Change in mean serum creatinine, PAC-guided vs empiric therapy

Slides:



Advertisements
Similar presentations
Serum Lactate Post-Antibiotic antibiotic † † * * Kumar et al. J Infect Dis 2006; 193:
Advertisements

CARRESS Cardiorenal Rescue Study in Acute Decompensated Heart Failure Duke Heart Failure Research Pager:
Survival of Patients with Acute Heart Failure in Need of Intravenous Inotropic Support SURVIVE-WSURVIVE-W Presented at The American Heart Association Scientific.
7/27/2006 Outcomes in Hypertensive Black and Nonblack Patients Treated with Chlorthalidone, Amlodipine, and Lisinopril* * Wright JT, Dunn JK, Cutler JA.
Impact of Multidisciplinary Team Care on Older People with Polypharmacy Liang-Kung Chen Center for Geriatrics and Gerontology Taipei Veterans General Hospital.
Dronedarone in patients with congestive heart failure: insights from ATHENA by Stefan H. Hohnloser, Harry J.G.M. Crijns, Martin van Eickels, Christophe.
Date of download: 5/28/2016 From: New Fibrate Use and Acute Renal Outcomes in Elderly Adults: A Population-Based Study Ann Intern Med. 2012;156(8):
Clinical Pharmacology of Diuretics. DIURETIC DRUGS  diuretics are considered to be substances that aid in removing excess extracellular fluid and electrolytes.
Meeting of the Balkan Excellent Centers
Based on work of the PPRNet
NYHA III* or IV heart failure ACE-I + loop diuretic ± digoxn
CORAL Trial design: Patients with renal artery stenosis and hypertension or chronic kidney disease were randomized to renal artery stenting (n = 467) vs.
Figure 1. Serum creatinine trend in the patient
high-flux dialysis membrane
Heart Failure and Hospital Readmissions
Summary of Design Aim: Effect of Ramipril (up to 10mg/d) or Vit E (400 IU/d) vs its placebo on CV death, M I or stroke (primary) Design: Randomized double.
Measure Baseline 1 year p Coronary calcium scores
Drug Rate ratio 95% CI Thiazide diuretics 1.0 Reference ACE inhibitors
Thiazide-Associated Hyponatremia, Report of the Hyponatremia Registry: An Observational Multicenter International Study Burst et al. Am J Nephrol 2017;45:
Expert Insights on Complex Clinical Cases of Edema
Creatinine clearance in cases and controls
SIGNIFY Trial design: Participants with stable coronary artery disease without clinical heart failure and resting heart rate >70 bpm were randomized to.
End point Fenoldopam, n (%) Dopamine, n (%) p
Calculation Nesiritide (%) Control (%) HR (95% CI) p Unadjusted 93.5
Assessment of nephrotoxicity in patients receiving amphotericin B lipid complex: a pharmacosurveillance study in Spain  J.-M. Aguado, C. Lumbreras, D.
TACTICS-HF Trial design: Patients with acute heart failure (reduced or preserved ejection fraction) were randomized to tolvaptan 30 mg at 0, 24, and 48.
Table of Contents Why Do We Treat Hypertension? Recommendation 5
J Foland, J Fortenberry, B Warshaw,
Differing renal outcomes associated with AKI electronic alerts for clinical location of AKI subsets. Differing renal outcomes associated with AKI electronic.
Composite of complications including cardiovascular (CV): acute myocardial infarction, cardiac arrhythmia requiring medical treatment and heart failure;
Baseline Characteristics
Welcome Ask The Experts March 24-27, 2007 New Orleans, LA.
CHAMPION Trial design: Patients with recent hospitalization for heart failure were implanted with a pulmonary artery pressure monitor and randomized so.
Demonstrating changes in brachial artery diameter, with FMD transient response following cuff deflation at 5 min (frame ∼1800) and sustained NMD response.
Maria R. Costanzo et al. JCHF 2016;4:
(A) Safety outcome: risk of major bleeding between triple antiplatelet therapy (TAPT) versus dual antiplatelet therapy (DAPT). (A) Safety outcome: risk.
Baseline Clinical Characteristics
Baseline Demographic Characteristics of Adults With Diagnosed Heart Failure and Eligible to Receive Lipid-Lowering Therapy Alan S. Go, et al.
Kai Singbartl, John A. Kellum  Kidney International 
Study flow diagram. aPatients were excluded in order as listed
Entry, Randomization, and Follow-up of Patients in the Hypertension in the Very Elderly Trial Of the 461 patients who did not meet the protocol criteria,
Figure 1 Annual trend in specimen type submitted as first sample for aquaporin-4 immunoglobulin G testing (serum only vs CSF only vs both) from 101,065.
Maria Rosa Costanzo et al. JCHF 2016;4:95-105
UK paediatric cardiac surgery mortality rate by year for all cases and total number of procedures performed between 2000 and 2009/2010. UK paediatric cardiac.
