Extracorporeal ultrafiltration is a potential therapeutic option for acute heart failure with fluid overload, though current evidence shows conflicting results due to study heterogeneity.
Does extracorporeal ultrafiltration improve outcomes in patients with acute heart failure and fluid overload not fully responsive to diuretic therapy?
This review highlights the controversial findings regarding ultrafiltration in acute heart failure and emphasizes the need for careful patient selection, particularly targeting those with fluid overload unresponsive to diuretics.
Most patients presenting with acute heart failure (AHF) show signs and symptoms of fluid overload, which are closely associated with short-term and long-term outcomes. Ultrafiltration is an extremely appealing strategy for patients with AHF and concomitant overt fluid overload not fully responsive to diuretic therapy. However, although there are several theoretical beneficial effects associated with ultrafiltration, published reports have shown controversial findings. Differences in selection of the study population and in ultrafiltration indications and protocols, and high variability in the pharmacologic therapy used for the control group could explain some of these conflicting results. Here, we aimed to provide an overview on the current medical evidence supporting the use of ultrafiltration in AHF, with a special focus on the identification of potential candidates who may benefit the most from this therapeutic option.
Milazzo et al. (Fri,) conducted a review in Acute heart failure. Extracorporeal ultrafiltration vs. Pharmacologic therapy (diuretics) was evaluated. Extracorporeal ultrafiltration is a potential therapeutic option for acute heart failure with fluid overload, though current evidence shows conflicting results due to study heterogeneity.