PDF(Pubmed)
Abstract：
Ultrafiltration is an effective method to get rid of fluid retention and congestion in patients with acute decompensated heart failure (HF) without affecting the circulating volume. Although its efficacy in comparison to diuretics is debatable, the evaluation of our analysis is based on various studies that comprise published clinical trials on ultrafiltration and studies comparing the efficacy of diuretics and ultrafiltration. Apart from this, we also look at literature that provides shortcomings of the said procedure and its scope for future advancements. Heart failure ultimately leads to volume overload, which is a highly concerning complication. Diuretics have been used as a first-line treatment for fluid overload but are becoming inefficacious due to the development of resistance and renal dysfunction. Ultrafiltration, on the other hand, is an attractive alternative to counter volume overload and congestion, which are unresponsive to medical therapy. There is also evidence that it significantly decreases the probability of future episodes of decompensation. There are, however, disagreements about whether ultrafiltration is an effective method to improve mortality in these patients. There is a lack of conclusive studies demonstrating the superiority of one fluid removal method over another. Hence, it is imperative to continue searching for the most effective method to treat congestion. Priority should be given to more mechanistic studies regarding ultrafiltration.
摘要：
超滤是消除急性失代偿性心力衰竭（HF）患者的液体潴留和充血而不影响循环量的有效方法。尽管与利尿剂相比，其疗效尚有争议，我们的分析评估是基于各种研究，包括已发表的关于超滤的临床试验，以及比较利尿剂和超滤疗效的研究。除此之外,我们还看提供上述程序的缺点及其未来进步的范围的文献。心力衰竭最终导致容量超负荷,这是一个高度令人担忧的并发症。利尿剂已被用作液体超负荷的一线治疗，但由于耐药性和肾功能障碍的发展而变得无效。超滤,另一方面,是一个有吸引力的替代计数器体积过载和拥塞，对药物治疗没有反应。也有证据表明，它显着降低了未来代偿失调发作的可能性。有,然而,关于超滤是否是改善这些患者死亡率的有效方法存在分歧。缺乏结论性研究证明一种流体去除方法优于另一种方法。因此，必须继续寻找最有效的方法来治疗拥堵。应优先考虑有关超滤的更多机理研究。
