Cardiologia (Rome, Italy)
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Cardiologia (Rome, Italy) · Nov 1998
Comparative Study[Intra- and extravascular volumes in congestive heart failure and their redistribution following extracorporeal ultrafiltration].
In advanced congestive heart failure with fluid retention, extracorporeal ultrafiltration (UF) causes persistent relief of edema or anasarca through hemodynamic and humoral changes that interrupt refractoriness to diuretics. The intra and extravascular fluid partition in congestive heart failure, as well as changes occurring in the two compartments following fluid withdrawal with UF, are unknown. In 8 congestive heart failure patients with severe fluid retention undergoing UF, we measured total (TBV), intrathoracic (ITBV) and pulmonary blood volumes (PBV), and extravascular lung water (EVLW). ⋯ Both pulmonary wedge and right atrial pressures significantly decreased after UF, and cardiac output increased. In conclusion, congestive heart failure is associated with normal TBV and EVLW content and with intravascular intrathoracic hypervolemia and extrathoracic hypovolemia. UF induces hemodynamic improvement through a selective fluid removal from the extravascular systemic space without changes in both TBV and EVLW.