Congestive heart failure ultrafiltration

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ACC/AHA Guideline Recommendations Initial and Serial Evaluation of the HF Patient Hospitalized Patient Patients With a Prior MI Sudden Cardiac Death Prevention Surgical/Percutaneous/Transcather Interventional Treatments of HF Patients at high risk for developing heart failure (Stage A) Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B) Patients with current or prior symptoms of heart failure (Stage C) Patients with refractory end-stage heart failure (Stage D) Coordinating Care for Patients With Chronic HF Quality Metrics/Performance Measures
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Specific Groups: Special Populations Patients who have concomitant disorders Obstructive Sleep Apnea in the Patient with CHF NSTEMI with Heart Failure and Cardiogenic Shock
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

• Ultrafiltration has been associated with a reduced incidence of hospitalization compared with diuretics in the UNLOAD trial. There was no difference in mortality.
• 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

References

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