Experimental study on the effects of the extracorporeal ultrafiltration method in advanced congestive heart failure

The effects of the extracorporeal ultrafiltration method were studied in an experimental canine model of advanced congestive heart failure with mitral regurgitation, coronary artery occlusion and overhydration. With the application of this technique, cardiac output, stroke work, systemic vascular resistance and left ventricular dp/dt increased significantly associated with reduction in the right atrial and left ventricular filling pressures. Serum electrolytes were stable throughout the procedure, and there were significant elevations in serum protein and hematocrit levels. The composition of the ultrafiltrate indicated that excessive extracellular fluid was removed. Five out of seven cardiogenic shock subjects also benefited. The clinical application of this approach using recently developed dialyzers to treat intractable heart failure with overhydration under close hemodynamic monitoring is warranted.