OBJECTIVES: The goal of this study was to investigate the hemodynamic and circulatory adjustments to extracorporeal ultrafiltration (UF) in refractory congestive @entity712 (rCHF). BACKGROUND: In rCHF, UF allows clinical improvement and restores diuretic efficacy. However, in the course of a UF session, @entity1 are exposed to rapid variations of body fluid composition so that, as fluid is withdrawn from the intravascular compartment, @entity551 or even shock could occur. METHODS: In 24 @entity1 with rCHF undergoing UF, we measured, after every liter of plasma water removed, hemodynamics, blood gas analysis (in both @entity358 ), plasma volume changes (PV) and plasma refilling rate (PRR). The PV and PRR were calculated by considering hematocrit and ultrafiltrate volume. RESULTS: In all @entity1 , UF was performed safely, without side effects or hemodynamic instability (ultrafiltrate = 4,880 +/- 896 ml). Mean right @entity358 and wedge pressures progressively reduced during the procedure. Cardiac output increased at the end of the procedure and, to a greater extent, 24 h later, in relation to the increase of @entity64 volume. Heart rate and systemic vascular resistance did not increase, and other peripheral biochemical parameters did not worsen during UF. Intravascular volume remained stable throughout the entire duration of the procedure, indicating that a proportional volume of fluid was refilled from the congested parenchyma. CONCLUSIONS: In @entity1 with rCHF, subtraction of plasma water by UF is associated with hemodynamic improvement. Fluid refilling from the overhydrated interstitium is the major compensatory mechanism for intravascular fluid removal, and @entity551 does not occur when plasma refilling rate is adequate to prevent @entity3485 .

Circulatory response to fluid overload removal by extracorporeal ultrafiltration in refractory congestive XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity358 :: ('MESH:D008171', 'Disease') :: ['atrial, pulmonary artery', 'systemic and pulmonary arteries'] @entity3485 :: ('MESH:D020896', 'Disease') :: ['hypovolemia'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension']
@entity712 :: (MESH:D006333,Disease) :: ['heart failure']
