PMID- 8814923
OWN - NLM
STAT- MEDLINE
DCOM- 19961010
LR  - 20191101
IS  - 1073-4449 (Print)
IS  - 1073-4449 (Linking)
VI  - 3
IP  - 2
DP  - 1996 Apr
TI  - Refractory congestive heart failure: overview and application of extracorporeal 
      ultrafiltration.
PG  - 166-73
AB  - Congestive heart failure (CHF) from ischemic cardiomyopathy has emerged as an 
      epidemic health problem. The pathogenesis of CHF is characterized by heightened 
      activity of many neuroendocrine factors, including norepinephrine, angiotensin 
      II, and arginine vasopressin, which lead to heightened systemic vascular 
      resistance and further impedance of left ventricular ejection. Once CHF reaches 
      New York Heart Association (NYHA) class III or IV with heightened activity of the 
      many neurohumoral factors, it tends to be refractory to conventional therapy of 
      vasodilators, inotropic agents, and diuretics. Treatment of refractory CHF 
      appears to require a break in the neurohumoral hemodynamic vicious cycle, and 
      ultrafiltration appears able to produce this interruption. Ultrafiltration has 
      been shown to be successful in patients with NYHA class III to VI CHF and urine 
      output less than 1,000 mL/d. It relieves pulmonary edema, reduces ascites and 
      peripheral edema, and enhances the response to subsequent diuretic therapy. In 
      patients with refractory CHF, the ability to provide adequate volume removal, 
      thus improving overall volume status, normalizing filling pressures, and reducing 
      clinical symptoms, offers an improvement in overall quality of life. Early 
      results have shown that ongoing therapy actually may be associated with decreased 
      hospital readmissions or, at the very least, shortened intensive care unit length 
      of stay.
FAU - Blake, P
AU  - Blake P
AD  - Cleveland Clinic Foundation, OH 44195-5176, USA.
FAU - Paganini, E P
AU  - Paganini EP
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Adv Ren Replace Ther
JT  - Advances in renal replacement therapy
JID - 9433799
SB  - IM
MH  - Heart Failure/*therapy
MH  - Humans
MH  - *Renal Dialysis
MH  - Ultrafiltration
RF  - 50
EDAT- 1996/04/01 00:00
MHDA- 1996/04/01 00:01
CRDT- 1996/04/01 00:00
PHST- 1996/04/01 00:00 [pubmed]
PHST- 1996/04/01 00:01 [medline]
PHST- 1996/04/01 00:00 [entrez]
AID - S1073-4449(96)80057-4 [pii]
AID - 10.1016/s1073-4449(96)80057-4 [doi]
PST - ppublish
SO  - Adv Ren Replace Ther. 1996 Apr;3(2):166-73. doi: 10.1016/s1073-4449(96)80057-4.