Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/30898
Title: | Real World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure | Authors: | Griffin, Matthew Soufer, Aaron Goljo, Erden Colna, Matthew Rao, Veena S. Jeon, Sangchoon Raghavendra, Parinita D'Ambrosi, Julie Riello, Ralph Coca, Steven G. Mahoney, Devin Jacoby, Daniel Ahmad, Tariq Chen, Michael Tang, W. H. Wilson Turner, Jeffrey MULLENS, Wilfried Wilson, Francis P. Testani, Jeffrey M. |
Issue Date: | 2020 | Publisher: | ELSEVIER SCI LTD | Source: | JACC-Heart Failure, 8 (3) , p. 199 -208 | Abstract: | OBJECTIVES The purpose of this study was to investigate real world safety and efficacy of hypertonic saline therapy in cases of refractory acute decompensated heart failure (ADHF) at a large U.S. academic medical center. BACKGROUND Hypertonic saline therapy has been described as a potential management strategy for refractory ADHF, but experience in the United States is limited. METHODS A retrospective analysis was performed in all patients receiving hypertonic saline for diuretic therapy-resistant ADHF at the authors' institution since March 2013. The primary analytic approach was a comparison of the trajectory of clinical variables prior to and after administration of hypertonic saline, with secondary focus on predictors of treatment response. RESULTS A total of 58 hypertonic saline administration episodes were identified across 40 patients with diuretic-therapy refractory ADHF. Prior to hypertonic saline administration, serum sodium, chloride, and creatinine concentrations were worsening but improved after hypertonic saline administration (p < 0.001, all). Both total urine output and weight loss significantly improved with hypertonic saline (p = 0.01 and <0.001, respectively). Diuretic efficiency, defined as change in urine output per doubling of diuretic dose, also improved over this period (p < 0.01). There were no significant changes in respiratory status or overcorrection of serum sodium with the intervention. CONCLUSIONS In a cohort of patients who were refractory to ADHF, hypertonic saline administration was associated with increased diuretic efficiency, fluid and weight loss, and improvement of metabolic derangements, and no adverse respiratory or neurological signals were identified. Additional study of hypertonic saline as a diuretic adjuvant is warranted. (C) 2020 by the American College of Cardiology Foundation. | Notes: | Testani, JM (reprint author), Yale Sch Med, Sect Cardiovasc Med, 135 Coll St,Suite 230, New Haven, CT 06520 USA. jeffrey.testani@yale.edu |
Other: | Testani, JM (reprint author), Yale Sch Med, Sect Cardiovasc Med, 135 Coll St,Suite 230, New Haven, CT 06520 USA. jeffrey.testani@yale.edu | Keywords: | cardiorenal;diuretic resistance;sodium regulation | Document URI: | http://hdl.handle.net/1942/30898 | ISSN: | 2213-1779 | e-ISSN: | 2213-1787 | DOI: | 10.1016/j.jchf.2019.10.012 | ISI #: | WOS:000517317900006 | Rights: | 2020 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION PUBLISHED BY ELSEVIER | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
1-s2.0-S2213177919308753-main.pdf | Published version | 744.75 kB | Adobe PDF | View/Open |
SCOPUSTM
Citations
6
checked on Sep 2, 2020
WEB OF SCIENCETM
Citations
59
checked on Jul 11, 2024
Page view(s)
32
checked on Jun 15, 2022
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.