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使用标准外周静脉导管进行大容量超滤治疗急性失代偿性心力衰竭

Large volume ultrafiltration for acute decompensated heart failure using standard peripheral intravenous catheters.

作者信息

Dahle Thom G, Blake Donnevan, Ali Syed S, Olinger Chad C, Bunte Matthew C, Boyle Andrew J

机构信息

University of Minnesota, Minneapolis, Minnesota 55455, USA.

出版信息

J Card Fail. 2006 Jun;12(5):349-52. doi: 10.1016/j.cardfail.2006.02.012.

Abstract

BACKGROUND

Ultrafiltration for decompensated heart failure has recently generated significant clinical interest with the development of a portable machine that does not require an intensive care or dialysis unit. This case series was designed to demonstrate the feasibility and effectiveness of performing large volume ultrafiltration via peripherally inserted standard intravenous (IV) catheters in patients with acute decompensated heart failure.

METHODS AND RESULTS

Nine hospitalized patients with decompensated heart failure underwent peripheral ultrafiltration (PUF) therapy with peripheral IV catheters. The mean length of time of PUF therapy was 33.3 +/- 20.0 hours with a mean volume removed of 7.0 +/- 4.9 L. All patients experienced a statistically significant mean weight loss of 6.2 +/- 5.0 kg, P = .01. There was no statistically significant change in renal function.

CONCLUSION

We report the first successful implementation of ultrafiltration via standard peripheral IV catheters to remove a large volume of fluid over an extended period of time reliably in a small group of patients. The ability to use PUF therapy via peripheral IV catheters will potentially allow this therapy to be implemented more easily in a variety of care settings to treat patients with resistant heart failure.

摘要

背景

随着一种无需重症监护或透析单元的便携式机器的开发,用于失代偿性心力衰竭的超滤技术最近引起了极大的临床关注。本病例系列旨在证明在急性失代偿性心力衰竭患者中通过外周插入标准静脉(IV)导管进行大容量超滤的可行性和有效性。

方法与结果

9例住院的失代偿性心力衰竭患者接受了外周静脉导管外周超滤(PUF)治疗。PUF治疗的平均时间为33.3±20.0小时,平均超滤量为7.0±4.9升。所有患者平均体重减轻6.2±5.0千克,差异有统计学意义(P = 0.01)。肾功能无统计学意义的变化。

结论

我们报告了首次通过标准外周静脉导管成功实施超滤,在一小群患者中长时间可靠地清除大量液体。通过外周静脉导管使用PUF治疗的能力可能使这种治疗在各种护理环境中更容易实施,以治疗难治性心力衰竭患者。

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