Acute Heart Failure, Acute Renal Failure
Conditions
Brief summary
Studies have shown that more than 30% of the overall acute decompensated heart failure (ADHF) patients develop renal dysfunction. Several studies have tried to find a correlation between hemodynamic Parameters (blood pressure , heart rate, central venous pressure CVP) and worsening of renal function in acute decompensated heart failure patients. Results showed that there were no correlation between baseline hemodynamics or change in hemodynamics and worsening of renal function. Another study showed that intra-abdominal pressure (IAP) measuring was a better corollary to renal failure status then measuring cardiovascular hemodynamics using pulmonary artery catheterization in ADHF patients.. An increased IAP was associated with worse renal function and that level of IAP far below abdominal compartment syndrome may adversely affect renal function in patients with ADHF.
Interventions
DEVICEBARD® Intra-abdominal Pressure monitor
monitor linked to foley catheter that is able to measure pressure inside bladder
Sponsors
Northwell Health
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Any ICU(intensive care unit) or CCU(critical care unit) patient older than 18 y. * Patient diagnosed on admission with pulmonary edema/CHF (fluid in the lungs) - independently from the baseline renal function. * No subject will be accepted to take part in the study unless they are able to sign or if Health care proxy signs a consent
Exclusion criteria
* Pregnant women * Cognitively impaired patients * Age\<18 yrs old * Patients diagnosed on admission with ARDS. * Patients admitted with a diagnosis of sepsis ( WBC\> 12000, CXR findings consistent with pneumonia, positive blood cultures on admission, UTI)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| High intraabdominal pressure and effect on renal function | from admission (baseline) until 72 hours later | IAP measurements will be recorded concomitantly with renal indices. Correlations will be made in regard to pressure measurements and worsening renal function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Effect of diuretics use on intrabdominal pressure | 3 days from admission | Early initiation of diuretics in acute heart failure improvement correlating with decreasing IAP measurements. |
Countries
United States
Outcome results
None listed