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Extracorporeal ultrafiltration for acute heart failure: patient selection and perspectives

Authors Milazzo V, Cosentino N, Marenzi G

Received 17 July 2017

Accepted for publication 27 October 2017

Published 11 December 2017 Volume 2017:13 Pages 449—456

DOI https://doi.org/10.2147/VHRM.S128608

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Daniel Duprez


Valentina Milazzo, Nicola Cosentino, Giancarlo Marenzi

Intensive Cardiac Care Unit, Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy

Abstract: Most patients presenting with acute heart failure (AHF) show signs and symptoms of fluid overload, which are closely associated with short-term and long-term outcomes. Ultrafiltration is an extremely appealing strategy for patients with AHF and concomitant overt fluid overload not fully responsive to diuretic therapy. However, although there are several theoretical beneficial effects associated with ultrafiltration, published reports have shown controversial findings. Differences in selection of the study population and in ultrafiltration indications and protocols, and high variability in the pharmacologic therapy used for the control group could explain some of these conflicting results. Here, we aimed to provide an overview on the current medical evidence supporting the use of ultrafiltration in AHF, with a special focus on the identification of potential candidates who may benefit the most from this therapeutic option.

Keywords: ultrafiltration, acute heart failure, fluid overload, diuretics

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