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Miller WL. Assessment and Management of Volume Overload and Congestion in Chronic Heart Failure: Can Measuring Blood Volume Provide New Insights?. Kidney Dis (Basel). 2016;2(4):164-169doi: 10.1159/000450526.
Miller, W. L. (2017). Assessment and Management of Volume Overload and Congestion in Chronic Heart Failure: Can Measuring Blood Volume Provide New Insights?. Kidney diseases (Basel, Switzerland), 2(4), 164-169. https://doi.org/10.1159/000450526
Miller, Wayne L. "Assessment and Management of Volume Overload and Congestion in Chronic Heart Failure: Can Measuring Blood Volume Provide New Insights?." Kidney diseases (Basel, Switzerland) vol. 2,4 (2017): 164-169. doi: https://doi.org/10.1159/000450526
Miller WL. Assessment and Management of Volume Overload and Congestion in Chronic Heart Failure: Can Measuring Blood Volume Provide New Insights?. Kidney Dis (Basel). 2017 Jan;2(4):164-169. doi: 10.1159/000450526. Epub 2016 Oct 12. PMID: 28232933; PMCID: PMC5260569.
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Kidney Dis (Basel). 2017 Jan;2(4):164-169. doi: 10.1159/000450526. Epub 2016 Oct 12.

Assessment and Management of Volume Overload and Congestion in Chronic Heart Failure: Can Measuring Blood Volume Provide New Insights?.

Kidney diseases (Basel, Switzerland)

Wayne L Miller

Affiliations

  1. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn., USA.

PMID: 28232933 PMCID: PMC5260569 DOI: 10.1159/000450526

Abstract

BACKGROUND: Volume overload and fluid congestion remain primary clinical challenges in the assessment and management of patients with chronic heart failure (HF).

SUMMARY: The pathophysiology of volume regulation is complex, and the simple concept of passive intravascular fluid accumulation is not adequate. The dynamics of interstitial and intravascular fluid compartment interactions and fluid redistribution from venous splanchnic beds to the central pulmonary circulation need to be taken into account in strategies of volume management. Clinical bedside evaluations and right heart hemodynamic assessments can alert of changes in volume status, but only the quantitative measurement of total blood volume can help identify the heterogeneity in plasma volume and red blood cell mass that are features of volume overload in chronic HF. The quantitative assessment of intravascular volume is an effective tool to help guide individualized, appropriate therapy.

KEY MESSAGE: Not all volume overload is the same, and the measurement of intravascular volume identifies heterogeneity to guide tailored therapy.

Keywords: Blood volume quantitation; Chronic heart failure; Hemodynamic congestion; Symptomatic clinical congestion; Volume overload congestion

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