Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure
Autor(a) principal: | |
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Data de Publicação: | 2002 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/19721 |
Resumo: | Objective - To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. Methods - Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. Results - We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001). We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001) and central venous pressure (r=0.63; P<0.001). After clinical optimization, improvement in functional class occurred (P< 0.001), with a tendency towards improvement in ejection fraction and no impairment to renal function. Conclusion - Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in immediate benefits for patients with severe heart failure. |
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Rohde, Luis Eduardo PaimFurian, Thiago QuediCampos, Candice P.Biolo, AndreiaSilva, Eneida Rejane Rabelo daFoppa, MuriloClausell, Nadine Oliveira2010-04-16T09:11:20Z20020066-782Xhttp://hdl.handle.net/10183/19721000389514Objective - To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. Methods - Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. Results - We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001). We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001) and central venous pressure (r=0.63; P<0.001). After clinical optimization, improvement in functional class occurred (P< 0.001), with a tendency towards improvement in ejection fraction and no impairment to renal function. Conclusion - Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in immediate benefits for patients with severe heart failure.application/pdfengArquivos brasileiros de cardiologia. São Paulo. Vol. 78, n. 3 (mar. 2002), p. 261-266Insuficiência cardíacaHemodinâmicaCateterismo cardíacoDiuréticosVasodilatadoresPressão ventricularDébito cardíacoImplications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failureinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL000389514.pdf000389514.pdfTexto completo (inglês)application/pdf334272http://www.lume.ufrgs.br/bitstream/10183/19721/1/000389514.pdf3ce61a5a9f0cb42c977deab314b717e7MD51TEXT000389514.pdf.txt000389514.pdf.txtExtracted Texttext/plain27474http://www.lume.ufrgs.br/bitstream/10183/19721/2/000389514.pdf.txt9cc9b1a73bb246d51ff663ea45e6e697MD52THUMBNAIL000389514.pdf.jpg000389514.pdf.jpgGenerated Thumbnailimage/jpeg2105http://www.lume.ufrgs.br/bitstream/10183/19721/3/000389514.pdf.jpgb6b15d24101558613c30b5fd1810bc07MD5310183/197212023-07-02 03:41:36.381247oai:www.lume.ufrgs.br:10183/19721Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-07-02T06:41:36Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
title |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
spellingShingle |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure Rohde, Luis Eduardo Paim Insuficiência cardíaca Hemodinâmica Cateterismo cardíaco Diuréticos Vasodilatadores Pressão ventricular Débito cardíaco |
title_short |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
title_full |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
title_fullStr |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
title_full_unstemmed |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
title_sort |
Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
author |
Rohde, Luis Eduardo Paim |
author_facet |
Rohde, Luis Eduardo Paim Furian, Thiago Quedi Campos, Candice P. Biolo, Andreia Silva, Eneida Rejane Rabelo da Foppa, Murilo Clausell, Nadine Oliveira |
author_role |
author |
author2 |
Furian, Thiago Quedi Campos, Candice P. Biolo, Andreia Silva, Eneida Rejane Rabelo da Foppa, Murilo Clausell, Nadine Oliveira |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Rohde, Luis Eduardo Paim Furian, Thiago Quedi Campos, Candice P. Biolo, Andreia Silva, Eneida Rejane Rabelo da Foppa, Murilo Clausell, Nadine Oliveira |
dc.subject.por.fl_str_mv |
Insuficiência cardíaca Hemodinâmica Cateterismo cardíaco Diuréticos Vasodilatadores Pressão ventricular Débito cardíaco |
topic |
Insuficiência cardíaca Hemodinâmica Cateterismo cardíaco Diuréticos Vasodilatadores Pressão ventricular Débito cardíaco |
description |
Objective - To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. Methods - Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. Results - We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001). We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001) and central venous pressure (r=0.63; P<0.001). After clinical optimization, improvement in functional class occurred (P< 0.001), with a tendency towards improvement in ejection fraction and no impairment to renal function. Conclusion - Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in immediate benefits for patients with severe heart failure. |
publishDate |
2002 |
dc.date.issued.fl_str_mv |
2002 |
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2010-04-16T09:11:20Z |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Arquivos brasileiros de cardiologia. São Paulo. Vol. 78, n. 3 (mar. 2002), p. 261-266 |
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