[Technical equipment of modern coronary care units: respiratory and renal function assist devices].
Respiratory and renal comorbidities have a negative impact on health status and prognosis of patients suffering from cardiovascular diseases. That is why cardiologists must know the pathophysiological bases of renal and respiratory function and should be able to use the available mechanical devices meant to support lung and kidney function. A review of the recent literature suggests that the use of non-invasive ventilation (continuous positive airway pressure, bilevel positive airway pressure) in patients with acute cardiogenic pulmonary edema may reduce the need for endotracheal intubation and the risk of mortality when compared to conventional oxygen therapy. In addition to this, the support of renal ultrafiltration (continuous veno-venous hemofiltration) effectively and safely produces a greater weight and fluid loss, decreases length of stay and increases time to readmission compared to standard intravenous diuretic therapy in patients hospitalized for acute decompensated heart failure presenting with volume overload and diuretic resistance; moreover, in patients with preexisting renal failure who undergo percutaneous coronary intervention, continuous veno-venous hemofiltration appears to be effective in preventing contrast-induced nephropathy.
Cuccia
Claudio
C
Divisione di Cardiologia, Istituto Ospedaliero Fondazione Poliambulanza, Brescia. cuccia-claudio@poliambulanza.it
Forgione
Chiara
C
D003325:Coronary Care Units / Q000592:standards*; D006801:Humans; D007558:Italy; D017582:Renal Replacement Therapy / Q000295:instrumentation*; D012122:Ventilators, Mechanical