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

Journal of the American College of Cardiology
Maria Rosa CostanzoAdriaan A Voors

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.

Associated Clinical Trials

Citations

Apr 10, 2018·The Korean Journal of Internal Medicine·Pieter Martens, Wilfried Mullens
May 29, 2018·European Journal of Heart Failure·Maria G Crespo-LeiroFrank Ruschitzka
May 8, 2018·Circulation·Maria Rosa Costanzo, Jonathan Barasch
Oct 21, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Masatake KobayashiNicolas Girerd
Dec 21, 2018·ESC Heart Failure·Elisabetta DinatoloMarco Metra
Jul 31, 2019·Artificial Organs·Rebecca C Gologorsky, Shuvo Roy
Mar 9, 2019·Cardiac Failure Review·Maria Rosa Costanzo
Mar 9, 2019·Cardiac Failure Review·Marco MetraNicolò Dasseni
Aug 31, 2019·European Journal of Heart Failure·Trejeeve Martyn, W H Wilson Tang
Mar 7, 2020·Nature Reviews. Disease Primers·Mattia ArrigoAlexandre Mebazaa
Apr 12, 2019·Heart Failure Reviews·Michele CorrealeNatale Daniele Brunetti
Apr 20, 2018·European Journal of Heart Failure·Maria Rosa Costanzo, Amir Kazory
Jul 1, 2020·European Heart Journal. Acute Cardiovascular Care·Hannah Ai SchaubroeckEric Aj Hoste
Jun 1, 2017·BMC Nephrology·Franz Maximilian RascheStephan Schiekofer
Dec 31, 2019·ESC Heart Failure·Markus S AnkerUNKNOWN Heart Failure Association Cardio-Oncology Study Group of the European Society of Cardiology
May 18, 2020·Nature Reviews. Cardiology·Eva M BoorsmaAdriaan A Voors
Aug 7, 2020·ESC Heart Failure·Aaron O KoshyKlaus K Witte
Nov 13, 2020·Nature Reviews. Nephrology·Raghavan MuruganJohn A Kellum
Mar 13, 2019·Lancet·Patrick RossignolFaiez Zannad
Jun 26, 2021·Heart·David Jonathan CookAlastair Proudfoot
Aug 29, 2020·Journal of the American College of Cardiology·Jacob C JentzerUNKNOWN Critical Care Cardiology Working Group of the Heart Failure and Transplant Section Leadership Council

❮ Previous
Next ❯

Clinical Trials Mentioned

NCT02448342

Software Mentioned

HF
UNLOAD
AVOID
CARRESS
CUORE

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.

Related Papers

Current Treatment Options in Cardiovascular Medicine
Valentina Lazzarini, G Michael Felker
The New England Journal of Medicine
Bradley A BartHeart Failure Clinical Research Network
Current Opinion in Cardiology
Lisa M MielniczukRoss A Davies
© 2022 Meta ULC. All rights reserved