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Review
. 2023 May 26;15(5):205-216.
doi: 10.4330/wjc.v15.i5.205.

Extracorporeal veno-venous ultrafiltration in congestive heart failure: What's the state of the art? A mini-review

Andrea Urbani  1 , Filippo Pensotti  2 , Andrea Provera  2 , Andrea Galassi  3 , Marco Guazzi  2 , Diego Castini  2
Affiliations
Review

Extracorporeal veno-venous ultrafiltration in congestive heart failure: What's the state of the art? A mini-review

Andrea Urbani et al. World J Cardiol. .

Abstract

Hospitalizations for heart failure exceed 1 million per year in both the United States and Europe and more than 90% are due to symptoms and signs of fluid overload. Rates of rehospitalizations or emergency department visit at 60 days are remarkable regardless of whether loop diuretics were administered at low vs high doses or by bolus injection vs continuous infusion. Ultrafiltration (UF) has been considered a promising alternative to stepped diuretic therapy and it consists in the mechanical, adjustable removal of iso-tonic plasma water across a semipermeable membrane with the application of hydrostatic pressure gradient generated by a pump. Fluid removal with ultrafiltration presents several advantages such as elimination of higher amount of sodium with less neurohormonal activation. However, the conflicting results from UF studies highlight that patient selection and fluid removal targets are not completely understood. The best way to assess fluid status and therefore establish the fluid removal target is also still a matter of debate. Herein, we provide an up-to-date systematic review about the role of ultrafiltration among patients with fluid overload and its gaps in daily practice.

Keywords: Diuretics; Fluid overload; Heart failure; Ultrafiltration.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflict of interest regarding this article.

Figures

Figure 1
Figure 1
Direct and indirect non-invasive estimation of fluid overload with point of care ultrasound. IVC: Inferior vena cava; POCUS: Point-of-care ultrasound; HF: Heart failure.
Figure 2
Figure 2
A schematic representation of the ultrafiltrative process.
See this image and copyright information in PMC

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