Empleo de la ultrafiltración extracorpórea aislada para el tratamiento de la insuficiencia cardiaca descompensada: dificultades técnicas y evolución clínica

Abstract

Isolated extracorporeal ultrafiltration has shown itself to be a possible therapeutic strategy for patients with diuretic-resistant decompensated heart failure. Our aim was to assess the short-term clinical evolution of patients undergoing isolated extracorporeal ultrafiltration and the technical/clinical incidents.
Material and method: A transversal prospective descriptive study in patients with heart failure at stage III-IV according to the New York Heart Association, resistant to diuretic treatment. Isolated extracorporeal ultrafiltration was carried out with the Dedyca® system, using a central venous catheter for vascular access. The ultrafiltration rate wasadjusted in line with the patient's blood pressure. Toassess the clinical evolution, clinical and analyticalcontrols were carried out before and 1 month afterthe isolated extracorporeal ultrafiltration sessions.To assess the technical/clinical complications, thenursing records were reviewed.
Results: Six patients were studied, who underwent anaverage of 2 sessions with a mean duration of 5 hoursand with a mean ultrafiltration of 2100cc per session.As far as technical complications are concerned, onlyone patient presented partial coagulation of the system. No patients presented adverse effects during theisolated extracorporeal ultrafi ltration.
Conclusions: After the isolated extracorporeal ultrafiltration, diuresis increases with the same doseof diuretic and even with a progressive reduction. Itis a simple technique, without technical complications for nurses who are familiar with extracorporeal purification techniques.