Ultrafiltration in heart failure

摘要: Fluid overload is a key pathophysiologic mechanism underlying both the acute decompensation episodes of heart failure and progression syndrome. Moreover, it represents most important factor responsible for high readmission rates observed in these patients often associated with renal function worsening, which by itself increases mortality risk. In this clinical context, ultrafiltration (UF) has been proposed as an alternative to diuretics obtain quicker relief pulmonary/systemic congestion. This review illustrates technical issues, mechanisms, efficacy, safety, costs, indications UF failure. The available evidence does not support widespread use substitute diuretic therapy. Owing its operative characteristics, cannot be expected directly influence serum electrolyte levels, azotemia, acid-base balance, or remove high-molecular-weight substances (eg, cytokines) clinically relevant amounts. Ultrafiltration should used neither way achieve sort mechanical diuresis nor remedy inadequately prescribed administered Instead, reserved selected advanced true resistance, part more complex strategy aiming at adequate control fluid retention.