The use of peripherally inserted central catheter reduced the incidence of phlebitis in heart failure patients: A randomized trial

2021 ◽  
pp. 112972982110596
Author(s):  
Eunice Vieira Cavalcante Silva ◽  
Marcelo Eidi Ochiai ◽  
Kelly Regina Novaes Vieira ◽  
Antonio Carlos Pereira Barretto
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Severe Heart Failure ◽  
Decompensated Heart Failure ◽  
Venous Access ◽  
Control Group ◽  
Control Groups ◽  
Heart Failure Patients ◽  
Peripheral Venous Access ◽  
And Control

Background: During decompensated heart failure, the use of intravenous inotropes can be necessary. With peripheral venous access, prolonged inotrope infusion can cause phlebitis. However, traditional central venous catheters have possible complications. Peripherally inserted central catheters (PICCs) may be an alternative to traditional catheters. Aim: Our objective was to compare the incidence of phlebitis between patients with PICC and those with peripheral venous access catheter indwelling. Methods: In a randomized clinical trial, the patients were randomized to PICC and control groups, with 40 patients in each group. The inclusion criteria were hospitalized patients with advanced heart failure, ejection fraction of <0.45, and platelet count of >50,000/mm3 and current use of continuous intravenous infusion of dobutamine. The patients were randomly assigned to receive a PICC or keep their peripheral venous access. The primary end point was the occurrence of phlebitis. Results: The PICC and control groups included 40 patients each. The median age was 61.5 years; ejection fraction, 0.24; and dobutamine dose, 7.73 µg/(kg min). Phlebitis occurred in 1 patient (2.5%) in the PICC group and in 38 patients (95.0%) in the control group, with an odds ratio of 0.10% (95% confidence interval: 0.01%–1.60%, p < 0.001). Conclusion: In conclusion, in severe heart failure patients who received intravenous dobutamine, PICC use reduced the incidence of phlebitis when compared to patients with peripheral venous access. Therefore, the PICC use should considered over peripheral venous access for prolonged intravenous therapy in heart failure patients.

Abnormal nailfold videocapillaroscopic findings in heart failure patients with preserved ejection fraction

2020 ◽  
pp. 1-7
Author(s):  
Serkan Yüksel ◽  
Esra Pancar Yüksel ◽  
Murat Meriç
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Control Group ◽  
Preserved Ejection Fraction ◽  
Control Groups ◽  
Nailfold Videocapillaroscopy ◽  
Heart Failure Patients ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
And Control

BACKGROUND: Microvascular dysfunction is one of the pathophysiological mechanisms in heart failure. Nailfold videocapillaroscopy is a noninvasive technique used to examine the microvasculature. OBJECTIVE: In this study; we aimed to investigate the nailfold capillaroscopic abnormalities in heart failure patients with reduced and preserved ejection fraction and compare those with control group. METHODS: Three groups of patients were recruited for the study: HFrEF group includes the patients with heart failure with reduced ejection fraction (HFrEF), HFpEF group, patients with heart failure with preserved ejection fraction (HFpEF) and control group, healthy asymptomatic individuals. Nailfold videocapillaroscopy was performed with a videodermatoscope and all nailfold images were evaluated for enlargement and hemorrhages. RESULTS: Abnormal videocapillaroscopic findings including enlargement and/or hemorrhages were present in 7 (24%) patients in HFrEF group, 19 (66%) patients in HFpEF group and 11 (37%) in control group. The number of patients with abnormal videocapillaroscopic findings were significantly greater in HFpEF group compared to HFrEF (p <  0.05) and control groups (p <  0.05). However, no significant difference was observed in videocapillaroscopic findings between HFrEF and control groups. CONCLUSIONS: Our study showed that microvascular abnormalities demonstrated by videodermatoscopic examination of nailfold capillaries are considerably more common in HFpEF patients compared to HFrEF and control groups.

P4518Cerebral blood flow is lower in heart failure patients with reduced ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Babayigit ◽  
Y Cavusoglu ◽  
M Dural ◽  
K U Mert ◽  
T Ulus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Ejection Fraction ◽  
Control Group ◽  
Mean Flow ◽  
Control Groups ◽  
Reduced Ejection Fraction ◽  
And Control ◽  
Flow Velocities

