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- Title
Ultrafiltration in patients with decompensated heart failure and diuretic resistance: an Asian centre's experience.
- Authors
Loon Yee Louis Teo; Choon Pin Lim; Chia Lee Neo; Lee Wah Teo; Swee Ling Elaine Ng; Laura Lihua Chan; Manish Kaushik; Kheng Leng David Sim; Teo, Loon Yee Louis; Lim, Choon Pin; Neo, Chia Lee; Teo, Lee Wah; Ng, Swee Ling Elaine; Chan, Laura Lihua; Kaushik, Manish; Sim, Kheng Leng David
- Abstract
<bold>Introduction: </bold>Diuretics are the mainstay of therapy for restoring the euvolaemic state in patients with decompensated heart failure. However, diuretic resistance remains a challenge.<bold>Methods: </bold>We conducted a retrospective cohort study to examine the efficacy and safety of ultrafiltration (UF) in 44 hospitalised patients who had decompensated heart failure and diuretic resistance between October 2011 and July 2013.<bold>Results: </bold>Among the 44 patients, 18 received UF (i.e. UF group), while 26 received diuretics (i.e. standard care group). After 48 hours, the UF group achieved lower urine output (1,355 mL vs. 3,815 mL, p = 0.0003), greater fluid loss (5,058 mL vs. 1,915 mL, p < 0.0001) and greater weight loss (5.0 kg vs. 1.0 kg, p < 0.0001) than the standard care group. The UF group also had a shorter duration of hospitalisation (5.0 days vs. 9.5 days, p = 0.0010). There were no differences in the incidence of 30-day emergency department visits and rehospitalisations for heart failure between the two groups. At 90 days, the UF group had fewer emergency department visits (0.2 vs. 0.8, p = 0.0500) and fewer rehospitalisations for heart failure (0.3 vs. 1.0, p = 0.0442). Reduction in EQ-5D™ scores was greater in the UF group, both at discharge (2.7 vs. 1.4, p = 0.0283) and 30 days (2.5 vs. 0.3, p = 0.0033). No adverse events were reported with UF.<bold>Conclusion: </bold>UF is an effective and safe treatment that can improve the health outcomes of Asian patients with decompensated heart failure and diuretic resistance.
- Subjects
HEART failure patients; DRUG resistance; ULTRAFILTRATION; DIURETICS; WEIGHT loss; THERAPEUTICS; HEART failure treatment; HOSPITAL care; HOSPITAL emergency services; TREATMENT effectiveness; RETROSPECTIVE studies; PATIENT readmissions
- Publication
Singapore Medical Journal, 2016, Vol 57, Issue 7, p378
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2016014