Clinical Experts Discuss Fluid Management Strategies in Critically Ill COVID-19 Patients during CHF Solutions Webinar
The webinar was moderated by
“The vast majority of patients after the initial resuscitative phase are globally volume overloaded,” McCullough said. “In at-risk patients, start ultrafiltration early and that may make the situation more favorable for the patients to have a continued response to diuretics and not to wait too long where they are too sick and they are too far behind on fluid balance. These patients really don’t have any margin.”
Additional clinically important observations made during the webinar include:
- A significant number of COVID-19 patients present with renal dysfunction, of which a large proportion have associated cardiopulmonary complications (cardio-renal syndrome). A particularly important constellation of findings is right ventricular dysfunction and pulmonary hypertension, which can contribute to significant fluid overload.
- Another complicating factor in many critically ill COVID-19-infected patients is cytokine storm and associated hemodynamic instability, which frequently necessitates aggressive hemodynamic support. Large fluid resuscitation volumes may lead to severe fluid overload, even if hemodynamic stability is eventually achieved.
- While some patients who are relatively young and free of underlying comorbidities may respond well to diuretics, others may be diuretic-resistant. In such patients, early transition from diuretics to ultrafiltration may facilitate volume management and lead to a more favorable response, including improvement in respiratory function.
- The constraints placed on caregivers due to COVID-19 limit direct patient contact and render invasive volume assessments more difficult. In this environment, cumulative fluid balance is an important parameter upon which clinicians may have to rely heavily to make treatment decisions. This and other clinical endpoints should guide early utilization of ultrafiltration in appropriate patients, as opposed to its use as a salvage therapy when diuretic therapy has clearly failed.
- Ultrafiltration with portable devices is simple to implement since patients in the ICU already have catheters that make small extracorporeal volume well tolerated.
“Over the last several months, we have gained significant insights about treating COVID-19 patients, especially from the dedicated medical professionals treating patients on the front lines around the global,” said
The audio replay of the webcast is available at http://ir.chf-solutions.com/events.
1. https://pubmed.ncbi.nlm.nih.gov/32336959/
About Fluid Overload in Critically Ill COVID-19 Patients
Fluid overload has become a common issue in COVID-19 patients, and when left untreated, it can be extremely dangerous for patients. When the kidneys cannot remove the excess fluid and waste in the body, patients can experience kidney failure and multi-organ failure. The standard protocol to address fluid overload is to use dialysis to cleanse the blood of excess sodium and waste and return it back to the body. However, at times, there are not enough dialysis machines to accommodate the number of COVID-19 patients who need them. Ultrafiltration therapy is being used to quickly and effectively help stabilize patients until a dialysis machine becomes available, buying time for patients who would otherwise have no therapy available.
About
About the Aquadex SmartFlow System
The Aquadex SmartFlow system delivers clinically proven therapy using a simple, flexible and smart method of removing excess fluid from patients suffering from hypervolemia (fluid overload). The Aquadex SmartFlow system is indicated for temporary (up to 8 hours) or extended (longer than 8 hours in patients who require hospitalization) use in adult and pediatric patients weighing 20 kg or more whose fluid overload is unresponsive to medical management, including diuretics. All treatments must be administered by a health care provider, within an outpatient or inpatient clinical setting, under physician prescription, both having received training in extracorporeal therapies.
Forward-Looking Statements
Certain statements in this release may be considered forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including without limitation, statements about the treatment of patients infected with the coronavirus. Forward-looking statements are predictions, projections and other statements about future events that are based on current expectations and assumptions and, as a result, are subject to risks and uncertainties. Many factors could cause actual future events to differ materially from the forward-looking statements in this release, including, without limitation, those risk associated with our ability to execute on our commercial strategy, the possibility that we may be unable to raise sufficient funds necessary for our anticipated operations, our post-market clinical data collection activities, benefits of our products to patients, our expectations with respect to product development and commercialization efforts, our ability to increase market and physician acceptance of our products, potentially competitive product offerings, intellectual property protection, our ability to integrate acquired businesses, our expectations regarding anticipated synergies with and benefits from acquired businesses, and other risks and uncertainties described in our filings with the
CONTACTS INVESTORS:Claudia Napal Drayton Chief Financial Officer,CHF Solutions, Inc. 952-345-4205 ir@chf-solutions.com MEDIA:Jessica Stebing Health+Commerce 260-336-6202 jstebing@healthandcommerce.com
Source: CHF Solutions, Inc.