scholarly journals Cardio-renal syndrome type 1 is associated with hospital-acquired disability in patients with acute decompensated heart failure

2021 ◽  
Vol 28 (3) ◽  
pp. 197-204
Author(s):  
Kotaro Hirakawa ◽  
Masakazu Saitoh ◽  
Takeshi Arimitsu ◽  
Keigo Iwai ◽  
Hiroshi Yamagata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Syndrome Type ◽  
Acquired Disability ◽  
Hospital Acquired

Tidal peritoneal dialysis versus ultrafiltration in type 1 cardiorenal syndrome: A prospective randomized study

2019 ◽  
Vol 42 (12) ◽  
pp. 684-694 ◽  
Author(s):  
Abdullah K Al-Hwiesh ◽  
Ibrahiem Saeed Abdul-Rahman ◽  
Nadia Al-Audah ◽  
Amani Al-Hwiesh ◽  
Mousa Al-Harbi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Creatinine Level ◽  
Acute Decompensated Heart Failure ◽  
Therapy Group ◽  
Decompensated Heart Failure ◽  
Cardiorenal Syndrome ◽  
Fluid Loss ◽  
Tidal Peritoneal Dialysis

Background: Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with acute decompensated heart failure. Little is known about the efficacy and safety of peritoneal dialysis in patients with acute decompensated heart failure complicated by acute cardiorenal syndrome. Methods: We randomly assigned a total of 88 patients with type 1 acute cardiorenal syndrome to a strategy of ultrafiltration therapy (44 patients) or tidal peritoneal dialysis (44 patients). The primary endpoint was the change from baseline in the serum creatinine level and left ventricular function represented as ejection fraction, as assessed 72 and 120 h after random assignment. Patients were followed for 90 days after discharge from the hospital. Results: Ultrafiltration therapy was inferior to tidal peritoneal dialysis therapy with respect to the primary endpoint of the change in the serum creatinine levels at 72 and 120 h ( p = 0.041) and ejection fraction at 72 and 120 h after enrollment ( p = 0.044 and p = 0.032), owing to both an increase in the creatinine level in the ultrafiltration therapy group and a decrease in its level in the tidal peritoneal dialysis group. At 120 h, the mean change in the creatinine level was 1.4 ± 0.5 mg/dL in the ultrafiltration therapy group, as compared with 2.4 ± 1.3 mg/dL in the tidal peritoneal dialysis group ( p = 0.023). At 72 and 120 h, there was a significant difference in weight loss between patients in the ultrafiltration therapy group and those in the tidal peritoneal dialysis group ( p = 0.025). Net fluid loss was also greater in tidal peritoneal dialysis patients ( p = 0.018). Adverse events were more observed in the ultrafiltration therapy group ( p = 0.007). At 90 days post-discharge, tidal peritoneal dialysis patients had fewer rehospitalization for heart failure (14.3% vs 32.5%, p = 0.022). Conclusion: Tidal peritoneal dialysis is a safe and effective means for removing toxins and large quantities of excess fluid from patients with intractable heart failure. In patients with cardiorenal syndrome type 1, the use of tidal peritoneal dialysis was superior to ultrafiltration therapy for the preservation of renal function, improvement of cardiac function, and net fluid loss. Ultrafiltration therapy was associated with a higher rate of adverse events.

International comparison of clinical use of inotrope and vasodilator therapy for acute decompensated heart failure

2008 ◽  
Vol 7 ◽  
pp. 60-61
Author(s):  
H YOKOYAMA ◽  
S NAKATANI ◽  
K HASHIMURA ◽  
M KITAKAZE ◽  
Y GOTO ◽  
...  
Keyword(s):  
Heart Failure ◽  
International Comparison ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Clinical Use ◽  
Vasodilator Therapy

Assessing Acute Decompensated Heart Failure – Strategies and Tools

2012 ◽  
Vol 8 (2) ◽  
pp. 128
Author(s):  
Ali Vazir ◽  
Martin R Cowie ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Pulse Contour Analysis ◽  
Decompensated Heart Failure ◽  
Rapid Onset ◽  
Clinical Syndrome ◽  
Response To Therapy ◽  
Contour Analysis ◽  
Physiological Variables ◽  
Co Morbidity

Acute heart failure – the rapid onset of, or change in, signs and/or symptoms of heart failure requiring urgent treatment – is a serious clinical syndrome, associated with high mortality and healthcare costs. History, physical examination and early 2D and Doppler echocardiography are crucial to the proper assessment of patients, and will help determine the appropriate monitoring and management strategy. Most patients are elderly and have considerable co-morbidity. Clinical assessment is key to monitoring progress, but a number of clinical techniques – including simple Doppler and echocardiographic tools, pulse contour analysis and impedance cardiography – can help assess the response to therapy. A pulmonary artery catheter is not a routine monitoring tool, but can be very useful in patients with complex physiology, in those who fail to respond to therapy as would be anticipated, or in those being considered for mechanical intervention. As yet, the serial measurement of plasma natriuretic peptides is of limited value, but it does have a role in diagnosis and prognostication. Increasingly, the remote monitoring of physiological variables by completely implanted devices is possible, but the place of such technology in clinical practice is yet to be clearly established.

Arterial elastance modulation by intra-aortic balloon counterpulsation in patients with acute decompensated heart failure and low-output state

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alice Sacco ◽  
Guido Tavazzi ◽  
Nuccia Morici ◽  
Giovanna Viola ◽  
Paolo Meani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Arterial Elastance ◽  
Output State ◽  
Intra Aortic Balloon Counterpulsation ◽  
Balloon Counterpulsation

Acute decompensated heart failure. What are we missing?

2012 ◽  
Vol 03 (01) ◽  
pp. 79-88
Author(s):  
Pradub Sukhum
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure
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