PMID- 8917742
OWN - NLM
STAT- MEDLINE
DCOM- 19961210
LR  - 20190512
IS  - 1460-2725 (Print)
IS  - 1460-2393 (Linking)
VI  - 89
IP  - 9
DP  - 1996 Sep
TI  - Long-term successful management of refractory congestive cardiac failure by 
      intermittent ambulatory peritoneal ultrafiltration.
PG  - 681-3
AB  - Despite advances in the pharmacological management of cardiac failure, some 
      patients remain refractory to this therapy. However, improved understanding of 
      the physiology and technique of peritoneal dialysis has recently allowed 
      ambulatory peritoneal ultrafiltration to be applied to the treatment of patients 
      with intractable heart failure. We report the management of three such patients 
      with New York Heart Association (NYHA) class IV cardiac failure, each with a left 
      ventricular ejection fraction < 20%. They had become unresponsive to maximum 
      pharmacological management with inotropes, diuretics and ACE inhibitors. All 
      patients had biochemical evidence of pre-renal azotemia. Initially, patients 
      received aggressive ultrafiltration by continuous veno-venous haemofiltration 
      (CVVH) or one- to two-hourly peritoneal dialysis exchanges until they achieved an 
      optimal dry body weight. Once stabilized, they were converted to an intermittent 
      ambulatory peritoneal ultrafiltration (IAPU) regimen of one to three exchanges 
      per 24 h according to their individual needs. During an 18 +/- 10-month 
      follow-up, their duration of hospital confinement was reduced by 85% and all 
      three patients improved from class IV to class II cardiac failure. IAPU may have 
      a useful role in the long-term management of intractable heart failure in a 
      selected group of patients.
FAU - Tormey, V
AU  - Tormey V
AD  - Department of Nephrology, Beaumont Hospital, Dublin, Ireland.
FAU - Conlon, P J
AU  - Conlon PJ
FAU - Farrell, J
AU  - Farrell J
FAU - Horgan, J
AU  - Horgan J
FAU - Walshe, J J
AU  - Walshe JJ
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - QJM
JT  - QJM : monthly journal of the Association of Physicians
JID - 9438285
SB  - IM
MH  - Chronic Disease
MH  - Female
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Long-Term Care
MH  - Male
MH  - Middle Aged
MH  - Peritoneal Dialysis/*methods
MH  - Treatment Outcome
MH  - Ultrafiltration
EDAT- 1996/09/01 00:00
MHDA- 1996/09/01 00:01
CRDT- 1996/09/01 00:00
PHST- 1996/09/01 00:00 [pubmed]
PHST- 1996/09/01 00:01 [medline]
PHST- 1996/09/01 00:00 [entrez]
AID - 10.1093/qjmed/89.9.681 [doi]
PST - ppublish
SO  - QJM. 1996 Sep;89(9):681-3. doi: 10.1093/qjmed/89.9.681.