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The number of patients with acute congestion on chronic heart failure is increasing. Ultrafiltration has recently been proposed as an alternative approach for the stabilization of volume balance, especially in patients with imminent diuretic resistance.
There is increasing evidence that ultrafiltration may relief cardiac congestion with lesser effects on blood pressure and activation of renin angiotensin system, respectively . However, recent studies revealed conflicting results: demonstration the superiority of ultrafiltration in comparison to diuretic treatment, and a lack of evidence of benefit, as well as an excess of adverse events with ultrafiltration.
Aquapheresis with adapted ultrafiltration rate guided by central venous pressure is safer than aquaphesis with a constant ultrafiltration with comparable effectiveness
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrafiltration | Procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in central venous pressure | Changes from Baseline to 48 h after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| amount of net fluid loss | 48 h | |
| Measure of dyspnea using a visual analog scale | Changes from Baseline to 48 h after intervention | |
| heart function |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with chronic heart failure listed for LVAD
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| Name | Affiliation | Role |
|---|---|---|
| Ralf Westenfeld, MD | Division of Cardiology, Pulmonary Diseases, Vascular Medicine, University Hospital Dusseldorf | Principal Investigator |
| Malte Kelm, MD | Division of Cardiology, Pulmonary Diseases, Vascular Medicine, University Hospital Dusseldorf | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Division of Cardiology, Pulmonary Diseases, Vascular Medicine, University Hospital Dusseldorf | Düsseldorf | Germany |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D014462 | Ultrafiltration |
| ID | Term |
|---|---|
| D005112 | Extracorporeal Circulation |
| D013514 | Surgical Procedures, Operative |
| D005374 | Filtration |
| D002623 | Chemistry Techniques, Analytical |
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right/left heart function measured by Echocardiography and BNP (Brain Natriuretic Peptide) |
| 7 days |
| Biomarker | GFR, Cystatin C, HCO3-, NT-proBNP, CK, Troponin, Hematocrit | Changes from Baseline to 48 h after intervention |
| Time until impaired plasma refill rate | 48 h |
| blood pressure | Changes from Baseline to 48 h after intervention |
| heart rate | Changes from Baseline to 48 h after intervention |
| Serum Creatinine level | 48 h |
| D008919 | Investigative Techniques |
| D055585 | Physical Phenomena |
| D055598 | Chemical Phenomena |