Ultrafiltration for acute decompensated heart failure.

For the 13th consecutive year, acute decompensated heart failure is the most common reason for admission to American hospitals. Most patients admitted for decompensated heart failure are by definition, diuretic resistant. The therapeutic objective in these patients is volume and sodium removal, and the restoration of diuretic sensitivity. In a significant proportion of patients, this objective is not met, subjecting patients to readmission for recurrent (or continued) heart failure decompensation. Ultrafiltration therapy offers the potential of greater volume and sodium removal as compared with conventional therapies in a more expeditious manner. Ultrafiltration can be accomplished safely, quickly and on a regular telemetry ward in extremely ill patients, but relies on earlier discharge with reduced readmission rates to be economically feasible.