Document Detail


Fluid overload contributing to heart failure.
MedLine Citation:
PMID:  16024828     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In advanced heart failure, the compensatory responses to reduced cardiac output, in spite of fluid retention, lead to maladaptive consequences. METHODS: We performed a Medline survey for fluid overload and heart failure as well as reviewing textbook chapters. RESULTS: The increased sympathetic nervous system, renin-angiotensin-aldosterone system, and antidiuretic hormone stimulation and release lead to a vicious cycle--augmenting pre-load, contractility and after-load, as well as increased fluid overload. The elevated work load on an already failed cardio-circulatory system results in further deterioration. Plasma volume is usually increased in untreated patients with increased extracellular fluid. However, it may range from reduced to increased in treated patients. Currently, diuretics remain the initial first line of therapy. In refractory cases, restoring plasma volume and osmolality, by adding albumin or hypertonic saline solutions, neurohormonal antagonists such as vasopressin receptors antagonists, aldosterone antagonists, or administration of nesiritide, may help in overcoming fluid overload. CONCLUSION: Exact measurement of plasma volume in various forms of heart failure and adjusting the treatment accordingly, establishing favourable and detrimental effects of various therapies, and introducing additional and new therapeutic options require further investigation.
Authors:
Avraham Shotan; Samir Dacca; Michael Shochat; Marc Kazatsker; David S Blondheim; Simcha Meisel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  20 Suppl 7     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-18     Completed Date:  2008-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  vii24-7     Citation Subset:  IM    
Affiliation:
Heart Institute, Hillel Yaffe Medical Center, Hadera, 38100, Israel. shotana@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output / physiology
Diuretics
Heart Failure / etiology*,  physiopathology*,  therapy
Heart Transplantation
Humans
Plasma Volume / physiology
Renal Dialysis
Water-Electrolyte Balance / physiology*
Chemical
Reg. No./Substance:
0/Diuretics
Comments/Corrections
Comment In:
Nephrol Dial Transplant. 2005 Jul;20 Suppl 7:vii37-40   [PMID:  16024832 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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