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The practical management of fluid retention in adults with right heart failure due to pulmonary arterial hypertension.
Journal article

The practical management of fluid retention in adults with right heart failure due to pulmonary arterial hypertension.

  • Stickel S University Hospital of Zurich, Department of Pneumonology, C HOER 4, Rämistrasse 100, 8091 Zurich, Switzerland.
  • Gin-Sing W National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, W12 0HS, UK.
  • Wagenaar M Amsterdam UMC, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
  • Gibbs JSR National Heart & Lung Institute, Imperial College London, Cale Street, London, SW3 6LY, UK.
  • 2019-12-21
Published in:
  • European heart journal supplements : journal of the European Society of Cardiology. - 2019
Endothelin receptor antagonists
Fluid retention
Oedema
Pulmonary arterial hypertension
Right heart failure
English Our aim with this review is to provide practical advice and management support for nurses and other healthcare practitioners in managing fluid retention in adults with right heart failure (RHF) due to pulmonary arterial hypertension (PAH). Vigilant management of RHF is important for maintaining patient quality of life, as fluid overload can lead to abdominal bloating (ascites) and peripheral oedema, which also has a major impact on patients' morbidity and mortality. Patients with RHF should be assessed regularly for signs of fluid retention. If fluid overload develops, it is important to determine whether it is caused by the progression of PAH, a side effect of PAH-specific treatment, or another drug or comorbid condition, as this affects both the prognosis and the management strategy. Right heart failure can be treated with both pharmacological and non-pharmacological interventions to reduce fluid retention; including altering fluid and salt intake, weight monitoring, and use of diuretics. All patients on diuretics should be regularly monitored for renal dysfunction and electrolyte imbalance and given advice on how to manage the side effects associated with diuretic use. Fluid retention is often assessed and treated in clinical practice by specialist nurses, who act as a key patient contact providing advice and information on symptom management. This review provides an overview of the challenges related to fluid retention, including strategies to help patients manage symptoms and side effects of treatment.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://sonar.ch/global/documents/18986
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