One of the exciting things about working in the medical profession is that you get to experience newer technology as it develops. I thought I would take the time to write about an interesting new medical technology and procedure that I have recently learned about: Aquapheresis, a new treatment for congestive heart failure and other problems. In fact, my medical floor is changing the way it treats patients, and aquapheresis is becoming a standard treatment for CHF patients.
What is Aquapheresis? Aquapheresis Medical Definition
Aquapheresis is a technology that assists in removing excess salt and water from the body. It is commonly used in patients suffering from fluid overload. The aim of the treatment is to remove the excess salt and water in an attempt to maintain a proper euvolemia. Aquapheresis is most commonly used to treat a condition called fluid overload or hypervolemia.
Why is Aquapheresis Necessary?
Patients can develop a condition called “fluid overload” due to heart failure (CHF), various kidney diseases, liver cirrhosis, or hypertension. Fluid overload can also be experienced after certain surgeries. As a cardiac nurse, I’ve seen fluid overload often in my heart failure patients.
When this fluid overload occurs, swelling is often present. Swelling can become severe in some cases, leaving the patient with extreme discomfort, pain, or other health risks. Sometimes, this fluid can affect the lungs and cause breathing difficulties. The swelling can present in any location, but is most often found in the extremeties (arms/legs), and abdomen region.
Aquapheresis is an alternative treatment for patients who don’t see results from other treatments from diuretics such as Lasix.
How Does Aquapheresis Work?
Aquapheresis works by passing the body’s fluids through a specialized filtration system that separates the blood from the excess salt and water. The blood is only 
outside of the body a short time (often less than one minute) before it is returned to the patient.
Because the blood can coagulate, anti-coagulation therapy is often used with aquapheresis to prevent blood clots during ultrafiltration filterering process. Patients may be placed on Herapid drips to aid in this process. Once the Heparin therapy is initiated, the patient’s PTT (partial thromboplastin time) levels will be monitored closely per hospital protocol to prevent excessive anti-coagulation.
If a patient is allergic to Heparin or has a condition known as Heparin-induced Thrombocytopenia (HIT), an alternative intravenous anti-coagulate may be used, such as Argatroban.
My Personal Experience with Aquapheresis
I think this is an interesting treatment. I’ve seen 11 liters of fluid removed from a patient after only two days of treatment. The patient looked remarkably better after the treatment, which is amazing considering diuretics don’t seem to be nearly as effective in reducing fluid overload.
I think this is going to become a more standardized treatment over time, and will gain more exposure in hospitals. It may one day be as common as a kidney failure patient getting a dialysis. I can see patients one day checking in every month or so to get their excess fluid removed.