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December 17, 2012European Journal of Heart FailureOpen Access

Chronic heart failure was associated with reduced plasma volume expansion at 24 hours in patients with acute pulmonary edema (P=0.03), indicating decreased bi-directional pulmonary fluid flux.

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Why the study?

Does chronic elevation of pulmonary microvascular pressure in chronic heart failure reduce bi-directional pulmonary fluid flux?

Population

Isolated rat lungs 7 weeks following left coronary artery ligation and patients presenting with acute…

Comparison

Chronic heart failure vs No chronic heart failure

Design

Preclinical

Follow-up

7 weeks (rats), 24 hours (patients)

Key result

Chronic heart failure was associated with reduced plasma volume expansion at 24 hours in patients with acute pulmonary edema (P=0.03), indicating decreased bi-directional pulmonary fluid flux.

Authors

DDDani‐Louise DixonGMGeorge C. MayneKGKim Griggs

Discussion

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Overview

May suggest adaptive barrier defense in chronic HF; leaves open effects on edema resolution and need for human trials.

Study Design

Type

Observational (n=90)

Structured PICO

Does chronic elevation of pulmonary microvascular pressure in chronic heart failure reduce bi-directional pulmonary fluid flux?

P
Population
74 isolated rat lungs and 16 patients presenting with acute pulmonary oedema (8 with and 8 without a history of chronic heart failure).
E
Exposure
Chronic heart failure (chronic elevation of pulmonary microvascular pressure)
C
Comparator
No chronic heart failure (control rats and patients without a history of chronic heart failure)
O
Outcome
Bi-directional pulmonary fluid flux (measured via fluid flux during acute rise in left atrial pressure, intrinsic alveolar fluid clearance, and plasma volume expansion)surrogate

Main Result

p-value: p=0.03

Chronic heart failure induces an adaptive decrease in bi-directional fluid flux at the alveolar-capillary barrier, which defends against alveolar flooding but may delay the resolution of pulmonary edema.

Cite This Study

Dixon et al. (2012) conducted an observational in Chronic heart failure and acute pulmonary oedema (n=90). Chronic heart failure vs. No history of chronic heart failure was evaluated on Plasma volume expansion at 24 h (p=0.03). Chronic heart failure was associated with reduced plasma volume expansion at 24 hours in patients with acute pulmonary edema (P=0.03), indicating decreased bi-directional pulmonary fluid flux.

synapsesocial.com/papers/6a7b6f05684c0941cf3265a2https://doi.org/10.1093/eurjhf/hfs201
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Capillary filtration is reduced in lungs adapted to chronic heart failure: morphological and haemodynamic correlates2001 · 83 citations
  2. 2Segmental pulmonary vascular remodeling in heart failure induced by chronic volume overload2026
  3. 3Alveolar fluid reabsorption is increased in rats with compensated heart failure2006 · 22 citations
  4. 4Total vascular pressure-volume relationship in conscious rats with chronic heart failure1986 · 26 citations
  5. 5Chronic heart failure modifies respiratory mechanics in rats: a randomized controlled trial2016 · 5 citations