title: Efficacy and cardiovascular tolerability of continuous veno-venous hemodiafiltration in acute decompensated heart failure: a randomized comparative study.
abstract: OBJECTIVE
  Recently, continuous veno-venous hemodiafiltration (CVVHDF) has received increased attention in the treatment of congestive heart failure (CHF). The aim of this study is to assess the safety and efficacy of CVVHDF compared with intravenous furosemide in patients with CHF.
  
  
  METHODS
  Forty patients having CHF were included in this prospective, randomized, comparative trial. We randomized patients to treatment for 72 hours with CVVHDF or intravenous furosemide. Outcomes assessed were weight loss, total fluid output, length of stay (LOS) in the intensive care unit (ICU), 30-day mortality, and cardiovascular stability.
  
  
  RESULTS
  Demographic data were comparable in both groups. Weight loss (P ≤ .05) and total fluid output (P ≤ .01) were greater in the CVVHDF group. Length of stay in the ICU was significantly reduced in the CVVHDF group (P ≤ .05). The mortality rates were comparable in both groups. The cardiac output and the stroke volume significantly increased, whereas the pulmonary capillary wedge pressure significantly decreased (P ≤ .05) in both groups compared with the baseline. A transient attack of hypotension occurred in 1 patient in the CVVHDF group.
  
  
  CONCLUSIONS
  In CHF, the use of CVVHDF effectively and safely produced greater weight and fluid loss and decreased LOS in the ICU more than the intravenous furosemide with no hemodynamic instability.
authors: Department of Anesthesia and Intensive Care, Cairo University, Egypt. saharbadawyi@yahoo.com
authors: Sahar S I
authors: SS
authors: Badawy
authors: Ahmed
authors: A
authors: Fahmy
mesh_terms: D000368:Aged; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy / Q000628:therapy*; D017583:Hemodiafiltration / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D004232:Diuretics; D005665:Furosemide