Ultrafiltration in Acute Decompensated Heart Failure

Acute heart failure is a major clinical and public health problem. Advanced refractory heart failure represents an important subgroup of patients presenting with acute heart failure syndrome. Fluid congestion is a hallmark in patients with advanced heart failure, and resistance to pharmacologic therapy - particularly diuretics - frequently develops as the disease progresses. When pharmacologic therapy is no longer feasible, ultrafiltration, dialysis, or phlebotomy may permit fluid removal. The role of ultrafiltration in the management of patients with acute decompensated heart failure is discussed in this issue of Cardiology Rounds.