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Management of Volume Overload in Acute Heart Failure: Diuretics and Ultrafiltration

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Acute Heart Failure

Abstract

Approximately 1 million hospitalizations, with an estimated cost of $28 billion, occur annually in the United States due to acutely decompensated heart failure1. Data from the Acute Decompensated Heart Failure National Registry (ADHERE) show that 90% of hospitalizations for acutely decompensated heart failure are due to fluid overload in patients who have failed treatment with oral diuretics2. The average length of stay for acutely decompensated heart failure is 4.3 days, and 42% of the patients are discharged without complete resolution of symptoms. With current treatment strategies, 50% of the patients lose ≤5 lbs from the admission weight and 20% gain weight during the hospitalization2. The failure to effectively resolve congestion and reduce weight may contribute to readmission rates, which may be as high as 50% at 6 months3.

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Authors and Affiliations

  1. Centre for Advanced Heart Failure, Edward Hospital—Midwest Heart Specialists, Naperville, IL, USA

    Maria Rosa Costanzo MD

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  1. Maria Rosa Costanzo MD
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Editors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France

    Alexandre Mebazaa MD, PhD (Professor of Medicine) (Professor of Medicine)

  2. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Mihai Gheorghiade MD, FACC (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service) (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service)

  3. Department of Cardiology Centre d’Investigation Clinique (CIC), INSERM U-684, Centre Hospitalier Universitaire, University Henri Poincaré, Nancy, France

    Faiez M. Zannad MD, PhD, FESC (Professor of Medicine) (Professor of Medicine)

  4. Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

  5. Cooper Heart Institute, Cooper University Hospital, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

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Costanzo, M.R. (2008). Management of Volume Overload in Acute Heart Failure: Diuretics and Ultrafiltration. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_47

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  • DOI: https://doi.org/10.1007/978-1-84628-782-4_47

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