Clinical Research
Heart Failure
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

https://doi.org/10.1016/j.jacc.2005.05.098Get rights and content
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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.

Abbreviations and Acronyms

CHF
congestive heart failure
IV
intravenous
UF
ultrafiltration

Cited by (0)

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.