Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure Current Status and Prospects for Further Research
Articolo
Data di Pubblicazione:
2017
Citazione:
Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure Current Status and Prospects for Further Research / M.R. Costanzo, C. Ronco, W.T. Abraham, P. Agostoni, J. Barasch, G.C. Fonarow, S.S. Gottlieb, B.E. Jaski, A. Kazory, A.P. Levin, H.R. Levin, G. Marenzi, W. Mullens, D. Negoianu, M.M. Redfield, W.H.W. Tang, J.M. Testani, A.A. Voors. - In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. - ISSN 0735-1097. - 69:19(2017 May), pp. 2428-2445. [10.1016/j.jacc.2017.03.528]
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 patientsâ 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.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
biomarkers; creatinine; diuretics; glomerular filtration rate; venous congestion; Blood Volume; Diuretics; Heart Failure; Humans; Pilot Projects; Randomized Controlled Trials as Topic; Hemofiltration; Cardiology and Cardiovascular Medicine
Elenco autori:
M.R. Costanzo, C. Ronco, W.T. Abraham, P. Agostoni, J. Barasch, G.C. Fonarow, S.S. Gottlieb, B.E. Jaski, A. Kazory, A.P. Levin, H.R. Levin, G. Marenzi, W. Mullens, D. Negoianu, M.M. Redfield, W.H.W. Tang, J.M. Testani, A.A. Voors
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