Abstract Purpose Heart and brain interaction is a well-known entity in heart failure (HF) and left ventricular systolic dysfunction poses an increased risk for stroke and cognitive impairment. Transcranial Doppler (TCD) provides valuable information on cerebral blood flow and detects microembolic signals that can be used to determine the risk of cerebrovascular events. However, less is known about cerebral blood flow in HF patients with reduced EF. So, we aimed to evaluate cerebral blood flow rates by means of TCD in HF patients with reduced ejection fraction (EF). Methods This study included 46 HF patients with an EF less than 35% (mean age 65.2±11 years, mean EF 20.1±3.8%) who underwent to TCD examination. In addition, 26 healthy individuals with sinus rhythm and EF >50% (mean age 64.4±9.0 years, mean EF 63.5±2.38%) were included in the study as a control group. Minimum, maximum and mean flow velocities of the both right middle cerebral artery (RMCA) and left middle cerebral artery (LMCA) determined by TCD were analyzed. Results The average of RMCA maximum and mean flow velocities were found to be significantly lower in HF patients than those in control group (76,06±23,7 cm/s and 48,49±16,4 cm/s in HF group vs 87,84±14,5 cm/s and 56,41±10,7 cm/s in control group, p=0,025 and p=0,016, respectively). The average of LMCA maximum and mean flow velocities were also significantly lower in HF patients than those in control group (75,1±22,3 cm/s and 47,57±14.8 cm/s in HF group vs 88,73±17,7 cm/s and 57,15±12,4 cm/s in control group, p=0,009 and p=0,007, respectively). However, there was no significant difference in minimum RMCA or LMCA flow velocities between HF group and control groups (33,5±10,6 cm/s and 32,86±9,58 cm/s in HF group vs 36,34±9,2 cm/s and 36,53±10,4 cm/s in control group, p=0,226 and p=0,157, respectively). No significant microembolic signals were detected in HF and control groups. Conclusions The results of this study showed that HF patients with reduced EF have lower cerebral blood flow velocities as compared to healthy controls, which might be one of the explanations of the adverse interaction between heart and brain in HF.

P2610Increase in comfortable walking speed during hospitalization predicts the readmission due to decompensated heart failure in heart failure patients with preserved ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Tabata ◽  
M Kato ◽  
N Hamazaki ◽  
T Masuda
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Ejection Fraction ◽  
Exercise Capacity ◽  
Walking Speed ◽  
Decompensated Heart Failure ◽  
Preserved Ejection Fraction ◽  
Functional Classification ◽  
Multivariate Logistic Regression ◽  
Heart Failure Patients

Abstract Background Heart failure patients with preserved ejection fraction (HFpEF) have reduced exercise capacity and poor prognosis as well as those with reduced ejection fraction (HFrEF). Both cardiac function and exercise capacity have been known as prognostic factors for patients with HFrEF. However, few reports documented the relations of comfortable walking speed (CWS) during hospitalization to exercise capacity and prognosis. is used as a clinical measure to assess their exercise capacity and prognosis. However, few reports documented the correlations of CWS with exercise capacity and prognosis in patients with HFpEF. Purpose This study aimed to investigate whether CWS at hospital discharge and the increase in CWS during hospitalization predicted the readmission due to decompensated heart failure in patients with HFpEF and HFrEF. Methods Patients who were hospitalized due to heart failure with New York Heart Association (NYHA) Functional Classification III or IV were prospectively followed up for 3 years after hospital discharge. Consequently, 264 patients, 173 males and 92 females, aged 73.2±6.8 years were studied. Patients were divided into 3 groups based on their ejection fraction (EF): HFpEF group (EF≥50%; n=98), HFrEF group (EF<40%; n=138) and heart failure with mid-range ejection fraction (HFmrEF) group (40%≤EF≤49%; n=28). We assessed clinical characteristics including age, gender, height, NYHA functional classification, etiology of CHF, plasma brain natriuretic peptide and left ventricular ejection fraction (LVEF) on admission, and measured CWS several days after admission and at discharge. We determined significant factors affecting the readmission and their cut-off values using univariate and multivariate logistic regression analyses and the area under the receiver operating characteristics curves in the three groups. Results Forty patients (40.8%), 54 (39.1%) and 6 (21.4%) were readmitted in the HFpEF, HFrEF and HFmrEF groups, respectively, within 3 years after the discharge. Univariate logistic regression analysis detected the age, LVEF, CWS at discharge and the CWS increase during hospitalization as significant limiting factors for readmission in the HFpEF and HFrEF groups (P<0.05, respectively). The multivariate logistic regression analysis detected the CWS increase during hospitalization as significant limiting factor for readmission in the HFpEF and HFrEF groups (P<0.001 and P<0.05, respectively). The odds ratios of readmission were 1.86 (P<0.01) and 1.44 (P<0.001) with each 5-meter decrease of CWS increase during hospitalization and predictive cut-off values of the CWS increase were 7.5 and 8.5 meters/min in the HFpEF and HFrEF groups, respectively. Conclusion This study demonstrated that the CWS increase during hospitalization was a strong predictor for readmission due to decompensated heart failure in patients not only with HFrEF but also with HFpEF and each predictive the cut-off value was 7.5 and 8.5 meters/min.

scholarly journals Association of admission and discharge anemia status with outcomes in patients hospitalized for acute decompensated heart failure: Differences between patients with preserved and reduced ejection fraction

2017 ◽  
Vol 8 (7) ◽  
pp. 606-614 ◽  
Author(s):  
Katsuya Kajimoto ◽  
Yuichiro Minami ◽  
Shigeru Otsubo ◽  
Naoki Sato
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Ejection Fraction ◽  
Primary Endpoint ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Hazard Ratio ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients

