ABSTRACT
INTRODUCTION Most of the signs and symptoms of heart failure are attributable to fl uid overload. Patients with persistent congestion remain symptomatic and are at increased risk for prolonged hospitalization, rehospitalization, and death. Therefore, effective volume reduction therapies are needed to address the morbidity and mortality of heart failure. Diuretics relieve symptoms in the majority of heart failure patients, yet they are diffi cult to use and rarely result in complete clinical decongestion. Ultrafi ltration, the mechanical removal of fl uid directly from the vasculature, has been used in heart failure patients for over 30 years. Originally reserved only for patients with refractory heart failure, ultrafi ltration is increasingly being used in a less sick population as an early therapy in for decompensated heart failure. This chapter reviews ultrafi ltration for the management of fl uid overload in heart failure.
