Fluid restriction in the management of decompensated heart failure: no impact on time to clinical stability.
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.
Travers
Bronagh
B
Heart Failure Unit, St. Vincent's University Hospital, Dublin, Ireland.
O'Loughlin
Christina
C
Murphy
Niamh F
NF
Ryder
Mary
M
Conlon
Carmel
C
Ledwidge
Mark
M
McDonald
Kenneth
K
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
D015415:Biomarkers; D004232:Diuretics; D020097:Natriuretic Peptide, Brain; D014508:Urea; D012964:Sodium; D003404:Creatinine