Background: In acute decompensated heart failure patients with a preserved or reduced ejection fraction, the association of admission and discharge anemia status with outcomes remains unclear. Methods and results: Of the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4433 patients (2017 with a preserved and 2416 with a reduced ejection fraction) were examined to investigate associations among the anemia status at admission and discharge (no anemia, developed anemia, resolved anemia, or persistent anemia), a preserved or reduced ejection fraction and the primary endpoint (all-cause death and readmission for heart failure). In the preserved ejection fraction group, adjusted analysis showed that either developed or persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.53; 95% confidence interval (CI): 1.11–2.11; p=0.009 and hazard ratio: 1.60; 95% CI: 1.26–2.04; p<0.001, respectively), but there was no association between resolved anemia and the primary endpoint (hazard ratio: 0.98; 95% CI: 0.67–1.45; p=0.937). In the reduced ejection fraction group, either developed or resolved anemia was associated with a tendency toward higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.29; 95% CI: 0.95–1.62; p=0.089, and hazard ratio: 1.31; 95% CI: 0.96–1.77; p=0.085, respectively), while persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.36; 95% CI: 1.12–1.65; p=0.002). Conclusions: In acute decompensated heart failure patients, the association of admission and discharge anemia status with outcomes differs markedly between patients with a preserved or reduced ejection fraction.

STUDY OF BRAIN-NATRIURETIC PEPTIDE, LACTATE LEVELS AND BLOOD PRESSURE IN PATIENTS WITH CONGESTIVE HEART FAILURE

2021 ◽  
pp. 45-46
Author(s):  
Shahrukh Khilji ◽  
Bushra Fiza ◽  
Shehreen Akhtar ◽  
Jai Prakash ◽  
Maheep Sinha
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Congestive Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Healthy Individual ◽  
Control Group ◽  
Heart Failure Patients ◽  
Lactate Levels ◽  
And Control

INTRODUCTION: Congestive Heart Failure is a complex physiological syndrome caused from structural or functional alterations to the myocardium. Lactate is produced by anaerobic metabolism and is secreted by the Brain-Natriuretic peptide heart ventricles in response to left ventricular stretching or wall tension. AIM: The aim of the study was to evaluate Brain-Natriuretic Peptide, Lactate levels and Blood pressure in Congestive Heart Failure patients and compared them with healthy individual. MATERIALS AND METHODS: Total 80 participants who fullled the inclusion and exclusion criteria were enrolled in the study. They were divided into two group i.e., case and control group. Case group included 40 patients of Congestive Heart Failure, age between 18-65 years and control group comprised of 40 healthy individuals with similar age range. Blood sample were drawn and analyzed for the evaluation of Serum lactate and Brain-Natriuretic Peptide. Blood Pressure was also measured in both the groups. RESULT: The present study has demonstrated that the level of Brain-Natriuretic Peptide and lactate were signicantly high in Congestive heart failure patients when compared with control group. Systolic and Diastolic blood pressure were also higher among patients group. CONCLUSION: The results of the study suggested that the levels of Lactate and Brain-Natriuretic Peptide were high in Congestive heart failure patients when compared with healthy individual. Systolic and Diastolic blood pressure were also higher among patients group. Elevated lactate and Brain-Natriuretic Peptide level can be recommended as useful indicator of poor prognosis and hence can be helpful in early identication of patients at risk.

scholarly journals Impact of Self-efficacy Strategies Education on Self-care Behaviors among Heart Failure Patients

2020 ◽  
Author(s):  
Nooshin Peyman ◽  
Fateme Shahedi ◽  
Mahbubeh Abdollahi ◽  
Hassan Doosti ◽  
Zohre Zadehahmad
Keyword(s):  
Heart Failure ◽  
Self Efficacy ◽  
Intervention Group ◽  
Self Care ◽  
Educational Interventions ◽  
Control Group ◽  
Heart Failure Patients ◽  
Positive Effects ◽  
The Mean ◽  
And Control

Background: Self-efficacy in self-care behaviors is an effective framework for measuring patients’ degree of ability to perform selfcare behaviors that significantly affect their recovery process and quality of life. This study was designed to investigate the effects of education based on self-efficacy strategies on self-care behaviors in heart failure patients. Methods: A semi-experimental study was conducted on 80 heart failure patients divided into 2 equal groups of test and control. The intervention group received three 60-minute practical and theoretical training sessions based on self-care and self-efficacy strategies, while the control group received the usual care services. Self-care behaviors and self-efficacy were evaluated before training, shortly after training, and 3 months after the training program using the Sullivan self-efficacy questionnaire for heart failure patients and the European self-care behaviors questionnaires. Results: The mean age of the patients was 55.00±8.48 and 51.61±8.51 years in the intervention and control groups, respectively. Women comprised 73.7% (n=59) of the study population. The mean score for the self-care and self-efficacy questionnaires in the experimental group was 23.50±6.58 and 18.57±6.64, correspondingly, before the intervention, which increased to 42.64±6.74 (P<0.014) and 32.29±7.06 (P<0.001), respectively, shortly after the intervention. A significant improvement also occurred at 3 months’ follow-up (P<0.001). Self-care behaviors also revealed a positive correlation with self-efficacy shortly after the intervention (r=0.82, P<0.001) and 3 months after the intervention (r=0.85, P<0.001). Conclusion: The implementation of educational interventions based on self-efficacy strategies could have positive effects on healthpromoting behaviors among heart failure patients.

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