Refractory Congestion: When to Use Ultrafiltration?

  • Bradley A. BartEmail author


The symptoms of and disability related to decompensated heart failure are manifestations of congestion. Therefore, congestion is the main treatment target and diuretics are recommended as first line therapy. Refractory congestion refers to situations in which diuretics fail to produce the desired clinical effect. In these circumstances, ultrafiltration may be appropriate for the relief of congestion and improved outcomes. This chapter will review the concept of refractory congestion; describe the use of diuretics and ultrafiltration in the treatment of congestion; and review the importance of case selection when choosing to treat refractory congestion with ultrafiltration.


Heart failure Congestion Ultrafiltration Diuretics Cardiorenal syndrome 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Hennepin County Medical CenterMinneapolisUSA
  2. 2.University of MinnesotaMinneapolisUSA

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