Ultrafiltration Versus Intravenous Diuretics For Treatment Of Acute Decompensated Heart Failure Versus Intravenous Diuretics For Treatment Of Acute Decompensated Heart Failure

Introduction: Few studies have been published comparing the use of ultrafiltration (UF) versus intravenous diuretics for the treatment of patients with acute decompensated heart failure. The results have been mixed and the ideal management strategy is still not clear. We aimed to perform a meta-analysis of the published literature in this regard. Methods: We searched Pubmed, MEDLINE, EMBASE and Cochrane databases for terms “ultrafiltration”, “diuretics”, “heart failure” and their combinations. We included only randomized studies published in English language. Studies with less than 10 patients were excluded. Results: A total of 8 studies were included for analysis. Compared to intravenous diuretics, UF was not associated with any significant differences in length of hospitalization (Mean difference (MD) -1.96 days, 95% confidence interval (CI) -5.18-1.26, P = .23), heart failure readmissions (Odds ratio (OR) 0.76, 95% CI 0.42–1.40, P = .38) or mortality (OR 1.01, 95% CI 0.66–1.54, P = .97). However, UF was associated with significant decrease in 48 hour weight loss (MD 3.22 kg, 95% CI 0.23–6.21, P = .03) and fluid loss (MD 2.34 liters, 95% CI 1.09–3.59, P = .0002) when compared to intravenous diuretics.