title: Fluid restriction in the management of decompensated heart failure: no impact on time to clinical stability.
abstract: BACKGROUND
  To examine the clinical effect of fluid restriction in patients admitted to the hospital with class IV heart failure (HF).
  
  
  RESULTS
  This is a single-blind randomized controlled study. Time to clinical stability was compared between the fluid restricted (FR: n = 34) and free fluid (FF: n = 33) groups respectively showing no significant difference (8.3 +/- 6.3 days versus 7.0 +/- 6.0 days, P = .17). There was no significant difference between groups in time to discontinuation of intravenous diuretic therapy (FR: 2.7 +/- 4.5 days, FF: 3.2 +/- 5.6 days, P = .70). Changes from baseline to achievement of clinical stability in serum urea (P = .23), serum creatinine (P = .14), BNP (P = .42), and sodium (P = .14) did not differ between the FF and FR groups. Baseline serum sodium levels did not predict the time to clinical stability (beta = -0.11, 95% CI: -0.60, 0.23).
  
  
  CONCLUSIONS
  Fluid restriction is not an evidence-based therapy although it is occasionally applied in the management of HF. These results suggest that FR is not of any clinical benefit in patients with acute decompensated HF and this hypothesis should be tested in a larger randomized controlled study.
authors: Heart Failure Unit, St. Vincent's University Hospital, Dublin, Ireland.
authors: Bronagh
authors: B
authors: Travers
authors: Christina
authors: C
authors: O'Loughlin
authors: Niamh F
authors: NF
authors: Murphy
authors: Mary
authors: M
authors: Ryder
authors: Carmel
authors: C
authors: Conlon
authors: Mark
authors: M
authors: Ledwidge
authors: Kenneth
authors: K
authors: McDonald
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000628:therapy*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010349:Patient Compliance; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012964:Sodium / Q000097:blood; D016896:Treatment Outcome; D014508:Urea / Q000097:blood; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers; D004232:Diuretics; D020097:Natriuretic Peptide, Brain; D014508:Urea; D012964:Sodium; D003404:Creatinine