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Compression wraps as adjuvant therapy in the management of acute systolic heart failure

BACKGROUND: Guidelines recommend targeting decongestion in management of decompensated HF, with lower extremity edema often serving as the clinical target. LECW are seldom used in the acute setting, with a paucity of data on efficacy in HF, despite serving as a cornerstone of chronic lymphedema mana...

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Autores principales: Fadel, Raef Ali, Cerna Viacava, Renato, Makki, Tarek, Fadel, Carina Dagher, Malette, Kelly, Demertzis, Zachary D., Ahluwalia, Guneet, Miller, Joseph, Russell, Cori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432693/
https://www.ncbi.nlm.nih.gov/pubmed/37600376
http://dx.doi.org/10.1016/j.heliyon.2023.e19008
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author Fadel, Raef Ali
Cerna Viacava, Renato
Makki, Tarek
Fadel, Carina Dagher
Malette, Kelly
Demertzis, Zachary D.
Ahluwalia, Guneet
Miller, Joseph
Russell, Cori
author_facet Fadel, Raef Ali
Cerna Viacava, Renato
Makki, Tarek
Fadel, Carina Dagher
Malette, Kelly
Demertzis, Zachary D.
Ahluwalia, Guneet
Miller, Joseph
Russell, Cori
author_sort Fadel, Raef Ali
collection PubMed
description BACKGROUND: Guidelines recommend targeting decongestion in management of decompensated HF, with lower extremity edema often serving as the clinical target. LECW are seldom used in the acute setting, with a paucity of data on efficacy in HF, despite serving as a cornerstone of chronic lymphedema management. PRIMARY OBJECTIVE: Study the efficacy and safety of LECW in acute decompensated HF. METHODS: Open-label, randomized, parallel-group clinical trial. PRIMARY OUTCOMES: Days on intravenous (IV) diuretic therapy, total hospital length of stay (LOS), and 30-day all-cause readmission. RESULTS: 32 patients were enrolled, with 29 patients completing the study. Enrollment was suspended due to the COVID-19 pandemic. Overall LOS was shorter in the intervention group (3.5 vs 6 days, p = 0.05), with no significant difference in total days on IV diuresis or 30-day readmission rate with use of LECW. Fewer patients required continuous diuretic infusion after treatment with LECW (0 vs 7 patients, p = 0.027). The intervention group scored significantly better on the MLWHF (55.5 vs 65, p = 0.021), including both the physical and emotional dimension scores. No adverse events were reported with use of LECW, including a significantly lower incidence of AKI (1 vs 13 patients, p = 0.005). CONCLUSION: The use of LECW resulted in reduced hospital LOS compared to standard therapy, with no difference in days of IV diuresis administration or 30-day readmission. Treatment with LECW also resulted in less continuous IV diuretic therapy, fewer incidence of AKI, and improved quality of life. Trends toward less escalation of diuresis, and greater reduction in edema were also observed.
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spelling pubmed-104326932023-08-18 Compression wraps as adjuvant therapy in the management of acute systolic heart failure Fadel, Raef Ali Cerna Viacava, Renato Makki, Tarek Fadel, Carina Dagher Malette, Kelly Demertzis, Zachary D. Ahluwalia, Guneet Miller, Joseph Russell, Cori Heliyon Research Article BACKGROUND: Guidelines recommend targeting decongestion in management of decompensated HF, with lower extremity edema often serving as the clinical target. LECW are seldom used in the acute setting, with a paucity of data on efficacy in HF, despite serving as a cornerstone of chronic lymphedema management. PRIMARY OBJECTIVE: Study the efficacy and safety of LECW in acute decompensated HF. METHODS: Open-label, randomized, parallel-group clinical trial. PRIMARY OUTCOMES: Days on intravenous (IV) diuretic therapy, total hospital length of stay (LOS), and 30-day all-cause readmission. RESULTS: 32 patients were enrolled, with 29 patients completing the study. Enrollment was suspended due to the COVID-19 pandemic. Overall LOS was shorter in the intervention group (3.5 vs 6 days, p = 0.05), with no significant difference in total days on IV diuresis or 30-day readmission rate with use of LECW. Fewer patients required continuous diuretic infusion after treatment with LECW (0 vs 7 patients, p = 0.027). The intervention group scored significantly better on the MLWHF (55.5 vs 65, p = 0.021), including both the physical and emotional dimension scores. No adverse events were reported with use of LECW, including a significantly lower incidence of AKI (1 vs 13 patients, p = 0.005). CONCLUSION: The use of LECW resulted in reduced hospital LOS compared to standard therapy, with no difference in days of IV diuresis administration or 30-day readmission. Treatment with LECW also resulted in less continuous IV diuretic therapy, fewer incidence of AKI, and improved quality of life. Trends toward less escalation of diuresis, and greater reduction in edema were also observed. Elsevier 2023-08-07 /pmc/articles/PMC10432693/ /pubmed/37600376 http://dx.doi.org/10.1016/j.heliyon.2023.e19008 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research Article
Fadel, Raef Ali
Cerna Viacava, Renato
Makki, Tarek
Fadel, Carina Dagher
Malette, Kelly
Demertzis, Zachary D.
Ahluwalia, Guneet
Miller, Joseph
Russell, Cori
Compression wraps as adjuvant therapy in the management of acute systolic heart failure
title Compression wraps as adjuvant therapy in the management of acute systolic heart failure
title_full Compression wraps as adjuvant therapy in the management of acute systolic heart failure
title_fullStr Compression wraps as adjuvant therapy in the management of acute systolic heart failure
title_full_unstemmed Compression wraps as adjuvant therapy in the management of acute systolic heart failure
title_short Compression wraps as adjuvant therapy in the management of acute systolic heart failure
title_sort compression wraps as adjuvant therapy in the management of acute systolic heart failure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432693/
https://www.ncbi.nlm.nih.gov/pubmed/37600376
http://dx.doi.org/10.1016/j.heliyon.2023.e19008
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