Abstract: PUB153
Assessing the Effectiveness of Diuresis Using Fractional Excretion of Sodium in Patients with Congestive Heart Failure on Diuretics
Session Information
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Samarneh, Majed, St. John's Riverside Hospital, Yonkers, New York, United States
- Kaceli, Tea, St. John's Riverside Hospital, Yonkers, New York, United States
- Moscatelli, Marc Alfred, St. John's Riverside Hospital, Yonkers, New York, United States
- Sharra, Klaus, St. John's Riverside Hospital, Yonkers, New York, United States
- Suyunov, Alex, St. John's Riverside Hospital, Yonkers, New York, United States
- Samarneh, Mary, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, United States
Background
We attempt to evaluate the use of FeNa to assess adequate diuresis in patients with CHF getting diuretics. If so, then we can use FeNa to help us adjust the dosing necessary for adequate diuresis, in CHF patients. Currently, we use Is&Os and daily weights to monitor diuresis. However, this is not sufficient because input and output is solely dependent on accurate measurements by nursing staff and in some cases require placing foley catheters, therefore increasing risks of catheter associated infections, microtrauma from placement and discomfort for patients. Daily weights are also not sufficient because the accuracy of this is again dependent on nursing staff and resource availability like weight scale beds. Some patients' weights are difficult to monitor for several reasons, including obesity, lack of nursing staff to help, or incorrect bed calibration.
The purpose of our study is to determine what level of FeNa equates with adequate diuresis in CHF patients on diuretics, to therefore determine if this set level of FeNa can accurately equate to adequate diuresis in such patients. The goal of our project is to find what FeNa level quantitatively correlates with improved clinical outcomes and thus moving forward, providers can use that to monitor diuresis and effectiveness of treatment.
Methods
Our study is to be conducted as a prospective cohort study to assess effectiveness of diuresis using Fractional Excretion of Sodium in Congestive Heart Failure patients on diuretic therapy. The study population will include CHF patients, male, and female, ages 18-100, presenting with difficulty breathing (dyspnea), leg or feet swelling, and fatigue and need diuresis. Data collection will include all patients be given standard of care, FeNa levels to be noted on admission and measured serially until full recovery from symptoms/discharge, diuretic dose adjustment will be noted as they change, and patient's daily weight, urine output and uric acid levels will be recorded. Data will also include age, sex, medical history, and renal function including BUN and Creatinine. Study instruments includes EMR, urine samples to be obtained and labelled serial and processed off the EMR system.
Results
Not available.
Conclusion
Not available.