Need for a unified decision-making tool for ultrafiltration therapy in heart failure; call for action

摘要: Although ultrafiltration portends several theoretical advantages over the standard therapy for acute decompensated heart failure, it might not be optimal treatment all patients presenting with an episode of decompensation. It is yet clear how to prospectively identify subset that would benefit from this therapeutic modality. Based on pathophysiologic mechanisms underlying early can appropriate initial management strategy those diuretic resistance whose associated renal dysfunction related hemodynamic changes rather than a structural abnormality. In absence widely accepted consensus guidelines, use currently subject considerable variations among physicians. A clinical tool (eg, scoring system) based individual patient's characteristics therefore needed candidates therapy. Using system likely portend better outcomes while helping avoid unnecessary exposure potential risks extracorporeal therapies.