Circulatory response to fluid overload removal by extracorporeal ultrafiltration in refractory congestive heart failure

摘要: Abstract OBJECTIVES The goal of this study was to investigate the hemodynamic and circulatory adjustments extracorporeal ultrafiltration (UF) in refractory congestive heart failure (rCHF). BACKGROUND In rCHF, UF allows clinical improvement restores diuretic efficacy. However, course a session, patients are exposed rapid variations body fluid composition so that, as is withdrawn from intravascular compartment, hypotension or even shock could occur. METHODS 24 with rCHF undergoing UF, we measured, after every liter plasma water removed, hemodynamics, blood gas analysis (in both systemic pulmonary arteries), volume changes (PV) refilling rate (PRR). PV PRR were calculated by considering hematocrit ultrafiltrate volume. RESULTS all patients, performed safely, without side effects instability (ultrafiltrate = 4,880 ± 896 ml). Mean right atrial, artery wedge pressures progressively reduced during procedure. Cardiac output increased at end procedure and, greater extent, h later, relation increase stroke Heart vascular resistance did not increase, other peripheral biochemical parameters worsen UF. Intravascular remained stable throughout entire duration procedure, indicating that proportional refilled congested parenchyma. CONCLUSIONS subtraction associated improvement. Fluid overhydrated interstitium major compensatory mechanism for removal, does occur when adequate prevent hypovolemia.