Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure
Yıl: 2016 Cilt: 25 Sayı: 1 Sayfa Aralığı: 79 - 87 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure
Öz: AMAÇ: Akut dekompanse kalp yetersizliği (ADKY) tedavisinde ultrafiltrasyon ve diüretikleri karşılaştıran çalışmalarda çelişkili sonuçlar elde edilmiştir. Çalışmamızda ADKY nedeniyle yatırılan, sol ventrikül sistolik disfonksiyonu üzerine sağ ventrikül fonksiyon bozukluğunun süperpoze olduğu (biventriküler kalp yetmezliği) hasta grubunda intravenöz diüretik tedavisi ile ultrafiltrasyonu, etkinlik ve güvenilirlik açısından karşılaştırdık.GEREÇ ve YÖNTEMLER: Çalışmamıza ultrafiltrasyon grubuna 10, diüretik grubuna 20 olmak üzere toplam 30 hasta alındı ve hastalar 3 ay takip edildi. BULGULAR: Taburcu olurken; ultrafiltrasyon ve diüretik grupları arasında kilo kaybı, toplam sıvı kaybı ve serum kreatinin düzeyindeki değişiklik açısından istatistiksel olarak anlamlı bir fark bulunmadı. Klinik olarak sağlanan dekonjesyon oranı, her iki grupta benzerdi. Ekokardiyografik parametrelerdeki, diğer biyokimyasal parametrelerdeki değişim, nörohormonal aktivasyonu değerlendirmek için bakılan serum renin ve aldosteron düzeylerindeki değişim de gruplar arasında farklı bulunmadı. İstenmeyen olaylar değerlendirildiğinde; hemodiyalize geçme ultrafiltrasyon grubunda %20, diüretik grubunda %5 oranında, kardiyak arrest ve ölüm ise ultrafiltrasyon grubunda %40, diüretik grubunda %10 oranında görüldü. Hastaların 1 ay ve 3 ay sonraki kilo değişimi, kreatinin ve elektrolit düzeyleri de benzer bulundu.sONUÇ: Sağ ve sol kalp yetersizliğinin birlikte olduğu hastalara uygulanan ultrafiltrasyon ve diüretik tedavilerinin, kilo kaybı, toplam sıvı kaybı, klinik olarak dekonjesyonun sağlanması, böbrek ve kardiyak fonksiyonlarında değişim, renin ve aldosteron düzeylerindeki değişim yönünden birbirine üstünlüğü gösterilemedi. Hemodiyalize geçme, kardiyak arrest ve ölümün ultrafiltrasyon grubunda daha fazla saptanmasına rağmen, istatistiksel değerlendirme yapılamadığından, ultrafiltrasyonun güvenilirliği değerlendirilememiştir. Ultrafiltrasyonun tedavide rutin uygulamaya girmesi için daha kapsamlı çalışmalara ihtiyaç vardır
Anahtar Kelime: Konular:
Akut Dekompanse Biventriküler Kalp Yetersizliği ile Yatırılan Hastalarda Ultrafiltrasyon ve İntravenöz Diüretiklerin Karşılaştırılması
Öz: OBJECTIVE: Studies comparing ultrafiltration and diuretics in management of ADHF have shown controversial results. In this study, we compared the efficacy and safety of intravenous diuretic therapy and ultrafiltration in patients admitted with acute decompensated heart failure (ADHF) who had right ventricular dysfunction superimposed on left ventricular systolic dysfunction. MATERIAL and METHODs: A total of 30 patients of whom 10 were in the ultrafiltration group and 20 were in the diuretic group were enrolled in this study and followed for 3 months. REsULTs: At discharge, there were no significant differences between the ultrafiltration and diuretic groups in terms of weight loss , total fluid loss, and changes in serum creatinine. The clinical decongestion rates were similar in the two groups. Moreover, echocardiographic and biochemical parameters and alterations in renin and aldosterone levels, as measured to assess neurohormonal activation, had overlapping results between the two groups. When unwanted events were analyzed, transition to hemodialysis was seen in 20% of the patients in the ultrafiltration group and 5% of the patients in the diuretic group. The frequency of cardiac arrest and death were 40% in the ultrafiltration group and 10% in the diuretic group. Weight change, creatinine, and electrolyte levels of the patients at 1 and 3 months were also similar.CONCLUsION: Despite the high frequency of hemodialysis transition, cardiac arrest, and death in the ultrafiltration group, safety of ultrafiltration could not be assessed because of inability to perform statistical analyses. Further studies are needed to investigate the practical uses of ultrafiltration in routine clinical practice
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | ŞEKER A, Kayataş M, Hüzmeli c, CANDAN F, YILMAZ M (2016). Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. , 79 - 87. |
| Chicago | ŞEKER Ayşe,Kayataş Mansur,Hüzmeli can,CANDAN Ferhan,YILMAZ MEHMET BIRHAN Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. (2016): 79 - 87. |
| MLA | ŞEKER Ayşe,Kayataş Mansur,Hüzmeli can,CANDAN Ferhan,YILMAZ MEHMET BIRHAN Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. , 2016, ss.79 - 87. |
| AMA | ŞEKER A,Kayataş M,Hüzmeli c,CANDAN F,YILMAZ M Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. . 2016; 79 - 87. |
| Vancouver | ŞEKER A,Kayataş M,Hüzmeli c,CANDAN F,YILMAZ M Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. . 2016; 79 - 87. |
| IEEE | ŞEKER A,Kayataş M,Hüzmeli c,CANDAN F,YILMAZ M "Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure." , ss.79 - 87, 2016. |
| ISNAD | ŞEKER, Ayşe vd. "Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure". (2016), 79-87. |
| APA | ŞEKER A, Kayataş M, Hüzmeli c, CANDAN F, YILMAZ M (2016). Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 25(1), 79 - 87. |
| Chicago | ŞEKER Ayşe,Kayataş Mansur,Hüzmeli can,CANDAN Ferhan,YILMAZ MEHMET BIRHAN Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 25, no.1 (2016): 79 - 87. |
| MLA | ŞEKER Ayşe,Kayataş Mansur,Hüzmeli can,CANDAN Ferhan,YILMAZ MEHMET BIRHAN Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, vol.25, no.1, 2016, ss.79 - 87. |
| AMA | ŞEKER A,Kayataş M,Hüzmeli c,CANDAN F,YILMAZ M Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2016; 25(1): 79 - 87. |
| Vancouver | ŞEKER A,Kayataş M,Hüzmeli c,CANDAN F,YILMAZ M Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2016; 25(1): 79 - 87. |
| IEEE | ŞEKER A,Kayataş M,Hüzmeli c,CANDAN F,YILMAZ M "Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure." Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 25, ss.79 - 87, 2016. |
| ISNAD | ŞEKER, Ayşe vd. "Comparison of Ultrafiltration and Intravenous Diuretic Therapies in Patients Hospitalized for Acute Decompensated Biventricular Heart Failure". Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 25/1 (2016), 79-87. |
