Ultrafiltration in patients with decompensated heart failure and diuretic resistance: an Asian centre experience

Singapore Medical Journal
Loon Yee Louis TeoKheng Leng David Sim

Abstract

Diuretics are the mainstay of therapy for restoring the euvolemic state in patients with decompensated heart failure (HF). However, diuretic resistance remains a challenge. We conducted a retrospective cohort study to examine the efficacy and safety of performing ultrafiltration (UF) in 44 patients who were hospitalised with decompensated HF and diuretic resistance between October 2011 and July 2013. Among the 44 patients, 18 received UF (i.e. UF group), while 26 received diuretics (i.e. standard care group). After 48 hours, the UF group achieved lower urine output (1,355 mL vs. 3,815 mL, p = 0.0003), greater fluid loss (5,058 mL vs. 1,915 mL, p < 0.0001) and greater weight loss (5.0 kg vs. 1.0 kg, p < 0.0001) than the standard care group. The UF group also had a shorter duration of hospitalisation (5.0 days vs. 9.6 days, p = 0.0010). There were no differences in the incidence of 30-day emergency department visits and rehospitalisations for HF between the two groups. At 90 days, the UF group had fewer emergency department visits (0.2 vs. 0.8, p = 0.0500) and fewer rehospitalisations for HF (0.3 vs. 1.0, p = 0.0442). Reduction in the EQ-5D scores was greater in the UF group, both at discharge (2.7 vs. 1.4, p = 0.0283) and at 30 ...Continue Reading

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