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2016 ; 57
(7
): 378-83
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Ultrafiltration in patients with decompensated heart failure and diuretic
resistance: an Asian centre s experience
#MMPMID26778634
Singapore Med J
2016[Jul]; 57
(7
): 378-83
PMID26778634
show ga
INTRODUCTION: Diuretics are the mainstay of therapy for restoring the euvolaemic
state in patients with decompensated heart failure. However, diuretic resistance
remains a challenge. METHODS: We conducted a retrospective cohort study to
examine the efficacy and safety of ultrafiltration (UF) in 44 hospitalised
patients who had decompensated heart failure and diuretic resistance between
October 2011 and July 2013. RESULTS: Among the 44 patients, 18 received UF (i.e.
UF group), while 26 received diuretics (i.e. standard care group). After 48
hours, the UF group achieved lower urine output (1,355 mL vs. 3,815 mL, p =
0.0003), greater fluid loss (5,058 mL vs. 1,915 mL, p < 0.0001) and greater
weight loss (5.0 kg vs. 1.0 kg, p < 0.0001) than the standard care group. The UF
group also had a shorter duration of hospitalisation (5.0 days vs. 9.5 days, p =
0.0010). There were no differences in the incidence of 30-day emergency
department visits and rehospitalisations for heart failure between the two
groups. At 90 days, the UF group had fewer emergency department visits (0.2 vs.
0.8, p = 0.0500) and fewer rehospitalisations for heart failure (0.3 vs. 1.0, p =
0.0442). Reduction in EQ-5D? scores was greater in the UF group, both at
discharge (2.7 vs. 1.4, p = 0.0283) and 30 days (2.5 vs. 0.3, p = 0.0033). No
adverse events were reported with UF. CONCLUSION: UF is an effective and safe
treatment that can improve the health outcomes of Asian patients with
decompensated heart failure and diuretic resistance.