Ultrafiltration, also called aquapheresis, is a procedure used to treat fluid overload (extra fluid and salts in the body). Fluid overload is when more fluid is going into your body than is coming out. Ultrafiltration can be done while you are an inpatient or outpatient at Ohio State’s Ross Heart Hospital.
What is Ultrafiltration?
Ultrafiltration may be used to remove extra fluids and salts from the body. During the treatment, excess fluid is collected by filtering blood outside of the body then returning the blood to your body. It may be done together with or instead of medicine that helps to get rid of extra body fluid (diuretics), medicine that helps the heart to push out more blood with each beat (inotropics) or drugs that dilate the blood vessels (vasodilators).
Why Would You Have Ultrafiltration?
Your physician may recommend you have ultrafiltration if you have fluid overload (more fluid going into your body than coming out). The main cause of fluid overload is heart failure (also known as Congestive Heart Failure). It may be a result of problems with the kidneys, lungs, side effects of some medications or following certain surgeries.
Common signs and symptoms of fluid overload include: fast weight gain; swelling of legs, ankles and/or feet; pain or swelling in the stomach; trouble with breathing when lying flat; tiredness; rise in blood pressure.
What to Expect During Ultrafiltration
Preparing for Your Procedure
Bloodwork is required before your ultrafiltration. You also will be given a blood thinner before and/or during your treatment to avoid any problems during the procedure. You are permitted to eat and drink before the ultrafiltration, but do not take your medication the day of your procedure. If you are having ultrafiltration as an outpatient, make sure you bring all of your medications with you to the hospital. You may take the medications at the hospital as long as your blood pressure is adequate.
During Your Procedure
A nurse will place a catheter in your vein for treatment. Your blood will be pumped through a filter outside of your body and the extra fluid will be collected in a collecting bag. Then your filtered blood (free of extra fluid) will flow back into your body.
Your scheduled treatment will last about eight hours. The average fluid removal rate is 250 ml/hr, or about half a pound an hour. Most patients will be able to go home after the treatment is completed. Some patients will require more than one day of treatment depending on how much fluid needs to be removed. This will be discussed and scheduled for you prior to the ultrafiltration procedure.
The rate of fluid removal can be adjusted so that extra fluid is slowly removed without upsetting your heart rate, blood pressure or body chemicals. (e.g. sodium, chloride, potassium).
You may notice that you feel better right away, or it may take some time. This depends on your health condition and how much extra fluid needs to be removed. Although the risks for this treatment are low, if you feel dizzy, nauseous, have pain/bruising at the site or experience any unusual symptoms during your treatment, tell the nurse immediately.
After Your Procedure
Patients are typically discharged within 30 minutes of completing the treatment. You should arrange for transportation as you will not be allowed to drive home after your ultrafiltration.
All patients will be assessed by a physician during their treatment with recommendations for follow-up given at that time. Follow-up may include: additional treatments, a follow-up appointment with a nurse practitioner within one-two weeks or routine follow-up as needed.
After treatment, the catheters may be removed or left in place for future treatments. If the catheters are removed, a bandage will be placed over the site. If you experience any bleeding once you are home, put some pressure at site. If bleeding persists, go to your local emergency room. Call your doctor if you have signs of infection, little or no urine production or if you feel light headed.