Ultrafiltration in Acute Decompensated Heart Failure

Acute decompensated heart failure (ADHF) is one of the leading causes of hospital admissions and a significant burden on the healthcare system. It can be attributed to medication noncompliance, comorbidities, diet, modifiable risk factors, disease progression, and/or treatment failure. The standard treatment is usually pharmacologic involving intravenous (IV) diuresis, mainly with loop diuretics. However, chronic diuretic therapy use is associated with negative neuro-hormonal effects which may lead to diuretic resistance and worsening renal function which in turn can lead to increased morbidity and mortality. There has been a growing interest in alternative strategies to manage volume overload in ADHF patients. The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) guidelines recommend pharmacological and non-pharmacological interventions to treat volume overload. Extracorporeal ultrafiltration (UF) is, therefore, an emerging alternative therapy of interest for treating volume overload in ADHF patients.