February 2007 | Back to Table of Contents

2006 American College of Physicians Poster Competition Winners

Each year, the state chapters of the American College of Physicians (ACP) invite medical students, residents, and fellows to participate in a scientific poster competition. Last year in Minnesota, there were more than 148 submissions in the categories of clinical vignette and research from students, residents, and fellows from the University of Minnesota, Mayo Clinic, Abbott Northwestern Hospital, and Hennepin County Medical Center.

The abstracts were reviewed and presented in poster form at the Minnesota Chapter ACP Scientific Meeting held at the Minneapolis Convention Center on November 3 and 4, 2006. Charles Reznikoff, M.D., Kevin Larsen, M.D., and Sandra Main, administrative coordinator for the Minnesota ACP chapter, coordinated the competition. Judges included teaching faculty and community physicians. Judging was done in small groups, and posters were assessed for originality, significance, and presentation.

Winners received prizes, and the winners of the research and clinical vignette categories (see abstracts) are guaranteed entry in the national competition, which will be held in San Diego in April 2007.

Congratulations to the winners and everyone who participated in the poster competition.

Research Winner

Enhanced Sodium Extraction with Ultrafiltration Compared to Intravenous Diuretics

By Syed S. Ali, M.D., Chad C. Olinger, D.O., Paul A. Sobotka, M.D., Steven Bernard, Thom G. Dahle, M.D., Matthew C. Bunte, M.D., Donnevan Blake, M.D., Scott Campbell, and Andrew J. Boyle, M.D., University of Minnesota, Minneapolis, and CHF Solutions, Brooklyn Park, Minnesota

Introduction: Head-to-head comparisons between ultrafiltration (UF) and intravenous diuretics (IVD) have consistently revealed superior volume removal and weight reduction with UF. However, the impact of these therapies in patients hospitalized with acute decompensated heart failure (ADHF) on total body sodium, potassium, and magnesium has not been described.
Hypothesis: UF, beyond removing excessive volume as compared with IVD, also removes more sodium and less potassium and magnesium.
Methods: Fifteen hospitalized ADHF patients with presumed diuretic resistance and clinical evidence of volume overload had their urine electrolyte concentrations measured after a dose of IVD. UF was then begun and ultrafiltrate electrolyte concentrations were measured 8 hours later and compared with the initial urine electrolyte values.
Results: The urine sodium in response to IVD (mean: 60 47 mg/dL) was less than the sodium in the ultrafiltrate (mean: 134 8.0 mg/dL) (p=0.000025). The urine potassium in response to IVD (mean: 41 23 mg/dL) was greater than the potassium in the
ultrafiltrate (mean: 3.7 0.6 mg/dL) (p=0.000017). The urine magnesium in response to IVD (mean: 5.2 3.1 mg/dL) was greater than the magnesium in the ultrafiltrate (mean: 2.9 0.7 mg/dL) (p=0.017).
Conclusions: In hospitalized patients with ADHF and presumed diuretic resistance, IVD are a poor natriuretic and cause significant losses of potassium and magnesium. In contrast, UF extracts significantly more sodium per liter than IVD while simultaneously removing less potassium and magnesium and reducing the need for supplementation. The reported sustained clinical benefits of UF as compared with IVD may be partly related to their disparate effects on total body sodium, potassium, and magnesium in addition to their differential efficacy of volume removal.