The EUPHORIA trial studied 20 patients with decompensated heart failure (a condition in which the heart is unable to keep the blood circulating well enough) and diuretic resistance. The doctors conducting the study wanted to see whether using ultrafiltration before intravenous diuretic drugs would result in removal of excess fluid and early discharge of patients from the hospital, without the patients' experiencing either low blood pressure or symptoms of worsening kidney disease. The patients were studied while they were hospitalized, and at 30 and 90 days after they were discharged.
An average of more than 8 liters of fluid was removed from the patients by ultrafiltration. Twelve patients were discharged from the hospital within three days of the procedure. Patients had improved symptoms of fluid overload and an average decrease in weight of about 6 kilograms (about 13 pounds) when they were discharged. (They lost weight because excess fluid was removed from their bodies.)
In the three months before the study, 10 hospitalizations occurred in nine patients. After undergoing ultrafiltration, only one patient was readmitted to the hospital in 30 days, and two patients were readmitted between 30 and 90 days for unrelated causes. The patients did not develop either low blood pressure or worsening kidney disease.
The doctors conducting the study also wanted to know whether the patients would feel better earlier in their hospitalization. Using two questionnaires (the Minnesota Living with Heart Failure Questionnaire and the Global Clinical Assessment) to determine how patients felt, they found that patients felt better after ultrafiltration, and at 30 and 90 days.
The doctors who conducted the EUPHORIA study concluded that, in heart failure patients with fluid overload and diuretic resistance, the use of ultrafiltration before the use of intravenous diuretic drugs effectively and safely decreases the length time patients have to be in the hospital and the number of times that they have to be readmitted to the hospital for additional treatment. In addition, the benefits that patients derive from ultrafiltration last at least three months.
To learn more about heart failure and treatments for fluid overload, take a look at the links on the next page.