 Healthcare
Professionals
Aquapheresis is a medical
therapy designed to remove excess salt and water from the body safely,
predictably, and effectively from patients suffering from fluid
overload and who have failed diuretics. It removes excess salt and
water and helps to restore a patient’s fluid balance or euvolemia.
Who
are Appropriate Patients for Aquapheresis?
Aquapheresis
is for patients who struggle with diuretics to manage their excess
fluid and weight. Patients such as those who:
- Exhibit renal insufficiency or renal resistance
- Have right side heart failure
- Are very volume overloaded, 20+ lbs up
Aquapheresis prescription
is based on its indication for use and is usually as follows:
- Signs and
symptoms of fluid overload
- > 10 lbs over dry weight, dyspnea,
edema
- Inadequate
diuretic and/or natriuretic response
- net fluid output < 125 cc/hr or 1,500
cc in 12 hours, net fluid output = urine output – fluid
intake
- Exclusion
of patients
- In which venous access cannot be achieved,
or requiring renal clearance (e.g. serum creatinine > 3.0
mg/dL, creatinine clearance < 15 cc/min)
Refer to 'Aquapheresis
Prescription' for additional details and information.
Why Prescribe
Aquapheresis?
- On patients not responding
to or failing diuretics, does it make sense to keep giving more
and more diuretics?
- Diuretics are associated with higher
morbidity and mortality, activation of neurohormones, loss
of electrolytes, increased risk for hospitalization for heart
failure, and many other nondesirable effects. 2,3,5,6,10,12,13,15,17,18
- 50% of fluid overloaded heart failure
patients fail to lose less than 5 lbs or actually gain weight
during their hospitalization 1
- Achieve a patient's dry
weight in hours instead of days.
- The average rate of removal in 24
hours is 6 Liters with Aquapheresis and 1 Liter with diuretics
(6 vs. 1)
- Compare the potential results of
Aquapheresis vs. diuretic therapy toward the volume reduction
goal (go to 'Volume
Calculator')
- Over 50
years of clinical evidence that supports its use
- Benefits have been known, but it
has never been in a form before that allowed its ease of use
(go to 'Clinical
Evidence')
- It has been shown to have
no clinically significant impact on electrolyte balance, blood
pressure or heart rate.
How Does Aquapheresis
work?
To understand Aquapheresis
better, go to 'Aquapheresis
and How It Works'
Sources:
1. Adhere National Benchmark Report, January
2001 to April 2006
2. Emerman JCF 2004;10(4):S116:368.
3. Bayliss, Br Heart J 1987;57:17-22.
4. Faris Int J Cardiol. 2002;82(2): 149-58.
5. Mehta JAMA 2002;288(20):2547-53.
6. Butler, Am Heart J 2004; 147:331-338.
7. Gottlieb JACC, 2000;35(1):56-59.
8. Brater DC NEJM 1998;339:387.
9. Firth Lancet 5/7/88.
10. Francis AIM 1985;103:1-6.
11. Ribboli Am J Physiol. 1994 Sep;267(3 Pt 2):H1054-61.
12. McCurley, JACC 2004;44(6):1301-1307.
13. Fonarow Am J Cardiol 2006;97:1759-1764.
14. Gottlieb Circ 2002;105:1348-1353.
15. Domanski JACC 2003;42:705-708.
16. Stampfer Circ 1968;37:900-911.
17. Laragh Hypert 2001;37:806-810.
18. Neuberg Am Heart J 2002;144:31-38
|
