Outcomes of Ultrafiltration in community-based hospitals.


Journal

Current problems in cardiology
ISSN: 1535-6280
Titre abrégé: Curr Probl Cardiol
Pays: Netherlands
ID NLM: 7701802

Informations de publication

Date de publication:
22 Jun 2024
Historique:
received: 07 06 2024
accepted: 19 06 2024
medline: 24 6 2024
pubmed: 24 6 2024
entrez: 23 6 2024
Statut: aheadofprint

Résumé

We sought to examine outcomes of ultrafiltration in real world community-based hospital settings. Ultrafiltration (UF) is an accepted therapeutic option for advanced decompensated heart failure (ADHF). the feasibility of UF in a community hospital setting, by general cardiologists in a start-up program had not been objectively evaluated. We retrospectively analyzed the first-year cohort of ADHF patients treated with UF from 10/1/2019 to 10/1/2020, which totaled 30 patients, utilizing the CHF Solutions Aquadex FlexFlow™ System with active UF rate titration. Baseline patient characteristics were similar to RCTs: mean age 63, 73% male; 27% female; 53% Caucasian; 47% African American; 77% had LVEF ≤ 40. The baseline mean serum creatinine (Cr) was 1.84 ±0.62 mg/dL, mean GFR of 36.95 ±9.60 ml/min. HF re-admission rates were not significantly different than prior studies (17.2% at 30 d, 23.3% at 60 d, but in our cohort, per patient HF re-admission rates were reduced significantly by 60 d (0.30 p = 0.017). Our analysis showed success with UF in mainstream setting with reproducible results of significant volume loss without adverse renal effect, mitigation of recurrent Hdmissions, and remarkable subjective clinical benefit.

Sections du résumé

OBJECTIVE OBJECTIVE
We sought to examine outcomes of ultrafiltration in real world community-based hospital settings.
BACKGROUND BACKGROUND
Ultrafiltration (UF) is an accepted therapeutic option for advanced decompensated heart failure (ADHF). the feasibility of UF in a community hospital setting, by general cardiologists in a start-up program had not been objectively evaluated.
METHODS METHODS
We retrospectively analyzed the first-year cohort of ADHF patients treated with UF from 10/1/2019 to 10/1/2020, which totaled 30 patients, utilizing the CHF Solutions Aquadex FlexFlow™ System with active UF rate titration.
RESULTS RESULTS
Baseline patient characteristics were similar to RCTs: mean age 63, 73% male; 27% female; 53% Caucasian; 47% African American; 77% had LVEF ≤ 40. The baseline mean serum creatinine (Cr) was 1.84 ±0.62 mg/dL, mean GFR of 36.95 ±9.60 ml/min. HF re-admission rates were not significantly different than prior studies (17.2% at 30 d, 23.3% at 60 d, but in our cohort, per patient HF re-admission rates were reduced significantly by 60 d (0.30 p = 0.017).
CONCLUSION CONCLUSIONS
Our analysis showed success with UF in mainstream setting with reproducible results of significant volume loss without adverse renal effect, mitigation of recurrent Hdmissions, and remarkable subjective clinical benefit.

Identifiants

pubmed: 38909929
pii: S0146-2806(24)00354-2
doi: 10.1016/j.cpcardiol.2024.102716
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

102716

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: John L. Jefferies, MD, MPH, Oguz Akbilgic, DBA, PhD reports financial support was provided by Nuwellis. John L. Jefferies, MD, MPH reports a relationship with Nuwellis Inc that includes: consulting or advisory and speaking and lecture fees. Oguz Akbilgic, DBA, PhD reports a relationship with Nuwellis Inc that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Viswanath R Chinta (VR)

Department of Advanced Heart Failure and Transplant Cardiology, HCA Houston HealthCare Medical Center, Houston, TX. Electronic address: viswanath.chinta@hcahealthcare.com.

Neelima P Theella (NP)

Department of Advanced Heart Failure and Transplant Cardiology, HCA Houston HealthCare Medical Center, Houston, TX.

Joel M Raja (JM)

University of Tennessee Health Science Center, Memphis, TN.

Aranyank Rawal (A)

University of Tennessee Health Science Center, Memphis, TN.

Anandbir Bath (A)

Ascension Borgess Hospital/Michigan State University Kalamazoo, Michigan.

David Jones (D)

University of Tennessee Health Science Center, Memphis, TN.

Atif Ibrahim (A)

North Mississippi Medical Center, Tupelo, MS.

Abdul Aziz A Asbeutah (AAA)

University of Tennessee Health Science Center, Memphis, TN.

Adedayo A Adeboye (AA)

University of Tennessee Health Science Center, Memphis, TN.

Oguz Akbilgic (O)

Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC.

Rami N Khouzam (RN)

Heart and Vascular institute, Grand Strand Medical Center, Myrtle Beach, SC.

James J Stamper (JJ)

Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL.

John L Jefferies (JL)

University of Memphis, Memphis, TN.

Classifications MeSH