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 R. Goldsmith

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344 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
Externally publishedYes

Bibliographical note

Funding Information:
Dr. Sobotka and Mr. Schollmeyer are employees of CHF Solutions Inc.; Dr. Goldsmith has received grant support as director of the Minnesota Heart Failure Consortium for administrative fees and overhead in connection with this trial. Funding for the project was provided by CHF Solutions Inc.

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