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

Ali Vazir, Victoria L. Simpkin, Philip Marino, Andrew Ludman, Winston Banya, Guido Tavazzi, Anthony J. Bastin, Sarah Trenfield, Arshad Ghori, Peter D. Alexander, Mark Griffiths, Susanna Price, Rakesh Sharma, Martin R. Cowie

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 ± 69 μmol/l, P 2 was significantly associated with Δcreatinine [β-coefficient of − 1.3 95%CI (− 1.8 to − 0.7), P 

Original languageEnglish
Pages (from-to)618-622
Number of pages5
JournalInternational Journal of Cardiology
Volume220
DOIs
Publication statusPublished - Oct 1 2016

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Ultrafiltration
Diuretics
Heart Failure
Hemodynamics
Kidney
Creatinine
Mortality
Blood Pressure
Survival Analysis
Cell Size
Electrolytes
Therapeutics
Multivariate Analysis
Heart Rate
Regression Analysis

Keywords

  • Central venous saturation
  • Heart failure
  • Ultrafiltration
  • Worsening renal function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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. / Vazir, Ali; Simpkin, Victoria L.; Marino, Philip; Ludman, Andrew; Banya, Winston; Tavazzi, Guido; Bastin, Anthony J.; Trenfield, Sarah; Ghori, Arshad; Alexander, Peter D.; Griffiths, Mark; Price, Susanna; Sharma, Rakesh; Cowie, Martin R.

In: International Journal of Cardiology, Vol. 220, 01.10.2016, p. 618-622.

Research output: Contribution to journalArticle

Vazir, Ali ; Simpkin, Victoria L. ; Marino, Philip ; Ludman, Andrew ; Banya, Winston ; Tavazzi, Guido ; Bastin, Anthony J. ; Trenfield, Sarah ; Ghori, Arshad ; Alexander, Peter D. ; Griffiths, Mark ; Price, Susanna ; Sharma, Rakesh ; Cowie, Martin R. / 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. In: International Journal of Cardiology. 2016 ; Vol. 220. pp. 618-622.
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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 ± 69 μmol/l, P 2 was significantly associated with Δcreatinine [β-coefficient of − 1.3 95{\%}CI (− 1.8 to − 0.7), P ",
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AU - Vazir, Ali

AU - Simpkin, Victoria L.

AU - Marino, Philip

AU - Ludman, Andrew

AU - Banya, Winston

AU - Tavazzi, Guido

AU - Bastin, Anthony J.

AU - Trenfield, Sarah

AU - Ghori, Arshad

AU - Alexander, Peter D.

AU - Griffiths, Mark

AU - Price, Susanna

AU - Sharma, Rakesh

AU - Cowie, Martin R.

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AB - 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 ± 69 μmol/l, P 2 was significantly associated with Δcreatinine [β-coefficient of − 1.3 95%CI (− 1.8 to − 0.7), P 

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