Extracorporeal ultrafiltration for acute heart failure: patient selection and perspectives

Vasc Health Risk Manag. 2017 Dec 11;13:449-456. doi: 10.2147/VHRM.S128608. eCollection 2017.

Abstract

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.

Keywords: acute heart failure; diuretics; fluid overload; ultrafiltration.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Aged
  • Clinical Decision-Making
  • Female
  • Fluid Shifts
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Hemofiltration* / adverse effects
  • Humans
  • Male
  • Patient Selection
  • Treatment Outcome
  • Water-Electrolyte Balance
  • Water-Electrolyte Imbalance / diagnosis
  • Water-Electrolyte Imbalance / physiopathology
  • Water-Electrolyte Imbalance / therapy*