title: Efficacy of continuous hemodiafiltration for patients with congestive heart failure.
abstract: OBJECTIVE
  The basic principle of treatment of congestive heart failure is achieving adequate control of preload and afterload through enhancement of cardiac contractility. In severe cases, however, we have usually applied continuous hemodiafiltration (CHDF) as a type of mechanical support. In this study, we investigated hemodynamic changes caused by CHDF in patients with congestive heart failure.
  
  
  METHODS
  We treated seven patients with congestive heart failure complicated by multiple organ failure by CHDF over 72 h, during which we measured hemodynamic parameters to determine their changes.
  
  
  RESULTS
  Implementation of CHDF resulted in a significant decrease in pulmonary artery occluded pressure and significant increases in cardiac index and left ventricular stroke work index. In addition, 72-hour cumulative water balance was found to be -1,791 +/- 2,119 ml, and systemic vascular resistance index decreased significantly.
  
  
  CONCLUSIONS
  Hemodynamics of patients were improved with CHDF through strict control of preload and consequently tissue oxygen metabolism was improved.
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, Chiba, Japan. kaznaka@ho.chiba-u.ac.jp
authors.forename: Kazuya
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hirasawa
authors.forename: Takao
authors.initials: T
authors.lastname: Sugai
authors.forename: Shigeto
authors.initials: S
authors.lastname: Oda
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Shiga
authors.forename: Nobuya
authors.initials: N
authors.lastname: Kitamura
authors.forename: Tomohito
authors.initials: T
authors.lastname: Sadahiro
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirano
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Abe
authors.forename: Takaaki
authors.initials: T
authors.lastname: Nakada
authors.forename: Go
authors.initials: G
authors.lastname: Hirasawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006334:Heart Function Tests; D017583:Hemodiafiltration; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D010101:Oxygen Consumption; D011651:Pulmonary Artery / Q000503:physiopathology; D015996:Survival Rate; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance