Annals of Emergency Medicine
Volume 51, Issue 3 , Pages 247-250, March 2008

Treatment of Massive Fluid Overload as a Result of Constrictive Pericarditis With Ultrafiltration in the Emergency Department

  • Phillip D. Levy, MD, MPH

      Affiliations

    • Department of Emergency Medicine, Wayne State University, Detroit, MI
    • Corresponding Author InformationAddress for correspondence: Phillip Levy, MD, MPH, Wayne State University Department of Emergency Medicine, Detroit, MI 48201; 313-993-8558, fax 313-993-7703
    • ,
  • Neelima Penugonda, MD

      Affiliations

    • Department of Internal Medicine, Wayne State University, Detroit, MI.
    • ,
  • Maya Guglin, MD, PhD

      Affiliations

    • Department of Internal Medicine, Wayne State University, Detroit, MI.

Received 9 December 2006; received in revised form 19 March 2007; accepted 16 April 2007. published online 18 May 2007.

We present a case of massive fluid overload as a result of chronic lupus-related constrictive pericarditis, which was treated in the emergency department (ED) with ultrafiltration. With this novel technique, a large volume (7,350 mL) was extracted during 19 hours, with dramatic clinical improvement. The patient was hemodynamically stable throughout the intervention, and the procedure was tolerated without complication. This report highlights the challenges associated with the treatment of such individuals and the potential benefits of ultrafiltration in the ED setting.

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 Supervising editor: W. Brian Gibler, MD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that may create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. Dr. Levy has received nonmonetary equipment support from Cardiodynamics, Inc. Dr. Guglin has received both monetary and equipment support from CHF Solutions, Inc. Cardiodynamics, Inc. and CHF Solutions, Inc. provided equipment for the clinical work described in this case report, but neither company provided any direct financial support. Additionally, this article was prepared and submitted independent of any input or review by representatives from either Cardiodynamics, Inc. or CHF Solutions, Inc.

 Reprints not available from the authors.

 Publication dates: Available online May 23, 2007.

PII: S0196-0644(07)00489-1

doi:10.1016/j.annemergmed.2007.04.012

Annals of Emergency Medicine
Volume 51, Issue 3 , Pages 247-250, March 2008

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