Fluid Overload

Description

Fluid overload is often observed in patients with heart failure and secondary oliguric states. A thorough assessment of the fluid status of the patient may help guide the therapy and prevent complications induced by inappropriate therapeutic strategies.The present publication is divided into four parts: Definition and Classification, Pathophysiology, Diagnosis and Therapy. In the first section, the authors present new definitions for heart failure, acute kidney injury and cardiorenal syndromes to facilitate the process of understanding the complex link between the heart and the kidney. Subsequently, different conditions leading to fluid overload are described, followed by an account of emerging diagnostic tools, therapies and technologies devoted to the treatment of patients with severe fluid-related disorders. Clearly structured and written, the present book is a practical tool for physicians and professionals involved in the management and care of patients with combined heart and kidney disorders. Moreover, it also serves as a reference textbook for medical students, residents and fellows dealing in everyday practice with fluid overloaded and oliguric patients.

Informations

• Publié par: S. Karger AG
• Date de parution: 05 mai 2010
• Nombre de lectures: 0
• EAN13: 9783805594172
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Fluid Overload: Diagnosis and Management
Contributions to Nephrology
Vol. 164
Series Editor
Claudio Ronco     Vicenza
 
Fluid Overload
Diagnosis and Management
Volume Editors
Claudio Ronco     Vicenza
Maria Rosa Costanzo     Naperville, Ill.
Rinaldo Bellomo     Melbourne, Vic.
Alan S. Maisel     San Diego, Calif.
29 figures, and 25 tables, 2010
Contributions to Nephrology
(Founded 1975 by Geoffrey M. Berlyne)
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Claudio Ronco Department of Nephrology Dialysis & Transplantation International Renal Research Institute San Bortolo Hospital I-36100 Vicenza (Italy)
Maria Rosa Costanzo Edward Heart Hospital 801 South Washington Street Naperville, IL 60566 (USA)
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Rinaldo Bellomo Department of Intensive Care Austin Hospital Melbourne, Vic. 3084 (Australia)
Alan S. Maisel VAMC Cardiology 111-A 3350 La Jolla Village Drive San Diego, CA 921161 (USA)
Library of Congress Cataloging–in–Publication Data
Fluid overload: diagnosis and management / volume editors, Claudio Ronco …[et al].
p.;cm. –– (Contributionstonephrology, ISSN0302–5144;vol.164)
Includes bibliographical references and index.
ISBN 978–3–8055–9416–5 (hard cover: alk. paper)
1. Body fluid disorders. 2. Congestive heart failure-Complications. I. Ronco, C. (Claudio), 1951– II. Series: Contributions to nephrology, vol. 164.0302–5144;
[DNLM: 1. Heart Failure. 2. Body Fluids. 3. Kidney Failure, Acute. 4. Oliguria. 5. Water-Electrolyte Balance. W1 C0778UN V.164 2010/WG 370 F646 2010]
RC630.F585 2010
616.1'29–dc22
2010007012
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents® and Index Medicus.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2010 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid–free and non–aging paper (ISO 9706) by Reinhardt Druck, Basel
ISSN 0302–5144
ISBN 978–3–8055–9416–5
e-ISBN 978–3–8055–9417–2
 
