Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK; Anglia Ruskin School of Medicine, Chelmsford, UK.
Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK; Anglia Ruskin School of Medicine, Chelmsford, UK.
Int J Cardiol. 2019 Jan 15;275:53-58. doi: 10.1016/j.ijcard.2018.09.085. Epub 2018 Oct 1.
Worsening heart failure complicated by congestion, hypotension, and renal dysfunction is difficult to manage, increasingly common and predicts a poor outcome. Novel therapies are required to facilitate diuresis and implementation of disease-modifying interventions in preparation for hospital discharge. Accordingly, we investigated the haemodynamic and renal effects of the Reitan Catheter Pump (RCP) percutaneous support device in patients admitted with decompensated heart failure (DHF).
This was a prospective observational study of 20 patients admitted with DHF, ejection fraction < 30%, and Cardiac index (CI) < 2.1 L/min/m in need of inotropic/mechanical support.
Patients underwent RCP support for a mean of 18.3 (±6.3) hours. The RCP increased CI from 1.84 L/min/m (±0.27), to 2.41 L/min/m (±0.45, p = 0.04), increased urine output (71 mL/h (±65) to 227 ml/h (±179) (p = 0.006) with a concomitant reduction in serum creatinine (188 μmol/L (±87) to 161 μmol/L (±78) (p = 0.0007). There were no clinically significant haemolysis, vascular injury, or thrombo-embolic complications.
For patients admitted with DHF, the RCP improves cardiac index, diuresis and renal function without causing important complications.
心力衰竭恶化伴充血、低血压和肾功能障碍的管理较为困难，且此类病例日益常见，并预示着预后不良。需要新的治疗方法来促进利尿，并实施疾病修正干预措施，为出院做准备。因此，我们研究了 Reitan 导管泵（RCP）经皮支持设备在因心力衰竭失代偿（DHF）入院的患者中的血液动力学和肾脏效应。
这是一项前瞻性观察研究，纳入了 20 名因 DHF 入院、射血分数 < 30%和心脏指数（CI）< 2.1 L/min/m 需要正性肌力/机械支持的患者。
患者接受 RCP 支持的平均时间为 18.3（±6.3）小时。RCP 使 CI 从 1.84 L/min/m（±0.27）增加到 2.41 L/min/m（±0.45，p = 0.04），尿量增加（71 ml/h（±65）到 227 ml/h（±179）（p = 0.006），同时血清肌酐降低（188 μmol/L（±87）到 161 μmol/L（±78）（p = 0.0007）。没有发生明显的溶血、血管损伤或血栓栓塞并发症。
对于因 DHF 入院的患者，RCP 可改善心指数、利尿和肾功能，而不会引起重要并发症。
