Ultrafiltration did not significantly improve the primary endpoint of weight loss at 24 hours compared to usual care (2.5 kg vs 1.86 kg, p=0.240), despite greater fluid removal.
RCT (n=40)
Does a single 8-hour ultrafiltration session improve weight loss and fluid removal compared to usual care in hospitalized patients with decompensated congestive heart failure?
Early ultrafiltration in acute decompensated heart failure is feasible and significantly increases fluid removal, though it did not significantly increase 24-hour weight loss compared to usual care in this small pilot study.
Absolute Event Rate: 2.5% vs 1.86%
p-value: p=0.240
OBJECTIVES: The purpose of this research was to assess the safety and efficacy of ultrafiltration (UF) in patients admitted with decompensated congestive heart failure (CHF). BACKGROUND: Ultrafiltration for CHF is usually reserved for patients with renal failure or those unresponsive to pharmacologic management. We performed a randomized trial of UF versus usual medical care using a simple UF device that does not require special monitoring or central intravenous access. METHODS: Patients admitted for CHF with evidence of volume overload were randomized to a single, 8 h UF session in addition to usual care or usual care alone. The primary end point was weight loss 24 h after the time of enrollment. RESULTS: Forty patients were enrolled (20 UF, 20 usual care). Ultrafiltration was successful in 18 of the 20 patients in the UF group. Fluid removal after 24 h was 4,650 ml and 2,838 ml in the UF and usual care groups, respectively (p = 0.001). Weight loss after 24 h, the primary end point, was 2.5 kg and 1.86 kg in the UF and usual care groups, respectively (p = 0.240). Patients tolerated UF well. CONCLUSIONS: The early application of UF for patients with CHF was feasible, well-tolerated, and resulted in significant weight loss and fluid removal. A larger trial is underway to determine the relative efficacy of UF versus standard care in acute decompensated heart failure.
Bart et al. (2005) conducted an RCT in decompensated congestive heart failure (CHF) (n=40). Ultrafiltration (UF) vs. usual care alone was evaluated on weight loss 24 h after the time of enrollment (p=0.240). Ultrafiltration did not significantly improve the primary endpoint of weight loss at 24 hours compared to usual care (2.5 kg vs 1.86 kg, p=0.240), despite greater fluid removal.