Congestive heart failure ultrafiltration: Difference between revisions
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| [[File:Siren.gif|30px|link= Congestive heart failure resident survival guide]]|| <br> || <br> | |||
| [[Acute decompensated heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] | |||
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| [[File:Critical_Pathways.gif|88px|link= Congestive heart failure critical pathways]]|| <br> || <br> | |||
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{{Congestive heart failure}} | {{Congestive heart failure}} | ||
{{CMG}}; {{AOEIC}} {{LG}} | {{CMG}}; {{AOEIC}} {{LG}} | ||
==Overview== | ==Overview== | ||
In the setting of congestive heart failure, [[ultrafiltration]] has been associated with a reduced incidence of hospitalization compared with diuretics in the UNLOAD trial, but no difference in mortality. | |||
==Ultrafiltration== | |||
===Mechanism=== | |||
Ultrafiltration removes plasma water from whole blood. Possible benefits of ultrafiltration include: | |||
*Provides fluid regulation | *Provides fluid regulation | ||
:* Relieve [[pulmonary edema]] | :* Relieve [[pulmonary edema]] | ||
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:* Reduce [[neurohormonal activation]] | :* Reduce [[neurohormonal activation]] | ||
==ACC/AHA Guidelines- Ultrafiltration | ==2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>== | ||
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== | ===Ultrafiltration in Patients Presenting With Heart Failure (DO NOT EDIT) <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>=== | ||
'''1.''' [[Ultrafiltration]] is reasonable for patients with refractory congestion not responding | |||
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Ultrafiltration]] is reasonable for patients with refractory [[congestion]] not responding tomedical therapy. <ref name="pmid17291932">{{cite journal |author=Costanzo MR, Guglin ME, Saltzberg MT, Jessup ML, Bart BA, Teerlink JR, Jaski BE, Fang JC, Feller ED, Haas GJ, Anderson AS, Schollmeyer MP, Sobotka PA |title=Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure |journal=[[Journal of the American College of Cardiology]] |volume=49 |issue=6 |pages=675–83 |year=2007 |month=February |pmid=17291932 |doi=10.1016/j.jacc.2006.07.073 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(06)02889-0 |accessdate=2012-04-06}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | |||
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==Vote on and Suggest Revisions to the Current Guidelines== | ==Vote on and Suggest Revisions to the Current Guidelines== | ||
*[[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]] | *[[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]] | ||
== | ==External Links== | ||
*[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref> | *[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref> | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Latest revision as of 21:06, 29 July 2020
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Resident Survival Guide |
| File:Critical Pathways.gif |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
In the setting of congestive heart failure, ultrafiltration has been associated with a reduced incidence of hospitalization compared with diuretics in the UNLOAD trial, but no difference in mortality.
Ultrafiltration
Mechanism
Ultrafiltration removes plasma water from whole blood. Possible benefits of ultrafiltration include:
- Provides fluid regulation
- Relieve pulmonary edema
- Reduce ascites and/or peripheral edema
- Hemodynamic stabilization
- Improve oxygenation
- Facilitates blood product replacement without excess volume
- Enable parenteral nutritional support without excess volume
- Improves solute regulation
- Correct acid-base balance
- Correct serum sodium content
- Eliminate myocardial depressant factors or known toxins
- Correct uremia
- Correct hyperkalemia
- Correct other electrolyte disturbances
- Helps to establish homeostasis
- Reset water omostat
- Restore diuretic responsiveness
- Reduce neurohormonal activation
2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) [1]
Ultrafiltration in Patients Presenting With Heart Failure (DO NOT EDIT) [1]
| Class IIa |
| "1. Ultrafiltration is reasonable for patients with refractory congestion not responding tomedical therapy. [2] (Level of Evidence: B) " |
Vote on and Suggest Revisions to the Current Guidelines
External Links
- 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation [1]
- The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult [3]
References
- ↑ 1.0 1.1 1.2 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967
- ↑ Costanzo MR, Guglin ME, Saltzberg MT, Jessup ML, Bart BA, Teerlink JR, Jaski BE, Fang JC, Feller ED, Haas GJ, Anderson AS, Schollmeyer MP, Sobotka PA (2007). "Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure". Journal of the American College of Cardiology. 49 (6): 675–83. doi:10.1016/j.jacc.2006.07.073. PMID 17291932. Retrieved 2012-04-06. Unknown parameter
|month=ignored (help) - ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112 (12):e154-235. DOI:10.1161/CIRCULATIONAHA.105.167586 PMID: 16160202