Monitoring decongestion in acute heart failure

Persistent congestion following an episode of acute heart failure is associated with higher morbidity and mortality. Monitoring diuretic therapy is essential to guide effective decongestion before patient discharge. Unfortunately, there are no markers which can predict on their own, the exact point in which euvolemia is achieved. Cardiothoracic and extra thoracic ultrasound are other tools to consider when evaluating hemodynamic and interstitial components of congestion. However, the question of which and how many parameters must be used for this purpose, is still unanswered.