Contents
Preface
Ronco, C. (Vicenza); Costanzo, M.R. (Naperville, Ill.); Bellomo, R. (Melbourne, Vic.); Maisel, A.S. (San Diego, Calif.)
Definition and Classification
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Heart Failure: Pathophysiology and Clinical Picture
Palazzuoli, A.; Nuti, R. (Siena)
Heart Failure Classifications - Guidelines
Jankowska, E.A.; Ponikowski, P. (Wroclaw)
Acute Kidney Injury: Classification and Staging
Cruz, D.N. (Vicenza); Bagshaw, S.M. (Edmonton, Alta.); Ronco, C. (Vicenza); Ricci, Z. (Rome)
Cardiorenal Syndromes: Definition and Classification
Ronco, C. (Vicenza)
Pathophysiology
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Oliguria and Fluid Overload
Rimmelé, T.; Kellum, J.A. (Pittsburgh, Pa.)
Pathophysiology of Fluid Retention in Heart Failure
Chaney, E.; Shaw, A. (Durham, N.C.)
Fluid Overload as a Biomarker of Heart Failure and Acute Kidney Injury
Bagshaw, S.M. (Edmonton, Alta.); Cruz, D.N. (Vicenza)
Fluid Balance Issues in the Critically III Patient
Bouchard, J. (Montréal, Qué.); Mehta, R.L. (San Diego, Calif.)
Prerenal Azotemia in Congestive Heart Failure
Macedo, E.; Mehta, R. (San Diego, Calif.)
Diagnosis
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Use of Biomarkers in Evaluation of Patients with Heart Failure
Slavin, L.; Daniels, L.B.; Maisel, A.S. (San Diego, Calif.)
Oliguria, Creatinine and Other Biomarkers of Acute Kidney Injury
Ronco, C.; Grammaticopoulos, S. (Vicenza); Rosner, M. (Charlottesville, Va.); De Cal, M.; Soni, S.; Lentini, P.; Piccinni, P. (Vicenza)
Current Techniques of Fluid Status Assessment
Peacock, W.F.; Soto, K.M. (Cleveland, Ohio)
Bioelectric Impedance Measurement for Fluid Status Assessment
Piccoli, A. (Padova)
Therapy
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Diuretic Therapy in Fluid-Overloaded and Heart Failure Patients
Bellomo, R.; Prowle, J.R.; Echeverri, J.E. (Melbourne, Vic.)
Pharmacological Therapy of Cardiorenal Syndromes and Heart Failure
House, A.A. (London, Ont.)
Extracorporeal Fluid Removal in Heart Failure Patients
Costanzo, M.R. (Naperville, Ill.); Agostoni, P.; Marenzi, G. (Milan)
Technical Aspects of Extracorporeal Ultrafiltration: Mechanisms, Monitoring and Dedicated Technology
Nalesso, F.; Garzotto, F.; Ronco, C. (Vicenza)
Use of Brain Natriuretic Peptide and Bioimpedanceto Guide Therapy in Heart Failure Patients
Valle, R. (Chioggia); Aspromonte, N. (Rome)
Fluid Management in Pediatric Intensive Care
Favia, I.; Garisto, C.; Rossi, E.; Picardo, S., Ricci, Z. (Rome)
Fluid Assessment and Management in the Emergency Department
Di Somma, S.; Gori, C.S.; Grandi, T.; Risicato, M.G.; Salvatori, E. (Rome)
Author Index
Subject Index
 
Preface
The condition of fluid overload is often observed in patients with heart failure and secondary oliguric states. In those conditions, a thorough assessment of the fluid status of the patient may help guide the therapy and prevent complications induced by inappropriate therapeutic strategies. For these reasons, it seems appropriate to collect a series of contributions in which the reader can start with the information relevant to the type of syndromes involved in the observed clinical picture, to progress subsequently towards the pathophysiologic foundations of such syndromes, to further advance in the analysis of diagnostic criteria and to finally conclude with the available therapeutic strategies. The present book represents a practical tool for physicians and professionals involved in the management and care of patients with combined heart and kidney disorders. It may also represent a reference textbook for medical students, residents and fellows dealing in everyday practice with fluid overloaded and oliguric patients. The book is an important source of information about new emerging diagnosting tools, therapies and technologies devoted to the treatment of patients with severe fluid-related disorders. Different conditions leading to fluid overload are described together with the possible diagnostic approaches and the therapeutic strategies. Various types of cardiorenal syndrome are discussed in detail with information concerning pathophysiology, biomarkers, pharmacological treatment and extracorporeal support. New definitions for heart failure, acute kidney injury and cardiorenal syndromes are reported to facilitate the reader in the process of understanding the complex link between the heart and the kidney.
The delicate concept of fluid balance is discussed with specific attention to the different components involved in the final composition of the body. Body hydration status is of remarkable importance, and bioimpedance vector analysis together with other techniques for the assessment of fluid status is discussed in depth. Pharmacological therapies together with extracorporeal treatments are presented in detail with special emphasis on critical care, cardiology, nephrology and emergency department populations. Pediatric populations are also taken into consideration.
The technology for extracorporeal ultrafiltration is described in detail, allowing the readers to appreciate the importance of this therapeutic approach in refractory oliguric states. The simplicity and effectiveness of modern equipment can make ultrafiltration a treatment easy to apply and safe to perform. Additional support to safety can be offered by chemical biomarkers, on-line blood volume monitoring and sequential bioimpedance determinations.
Based on all these considerations, the creation of a book covering all the important issues in the field as well as the available technology and methods represents an important project and a significant educational effort. We think that a book on this subject will constitute an important contribution i