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Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure: Current Status and Prospects for Further Research.

Abstract：

:More than 1 million heart failure hospitalizations occur annually, and congestion is the predominant cause. Rehospitalizations for recurrent congestion portend poor outcomes independently of age and renal function. Persistent congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No decongestive pharmacological therapy has reduced these harmful consequences. Simplified ultrafiltration devices permit fluid removal in lower-acuity hospital settings, but with conflicting results regarding safety and efficacy. Ultrafiltration performed at fixed rates after onset of therapy-induced increased serum creatinine was not superior to standard care and resulted in more complications. In contrast, compared with diuretic agents, some data suggest that adjustment of ultrafiltration rates to patients' vital signs and renal function may be associated with more effective decongestion and fewer heart failure events. Essential aspects of ultrafiltration remain poorly defined. Further research is urgently needed, given the burden of congestion and data suggesting sustained benefits of early and adjustable ultrafiltration.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Costanzo MR,Ronco C,Abraham WT,Agostoni P,Barasch J,Fonarow GC,Gottlieb SS,Jaski BE,Kazory A,Levin AP,Levin HR,Marenzi G,Mullens W,Negoianu D,Redfield MM,Tang WHW,Testani JM,Voors AA

doi

10.1016/j.jacc.2017.03.528

subject

Has Abstract

pub_date

2017-05-16 00:00:00

pages

2428-2445

issue

19

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(17)36697-4

journal_volume

69

pub_type

杂志文章,评审

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