Congestive heart failure ultrafiltration

Overview
In the setting of congestive heart failure, ultrafiltration has been associated with a reduced incidence of hospitalization compared with diuretics in the UNLOAD trial, but no difference in mortality.

Mechanism
Ultrafiltration removes plasma water from whole blood. Possible benefits of ultrafiltration include:
 * Provides fluid regulation
 * Relieve pulmonary edema
 * Reduce ascites and/or peripheral edema
 * Hemodynamic stabilization
 * Improve oxygenation
 * Facilitates blood product replacement without excess volume
 * Enable parenteral nutritional support without excess volume


 * Improves solute regulation
 * Correct acid-base balance
 * Correct serum sodium content
 * Eliminate myocardial depressant factors or known toxins
 * Correct uremia
 * Correct hyperkalemia
 * Correct other electrolyte disturbances


 * Helps to establish homeostasis
 * Reset water omostat
 * Restore diuretic responsiveness
 * Reduce neurohormonal activation

==ACC/AHA Guidelines- Ultrafiltration Recommendation == {{cquote|

Class IIa
1. Ultrafiltration is reasonable for patients with refractory congestion not responding to medical therapy. (Level of Evidence: B)}}

Vote on and Suggest Revisions to the Current Guidelines

 * The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

Guidelines Resources

 * 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation


 * The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult