperacyjnym u chorych z ryzykiem wystąpienia ostrego uszkodzenia nerek, poddawanych operacjom kardiochirurgicznym

Krzych

Wybraniec²,

Chudek³

et al. 2013

Anaesthesiol Intensive Ther

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Acute kidney injury is one of the most frequent and clinically important of all postoperative complications in cardiac surgery. It is estimated that almost half of subjects suffer from a deterioration of kidney function after a cardio-pulmonary by-pass. Renal insufficiency impacts upon the outcome in terms of an increase in postoperative morbidity and mortality, and a decrease in quality of life. Recently, a modified and unified classification of cardio-renal syndrome has been devised, which takes into account bilateral association between the heart and the kidneys. Because acute decompensation in heart function leads to acute kidney damage, therefore cardiac surgery-associated acute kidney injury may be recognised as a type 1 cardio-renal syndrome from a pathophysiological point of view. This paper aims to review the current data on the diagnosis of acute kidney injury and preventive strategies that can be implemented in cardiac surgery perioperative care.

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Peripherally inserted veno-venous ultrafiltration for rapid treatment of volume overloaded patients

Cited by 156 publications

References 15 publications

Ultrafiltration in patients with decompensated heart failure and diuretic resistance: an Asian centre’s experience

Ultrafiltration in patients with decompensated heart failure and diuretic resistance: an Asian centre’s experience

Ultrafiltration Therapy for Heart Failure: Balancing Likely Benefits against Possible Risks

Postępowanie w okresie okołooperacyjnym u chorych z ryzykiem wystąpienia ostrego uszkodzenia nerek, poddawanych operacjom kardiochirurgicznym

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