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• W2080201135 abstract "BackgroundUltrafiltration (UF) has been shown to be an effective option in the treatment of acute decompensated heart failure (ADHF). To date, the majority of published data have focused on the use of UF in the inpatient setting. Little information exists on the application of this treatment modality in the outpatient setting. Herein we report our preliminary experience with the use of UF for mild AHDF cases in an effort to avoid inpatient admissions.MethodsA retrospective chart analysis of patient who underwent UF in the outpatient setting between 2009-2011. Patients were initially identified as outpatient UF candidates after evaluation by the Heart Failure team at our institution. Patients with clinical findings suggestive of ADHF without hemodynamic compromise or acute cardiogenic shock were considered to be eligible. Additionally, proximity to our center with reliable transportation options for multiple days of treatment, if necessary, was considered.Data recorded included the length of therapy, fluid volume removed, change in weight, catheter type used, and adverse events. Freedom from an ED visit or inpatient admission within 2 weeks was also recorded. UF received within a short span (consecutive days or within 5 days) was considered to be a single episode.ResultsTwenty-one episodes of outpatient UF occurred in the specified time frame. Average length of therapy was 2.29 days (range 1-3), with UF occurring on average 7.92 hrs/d resulting in an average fluid removal of 2 liters/d. Total average weight loss was 8.4 kg (3.2% weight loss). Freedom from an unplanned acute presentation at 2 weeks was 75%. Eight of 21 UF episodes were delivered using a commercially available dual-lumen UF catheter (central line); the rest were through peripheral IV access. No adverse events were noted. Serum creatinine values pre- and post-UF were 1.48±0.52 and 1.50±0.52, respectively (p NS).ConclusionsOutpatient UF is a reasonable option for mild ADHF. Effective volume removal can be achieved safely without exposure to increased doses of loop diuretics, which may translate to improved HF outcomes. Outpatient UF may also reduce inpatient admissions in an otherwise high-risk population. BackgroundUltrafiltration (UF) has been shown to be an effective option in the treatment of acute decompensated heart failure (ADHF). To date, the majority of published data have focused on the use of UF in the inpatient setting. Little information exists on the application of this treatment modality in the outpatient setting. Herein we report our preliminary experience with the use of UF for mild AHDF cases in an effort to avoid inpatient admissions. Ultrafiltration (UF) has been shown to be an effective option in the treatment of acute decompensated heart failure (ADHF). To date, the majority of published data have focused on the use of UF in the inpatient setting. Little information exists on the application of this treatment modality in the outpatient setting. Herein we report our preliminary experience with the use of UF for mild AHDF cases in an effort to avoid inpatient admissions. MethodsA retrospective chart analysis of patient who underwent UF in the outpatient setting between 2009-2011. Patients were initially identified as outpatient UF candidates after evaluation by the Heart Failure team at our institution. Patients with clinical findings suggestive of ADHF without hemodynamic compromise or acute cardiogenic shock were considered to be eligible. Additionally, proximity to our center with reliable transportation options for multiple days of treatment, if necessary, was considered.Data recorded included the length of therapy, fluid volume removed, change in weight, catheter type used, and adverse events. Freedom from an ED visit or inpatient admission within 2 weeks was also recorded. UF received within a short span (consecutive days or within 5 days) was considered to be a single episode. A retrospective chart analysis of patient who underwent UF in the outpatient setting between 2009-2011. Patients were initially identified as outpatient UF candidates after evaluation by the Heart Failure team at our institution. Patients with clinical findings suggestive of ADHF without hemodynamic compromise or acute cardiogenic shock were considered to be eligible. Additionally, proximity to our center with reliable transportation options for multiple days of treatment, if necessary, was considered. Data recorded included the length of therapy, fluid volume removed, change in weight, catheter type used, and adverse events. Freedom from an ED visit or inpatient admission within 2 weeks was also recorded. UF received within a short span (consecutive days or within 5 days) was considered to be a single episode. ResultsTwenty-one episodes of outpatient UF occurred in the specified time frame. Average length of therapy was 2.29 days (range 1-3), with UF occurring on average 7.92 hrs/d resulting in an average fluid removal of 2 liters/d. Total average weight loss was 8.4 kg (3.2% weight loss). Freedom from an unplanned acute presentation at 2 weeks was 75%. Eight of 21 UF episodes were delivered using a commercially available dual-lumen UF catheter (central line); the rest were through peripheral IV access. No adverse events were noted. Serum creatinine values pre- and post-UF were 1.48±0.52 and 1.50±0.52, respectively (p NS). Twenty-one episodes of outpatient UF occurred in the specified time frame. Average length of therapy was 2.29 days (range 1-3), with UF occurring on average 7.92 hrs/d resulting in an average fluid removal of 2 liters/d. Total average weight loss was 8.4 kg (3.2% weight loss). Freedom from an unplanned acute presentation at 2 weeks was 75%. Eight of 21 UF episodes were delivered using a commercially available dual-lumen UF catheter (central line); the rest were through peripheral IV access. No adverse events were noted. Serum creatinine values pre- and post-UF were 1.48±0.52 and 1.50±0.52, respectively (p NS). ConclusionsOutpatient UF is a reasonable option for mild ADHF. Effective volume removal can be achieved safely without exposure to increased doses of loop diuretics, which may translate to improved HF outcomes. Outpatient UF may also reduce inpatient admissions in an otherwise high-risk population. Outpatient UF is a reasonable option for mild ADHF. Effective volume removal can be achieved safely without exposure to increased doses of loop diuretics, which may translate to improved HF outcomes. Outpatient UF may also reduce inpatient admissions in an otherwise high-risk population." @default.
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• W2080201135 date "2012-08-01" @default.
• W2080201135 modified "2023-10-14" @default.
• W2080201135 title "Outpatient Ultrafiltration for Acute Decompensated Heart Failure: Single Center Experience" @default.
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