Fluid overload is a risk factor for increased morbidity and mortality, especially in patients with heart disease. The treatment options are limited to diuretics and mechanical fluid removal using ultrafiltration or renal replacement therapy. This paper provides an overview of the challenges of managing fluid overload, outlines the risks and benefits of different pharmacological options and extracorporeal techniques, and provides guidance for clinical practice.
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http://dx.doi.org/10.1159/000529068 | DOI Listing |
Acta Anaesthesiol Scand
March 2025
Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.
Introduction: Fluid accumulation in critically ill patients is associated with adverse outcomes. However, there is a substantial variability in the terminology and definitions used to describe fluid accumulation. We aim to provide an overview of evidence describing fluid accumulation in critically ill adult patients admitted to the intensive care unit (ICU), including how it is defined, patient characteristics associated with fluid accumulation, ICU population, and outcomes assessed.
View Article and Find Full Text PDFBackground Dry weight management in dialysis patients is crucial but often subjective, primarily based on symptoms. Due to continuous fluid removal in peritoneal dialysis (PD) and intermittent ultrafiltration in hemodialysis (HD), symptom-based assessments may be biased, leading to varying results. Surprisingly, no direct comparison of dry weight changes between PD and HD has been conducted.
View Article and Find Full Text PDFInfect Drug Resist
January 2025
Department of Infectious Disease, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China.
The Hepatorenal Syndrome-Acute Kidney Injury (HRS-AKI) patients infected with methicillin-resistant (MRSA) urgently require safe and effective treatment options due to their compromised hepatic and renal functions, as well as thrombocytopenia resulting from hypersplenism. In our case, an HRS-AKI patient who underwent continuous renal replacement therapy for fluid overload developed fever with chills. His blood tests indicated elevated C-reactive protein and neutrophils, low platelet count, and bilateral lung infiltrates.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Fuwai Central China Cardiovascular Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China.
Objective: Impaired right ventricular (RV)-pulmonary arterial (PA) coupling, calculated by measuring the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP), can be used as an early indicator of right ventricular dysfunction (RVD) in patients with heart failure with a reduced ejection fraction (HFrEF). Patients suffering from HFrEF experience improvements in left ventricular (LV) function through the administration of sacubitril/valsartan therapy. In addition, the albumin-bilirubin (ALBI) score was associated with the fluid overload status and adverse clinical outcomes in patients with heart failure.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Staten Island University Hospital, Staten Island, USA.
Rhabdomyolysis (RML) arises from the breakdown of muscle tissue, leading to the release of intracellular components into the bloodstream and potentially causing multi-organ failure. Multiple drugs have been reported to cause RML. We present here a rare instance of erythromycin-triggered RML in a patient who was not on any other potential RML-inducing medications.
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