Dr. Michel White
Dr. Masip discussed the role of non invasive ventilation in patients with advanced and decompensated heart failure (HF). He showed that both continuous positive airway pressure ventilation (C-PAP) and non-invasive positive pressure ventilation (NIPPV) improve outcomes in patients receiving this treatment. However, there is no clear advantage to either of these modalities over the other. The key issue is to initiate treatment early, to optimise benefits. Dr. Mebazaa presented key differences between hemodialysis and ultrafiltration in patients with HF. The use of ultrafiltration is promising in this patient population, but future studies are needed to better identify the patients most likely to benefit from this therapy. Dr. Nanas outlined the beneficial effects of the early use of intra-aortic balloon pump in patients with cardiogenic shock. Unstable patients with cardiogenic shock caused by ischemic heart disease showed significantly greater benefits when treatment was initiated prior to the intervention. Dr. Mohr presented an elegant overview of the role of LV assist devices in advanced HF. Significant progress has been made in this field. Newer devices including those providing partial support are promising. Finally, Dr. Abraham presented the potential clinical utilities of implantable monitoring devices. Data from the FAST, HOMEOSTASIS and CHAMPION trials showed significant benefits in patients with severe heart failure using these devices. For example, in CHAMPION, a 38% reduction in hospitalisations for HF was reported. Additional data are needed to better select the populations most likely to benefit from these devices.
Devices for severe heart failure
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