Aquapheresis Efficacy in Outpatients With Decompensated Heart Failure

Launched by RAMONA GELZER BELL · Sep 29, 2020

Keywords

ClinConnect Summary

Congestive heart failure (CHF) affects nearly 2% of the U.S. population, with almost 1 million hospital admissions for acute decompensated CHF annually. Congestive heart failure is the most frequent cause of hospitalization in patients over the age of 65. Patients admitted for acute decompensated heart failure (ADHF) have a high 6-month readmission rate for acute CHF, ranging from 23% to 40% in different studies. It is estimated that 25 to 30% of these patients are diuretic resistant with 50% of patients losing less than 5 lbs. from admission weight and 20% actually gaining weight during th...

Gender

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Eligibility criteria

• Inclusion Criteria:
• • Subjects must be 18 years of age or older already on standard of care therapy including Angiotensin Converting Enzyme Inhibitors (ACE-I), Angiotensin
• Receptor Blockers (ARBs), Sacubitril/Valsartan, beta-blocker, oral diuretic (80 mg Lasix/2 mg Bumex/40 mg Torsemide+/-Thiazide diuretic), and meet the following inclusion criteria to be enrolled:
• Inclusion Criteria:
• • 1. CHF refractory to oral diuretic (80mg Lasix, 2mg Bumex, or 40mg Torsemide)
• 2. Volume overload secondary to systolic or diastolic HF, evidenced by at least 2 of the following:
• • 1. Elevated BNP (\>100)
• • 2. Paroxysmal nocturnal dyspnea or orthopnea
• • 3. Elevated jugular venous distention (\>/ 7 cm)
• • 4. X-ray findings consisted with CHF
• • 5. Presence of ascites or LE edema . -
• Exclusion Criteria:
• • 1. Acute Coronary Syndrome
• • 2. Hypertensive urgency or emergency
• • 3. Rapid atrial fibrillation difficult to control
• • 4. Contraindication to anticoagulation
• • 5. Pregnancy
• • 6. Requires hemodialysis (\> CR \> 3.0 mg/dl)
• • 7. Symptomatic hypotension
• • 8. Poor venous access
• • 9. Pressor dependent. -