Aquapheresis

Aquapheresis is a medical technology designed to remove excess salt and water from the body safely, predictably, and effectively from patients suffering from a condition called fluid overload. It removes the excess salt and water and helps to restore a patient’s fluid balance or euvolemia.

Uses

Aquapheresis is used to treat a condition called fluid overload or hypervolemia. Fluid overload can be caused by many reasons, including heart failure, liver cirrhosis, hypertension and certain kidney diseases. Fluid overload can also be experienced after certain surgical operations. Congestive Heart Failure is the most common reason for fluid overload.

How it Works

* Blood containing excess salt and water is withdrawn from a patient using peripheral or central venous catheters and passed through a special filter. Using a form of ultrafiltration, the filter separates the excess salt and water from the blood and the blood is returned to the patient while the fluid is collected in a bag for later disposal.

* The blood is outside the body for less than a minute and the total amount of blood is 33 milliliters (2.5 tablespoons). It is thus an extracorporeal therapy.

* Up to a 500 milliliter (1 lb) of excess fluid can be removed per hour. The average removal rate is 250 milliliter (1/2 lb) per hour.

* The fluid removed is isotonic to blood and therefore electrolyte balance is maintained throughout therapy and up to 3.2 grams of sodium per liter can be removed.

* Aquapheresis therapy is delivered by three basic components: a console (the machine with two pumps), the blood filter circuit, and the venous catheter(s).

References

* The UNLOAD Study: Costanzo MR et al. J Am Coll Cardiol 2007;49:675-683. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17291932&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* The EUPHORIA Study: Costanzo MR, J Am Coll Cardiol 2005;46(11):2047-2051. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16325040&ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* The RAPID Study: Bart B, J Am Coll Cardiol 2005; 46(11):2043-2046. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16325039&ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* The SAFE Study: Jaski B, Journal of Cardiac Failure 2003 9(3);227-231. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12815573&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* Marenzi G, J Am Coll Cardiol. 2001 Oct;38(4):963-968. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11583865&ordinalpos=107&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* Agostoni P, Am J Med. 1994 Mar;96(3):191-199. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8154506&ordinalpos=175&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* Pepi, Br Heart J. 1993 Aug;70(2):135-140. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8038023&ordinalpos=233&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* Agostoni P, J Am Coll Cardiol. 1993 Feb; 21(2):424-431. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8426008&ordinalpos=182&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]

* Hunt et al. Management of Fluid Status, ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult.© 2005 by the American College of Cardiology and the American Heart Association, Inc. [http://www.cardiosource.com/guidelines/guidelines/failure/hf_fulltext.pdf]

* Adams KF, Lindenfeld J, Arnold JMO, Baker DW, Barnard DH, Baughman KL, Boehmer JP, Deedwania P, Dunbar SB, Elkayam U, Gheorghiade M, Howlett JG, Konstam MA, Kronenberg MW, Massie BM, Mehra MR, Miller AB, Moser DK, Patterson JH, Rodeheffer RJ, Sackner-Bernstein J, Silver MA, Starling RC, Stevenson LW, Wagoner LE. Heart Failure Society of America (HFSA) 2006 Comprehensive Heart Failure Practice Guideline. J Cardiac Failure 2006;12:e1–e122. [http://www.hfsa.org/hf_guidelines.asp]

See also

* Fluid balance
* Fluid overload
* Diuretics
* Apheresis
* Congestive Heart Failure
* Hypervolemia

External links

* The UNLOAD Study: Ultrafiltration Versus Intravenous Diuretics for Patients Hospitalized for Acute Decompensated Heart Failure. http://www.unloadstudy.com
* Google Search on Aquapheresis: http://www.google.com/search?hl=en&q=aquapheresis