Liberal versus restricted fluid prescription in stabilised patients with chronic heart failure: result of a randomised cross-over study of the effects on health-related quality of life, physical capacity, thirst and morbidity.
OBJECTIVE
To compare the effects of a restrictive versus a liberal fluid prescription, on quality of life, physical capacity, thirst and hospital admissions, in patients who had improved from NYHA class (III-)IV CHF to a stable condition without clinical signs of significant fluid overload.


METHODS
The present study is a randomised cross-over study. Seventy-four patients (mean age 70+/-10 years, 16% women) -- with mild-moderate CHF -- were randomised 1:1 to either of two 16-week interventions. Intervention 1 prescribed a maximum fluid intake of 1.5 L/day. Intervention 2 prescribed a maximum fluid intake of 30-35 ml/kg body weight/day. Sixty-five patients completed the study.


RESULTS
There were no significant between-intervention differences in end-of-intervention quality of life, physical capacity or hospitalisation. However, there was a significant favourable effect on thirst and less difficulties to adhere to the fluid prescription during the liberal fluid prescription intervention.


CONCLUSIONS
The results from this study indicate that it may be beneficial and safe to recommend a liberal fluid prescription, based on body weight, in stabilised CHF patients. These results warrant further investigation of the effects of fluid advice in CHF.
Holst
Marie
M
Faculty of Health and Society, Malmo University, Sweden. marie.holst@skane.se
Strömberg
Anna
A
Lindholm
Maud
M
Willenheimer
Ronnie
R
D000222:Adaptation, Physiological; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D018592:Cross-Over Studies; D004326:Drinking / Q000502:physiology*; D005260:Female; D005440:Fluid Therapy; D006305:Health Status Indicators; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D009017:Morbidity; D011788:Quality of Life; D012720:Severity of Illness Index; D013894:Thirst