Clinical renoprotection trials involving angiotensin II-receptor antagonists and angiotensin-converting-enzyme inhibitors  Barry M. Brenner, Joann Zagrobelny 
Flow-mediated and nitrate-mediated dilation in following radial artery catheterisation. Flow-mediated and nitrate-mediated dilation in following radial.
Change in 6 min walk distance from baseline to each follow-up time for subjects randomised to CABG and to medical therapy alone. The median change and.
Flow chart showing reinterventions by type in patients with anomalous origin of coronary artery from the pulmonary artery patients, divided into early.
Receiver-operating characteristics analyses for predicting AKI progression or AKI progression with death. Receiver-operating characteristics analyses for.
Michael R. Lattanzio, Matthew R. Weir  Kidney International 
Serial measurements of serum glucose, anion gap, serum carbon dioxide, and serum triglycerides throughout the patient's hospital stay. Serial measurements.
Cost-effectiveness plane for all PARTNER-B vs all ADVANCE and all PARTNER vs ADVANCE high risk comparisons with ICERs from five studies; dashed line represents.
Kevin R. King et al. BTS 2016;1:73-86
Low/moderate intensity statins High intensity statins
Summary of STICH trial patients included in the analysis of 6 min walk distance. Reasons for non-inclusion at each follow-up time are given. CABG, coronary.
Mean pulmonary arterial systolic pressure (PASP) with 95% CI error bars and individual data points at rest breathing room air (baseline), during 20 min.
Mean (SD) serum creatinine levels (mg/dl; to convert values to μmol/l multiply by 88.4), creatinine clearance (ml/min), and sodium excretion (mmol/24 hours)
Unadjusted event-free survival (days alive and out-of-hospital) of participants with and without MCI in (A) overall cohort, (B) standard management cohort.
One-year cumulative incidence rates of adverse clinical outcomes in 9,428 outpatients with CHF stratified by diabetes status at baseline. One-year cumulative.
Relationship between organ failure and mortality in acute-on-chronic liver failure (ACLF). Relationship between organ failure and mortality in acute-on-chronic.
Changes in clinical parameters and use of catecholamines during hospitalisation (A) inotropic score, B) serum lactate levels and (C) SAPS II from baseline.
Low/moderate intensity statins High intensity statins
Risk of 30-day hospital encounter with ventricular arrhythmia
Change in 6 min walk distance at 12 months in subgroups defined by baseline characteristics. The mean (95% CI) for the difference between CABG and medical.
Mean with 95% CI error bars and individual data points of right ventricular function parameters at rest breathing room air (baseline), during 20 min breathing.
Baseline characteristics of people who inject drugs enrolled in the Montreal Hepatitis C Cohort (2004–2017), by prescribed dosage of opioid agonist treatment,
Comparison of heart failure admissions rates per annum (recorded hospital admissions/ population at risk) in western developed countries 1978 to.
Box plots showing the distribution of baseline brachial artery flow-mediated dilation (FMD) and nitroglycerine-mediated dilation (NMD). Box plots showing.
Identification of thresholds for significant renal recovery in relation to patient and renal survival. Identification of thresholds for significant renal.
Distribution of facility mean treatment time, by DOPPS region and phase. Distribution of facility mean treatment time, by DOPPS region and phase. Restricted.
Presentation transcript:

Change in mean serum creatinine, PAC-guided vs empiric therapy Time frame Clinically guided therapy PAC-guided therapy p From baseline to discharge (mg/dL) +0.14 -0.01 0.02 From baseline to hospital day 7 (mg/dL) +0.11 +0.02 0.01 PAC=pulmonary-artery catheter Nohria A et al. Heart Failure Society of America 2005 Annual Scientific Meeting; September 18-21, 2005; Boca Raton, FL.

Drug use, PAC-guided vs empiric therapy Drug class Clinically guided therapy (%) PAC-guided therapy (%) p Vasodilators, in-hospital (%) 20 39 <0.0001 Thiazide diuretics, in-hospital (%) 34 24 0.02 Loop diuretics, in-hospital (%) 99 NS Loop diuretics, mean discharge dosage levels (mg/d) 180 138 0.01 PAC=pulmonary-artery catheter Nohria A et al. Heart Failure Society of America 2005 Annual Scientific Meeting; September 18-21, 2005; Boca Raton, FL.