Key result
Ultrafiltration therapy offers the potential for greater volume and sodium removal compared with conventional therapies in patients with acute decompensated heart failure.
Ultrafiltration therapy offers a potential strategy for greater volume and sodium removal in diuretic-resistant acute decompensated heart failure, and can be safely implemented in non-intensive care settings.
Hypothesis-generating for ultrafiltration in diuretic-resistant ADHF; prospective outcome trials needed before practice change.
Acute decompensated heart failure is the most common reason for inpatient hospital admission. Most patients admitted for decompensated heart failure are by definition diuretic-resistant. The therapeutic objective for these patients is volume and sodium removal and restoration of diuretic sensitivity. In a significant proportion of patients, this objective is not met, subjecting patients to readmission for recurrent heart failure decompensation. Ultrafiltration therapy offers the potential of greater volume and sodium removal as compared with conventional therapies in a more expeditious manner. Ultrafiltration can be safely and effectively accomplished in a non-intensive care setting but relies on earlier discharge with reduced readmission rates to be economically feasible. This paper reviews the current data regarding ultrafiltration therapy and provides a practical guide to patient selection, implementation and management of this therapy.
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Dahle et al. (2008) conducted a review in Acute decompensated heart failure. Ultrafiltration vs. conventional therapies was evaluated. Ultrafiltration therapy offers the potential for greater volume and sodium removal compared with conventional therapies in patients with acute decompensated heart failure.
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