Coronary Unit Project OF HELP FOR THE ANDES FOUNDATION

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CORONARY UNIT PROJECT OF HELP FOR THE ANDES FOUNDATION AND THE

HOSPITAL CLINICO U CHILE: NONINVASIVE VENTILATIONS AND

ULTRAFILTRATION IN PATIENTS WITH ACUTE OR CHRONIC HEART FAILURE

We are working together to improve lives and expand opportunities in South

America

The Help for the Andes Foundation promotes the health and well-being of lowincome vulnerable populations in the Andes Region. We partner with organizations to implement high-impact programs that improve the quality of lives of those we serve.

Collaboration with organizations like yours is crucial to the success of our projects; therefore, we seek your support towards the improvement of health services at the Hospital Clínico Universidad de Chile, which fulfills an indisputable role in caring for patients, and training a large number of medical specialists, as it is the principal post-graduate training center in Chile.

The Coronary Care Unit of the Clinical Hospital of the University of Chile was established in the early 1970s with the aim of providing the most comprehensive care for patients with acute myocardial infarction available at the time. Over time, it became one of the major coronary care units in Chile due to the number of patients seen (approximately 1200 patients per year) and its training programs for various specialists (cardiologists, internists, intensivists, anesthesiologists and emergency medicine specialists. In addition, it’s a pioneer in Chile, in the implementation of new therapies such as post operative cardiac care, thrombosis, and the early use of angioplasty in the management of acute coronary syndrome with elevated ST.

This Unit handles postoperative care following cardiac surgery, coronary angioplasty, and non-coronary interventional procedures (percutaneous valvuloplasty, septal communications closure, post-implantation of defibrillators, etc.). Also in 2001, the Cardiovascular Department initiated a heart transplant program, whose center of operations for the management of acute care and complications is the coronary care unit. Finally, since 2005 we have had shortterm ventricular support such as ECMO followed by Levitronic.

In short, the coronary care unit, in addition to its indisputable role in caring for patients, plays an important teaching role, participating in the training of a large number of different specialists, as our hospital is the principal postgraduate training center in the country. For this important task, it is necessary to have more and better technology, for the benefit of our patients, as well as to better prepare our doctors-in-training.

Non-invasive Mechanical Ventilation and Ultrafiltration

Approximately a third of our patients are admitted for decompensated heart failure and a significant number of them are edematous, with hypervolemia, pulmonary congestion and varying degrees of renal failure. Limitations on the appropriate treatment of these patients in our unit are:

1. We have no non-invasive mechanical ventilators to allow adequate support, forcing us in many instances to connect the patient to an invasive mechanical ventilator.

2. Patients with cardio-renal syndrome, which is resistant to diuretics, must be continuously connected to conventional dialysis systems

We are requesting

1.

a) b)

A non-invasive mechanical ventilator with the following characteristics:

Equipment that has an integrated display screen that permits an easy reading of parameters and graphics in real time, including the following measures and values:

 IPAP and EPAP

Expiratory Volume

 Respiratory Frequency

Peak Inspiratory pressure

Leakage

Fraction of inspired oxygen 

Equipment that enables ventilation modes CPAP, BIPAP and others that would allow for better patient adaptation

Control of oxygen up to 100% c) d) e)

Flexible technology that allows updates

Alarm modules that include high and low pressure and apnea alarms

2 . A system of ultrafiltration that permits the quick, safe and efficient removal of water and salt from patients with heart failure who do not respond to conventional therapy, such as the FlexFlow Aquadex Fluid Removal

System.

This equipment will improve the in-hospital survival of our patients, by permitting shorter hospitalizations, briefer stays in the [cardiac] unit, and less of a need for invasive mechanical ventilation.

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