Evidence map›Paper›PMID 17291932›Full record

Trial reportJournal of the American College of Cardiology2007

Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure.

Maria Rosa Costanzo, Maya E Guglin, Mitchell T Saltzberg, Mariell L Jessup, Bradley A Bart, John R Teerlink, Brian E Jaski, James C Fang, Erika D Feller, Garrie J Haas and 4 more

Erratum issued 3 registry-linked trialsAbstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 278 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
278citing papers in PubMed, 14 pooled it
55.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00124137 nacompletednot on this map

Ultrafiltration Versus IV Diuretics for Patients Hospitalized for Acute Decompensated Heart Failure: A Prospective Randomized Clinical Trial

TypeinterventionalSponsorNuwellis, Inc.Ran2004 to 2005Enrolled200ConditionsCongestive Heart FailureArmsAquadex system, IV diuretic
NCT01474200 naterminatednot on this mapstarted 2012, after this paper: background citation

Aquapheresis Versus Intravenous Diuretics and Hospitalizations for Heart Failure (AVOID-HF)

TypeinterventionalSponsorNuwellis, Inc.Ran2012 to 2014Enrolled224ConditionsHeart Failure, Cardiac Failure, Acute Decompensated Heart Failure (ADHF)ArmsIsolated veno-venous ultrafiltration (AQ), IV Loop Diuretics (LD)
NCT04572867 nawithdrawnnot on this mapstarted 2021, after this paper: background citation

Efficacy of Aquapheresis in Patients Treated as Outpatients With Decompensated Heart Failure at a Veterans Hospital

TypeinterventionalSponsorRamona Gelzer BellRan2021 to 2021Enrolled0ConditionsHeart Failure, Congestive Heart Failure, Decompensated Heart FailureArmsAquapheresis, IV Diuretics
3 · Its place in the literature

Who cites it

278 citing papers in PubMed, 14 syntheses or guidelines pooled it, 1,105 citations in OpenAlex.

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  4. Right Heart Function in Cardiorenal Syndrome.Current heart failure reports · 2022
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  5. Ultrafiltration for acute heart failure.The Cochrane database of systematic reviews · 2022
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  6. The value of urinary sodium assessment in acute heart failure.European heart journal. Acute cardiovascular care · 2021
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218 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 11 institutions in 2 countries.

Maria Rosa CostanzoMidwest Heart Foundation, Edward Heart Hospital, Lombard, Illinois 60566, USA. mcostanzo@midwestheart.com
Maya E Guglin
Mitchell T Saltzberg
Mariell L Jessup
Bradley A Bart
John R Teerlink
Brian E Jaski
James C Fang
Erika D Feller
Garrie J Haas
Allen S Anderson
Michael P Schollmeyer
Paul A Sobotka
UNLOAD Trial Investigators
Brigham and Women's Hospital · USHeart Foundation · USHennepin County Medical Center · USNational Heart Foundation of Australia · AUSan Francisco VA Medical Center · USSharp Memorial Hospital · USThe Ohio State University · USUniversity of Chicago · USUniversity of Maryland, Baltimore · USUniversity of Pennsylvania · USWayne State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study was designed to compare the safety and efficacy of veno-venous ultrafiltration and standard intravenous diuretic therapy for hypervolemic heart failure (HF) patients.

backgroundEarly ultrafiltration may be an alternative to intravenous diuretics in patients with decompensated HF and volume overload.

methodsPatients hospitalized for HF with > or =2 signs of hypervolemia were randomized to ultrafiltration or intravenous diuretics. Primary end points were weight loss and dyspnea assessment at 48 h after randomization. Secondary end points included net fluid loss at 48 h, functional capacity, HF rehospitalizations, and unscheduled visits in 90 days. Safety end points included changes in renal function, electrolytes, and blood pressure.

resultsTwo hundred patients (63 +/- 15 years, 69% men, 71% ejection fraction < or =40%) were randomized to ultrafiltration or intravenous diuretics. At 48 h, weight (5.0 +/- 3.1 kg vs. 3.1 +/- 3.5 kg; p = 0.001) and net fluid loss (4.6 vs. 3.3 l; p = 0.001) were greater in the ultrafiltration group. Dyspnea scores were similar. At 90 days, the ultrafiltration group had fewer patients rehospitalized for HF (16 of 89 [18%] vs. 28 of 87 [32%]; p = 0.037), HF rehospitalizations (0.22 +/- 0.54 vs. 0.46 +/- 0.76; p = 0.022), rehospitalization days (1.4 +/- 4.2 vs. 3.8 +/- 8.5; p = 0.022) per patient, and unscheduled visits (14 of 65 [21%] vs. 29 of 66 [44%]; p = 0.009). No serum creatinine differences occurred between groups. Nine deaths occurred in the ultrafiltration group and 11 in the diuretics group.

conclusionsIn decompensated HF, ultrafiltration safely produces greater weight and fluid loss than intravenous diuretics, reduces 90-day resource utilization for HF, and is an effective alternative therapy. (The UNLOAD trial; http://clinicaltrials.gov/ct/show/NCT00124137?order=1; NCT00124137).

Indexed as

HemofiltrationUltrafiltrationDiureticsHeart FailureHumansInfusions, IntravenousMaleMiddle AgedTreatment OutcomeDiuretics

Identifiers

PMID17291932
OpenAlexW2119875370

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.