Aquadex SmartFlow

Aquapheresis – isotonic fluid removal at controlled rates of 10–500 mL/hour through peripheral venous access, independent of diuretic response.

In fluid-overloaded patients, escalating diuretics may fail or worsen instability. Aquadex provides controlled isotonic ultrafiltration at clinician-defined rates of 10–500 mL/hour through a low-volume (~35 mL) extracorporeal circuit with peripheral venous access, enabling gradual decongestion with hemodynamic tolerance and real-time fluid-removal control.
UNLOAD demonstrated greater weight and fluid removal at 48 hours, preserved creatinine, and significantly lower 90-day rehospitalisation versus IV diuretics; a 2025 JACC: Heart Failure study reported a 60% reduction in heart failure events at 30 days.

  • Isotonic fluid removal – Sodium and water in physiological ratio, independent of neurohormonal activation.
  • Precise fluid control – Real-time adjustment to patient-specific decongestion targets.
  • Diuretic-independent therapy – Effective in diuretic resistance.
  • Haemodynamic stability – Gradual removal supports stable circulation.
  • Renal function preservation – No significant change in creatinine or electrolyte balance versus high-dose diuretics.
  • Paediatric applicability – Cleared for patients ≥20 kg.
  • Improved clinical trajectory – Reduced heart failure events and readmissions in selected populations.
  • ~35 mL circuit – supports haemodynamically fragile and paediatric patients.
  • Peripheral access option – no mandatory central venous catheterisation.
  • Guided setup with automated controls.
  • Real-time clinician-defined ultrafiltration rate.
  • Integrated hematocrit and SvO₂ feedback.
  • ICU-compatible workload – nurse-led management.

Used in fluid-overloaded patients when controlled fluid removal is required despite limited diuretic response.
Enables gradual isotonic ultrafiltration with preservation of electrolytes and good hemodynamic tolerance.

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