Ultrafiltration versus usual care for hospitalized patients with heart failure: The relief for acutely fluid-overloaded patients with decompensated congestive heart failure (RAPID-CHF) trial

Bradley A Bart, Andrew Boyle, Alan J. Bank, Inder Anand, Maria Teresa Olivari, Mark Kraemer, Shari Mackedanz, Paul A. Sobotka, Mike Schollmeyer, Steven Goldsmith

Research output: Contribution to journalArticle

296 Scopus citations

Abstract

OBJECTIVES: The purpose of this research was to assess the safety and efficacy of ultrafiltration (UF) in patients admitted with decompensated congestive heart failure (CHF). BACKGROUND: Ultrafiltration for CHF is usually reserved for patients with renal failure or those unresponsive to pharmacologic management. We performed a randomized trial of UF versus usual medical care using a simple UF device that does not require special monitoring or central intravenous access. METHODS: Patients admitted for CHF with evidence of volume overload were randomized to a single, 8 h UF session in addition to usual care or usual care alone. The primary end point was weight loss 24 h after the time of enrollment. RESULTS: Forty patients were enrolled (20 UF, 20 usual care). Ultrafiltration was successful in 18 of the 20 patients in the UF group. Fluid removal after 24 h was 4,650 ml and 2,838 ml in the UF and usual care groups, respectively (p = 0.001). Weight loss after 24 h, the primary end point, was 2.5 kg and 1.86 kg in the UF and usual care groups, respectively (p = 0.240). Patients tolerated UF well. CONCLUSIONS: The early application of UF for patients with CHF was feasible, well-tolerated, and resulted in significant weight loss and fluid removal. A larger trial is underway to determine the relative efficacy of UF versus standard care in acute decompensated heart failure.

Original languageEnglish (US)
Pages (from-to)2043-2046
Number of pages4
JournalJournal of the American College of Cardiology
Volume46
Issue number11
DOIs
StatePublished - Dec 6 2005

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