ArticleJACC. Heart failure2020
Real World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure: A U.S. Center's Experience.
Article in JACC. Heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of sodium-glucose co-transporter-2 inhibitors on serum sodium and potassium in patients with Heart Failure: a systematic review and meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- The added value of hypertonic saline solution to furosemide monotherapy in patients with acute decompensated heart failure: A meta-analysis and trial sequential analysis.Clinical cardiology · 2023Pooled it
- Sodium chloride versus glucose solute as a volume replacement therapy for more effective decongestion in acute heart failure (SOLVRED-AHF): A prospective, randomized, mechanistic study.European journal of heart failure · 2025Trial
- The 'Chloride Theory' for Heart Failure Pathophysiology: An Updated Narrative Review 2025.Cardiology and therapy · 2026Review
- Hypertonic saline combined with furosemide enhances decongestion and preserves electrolytes in decompensated heart failure: a three-arm prospective comparative study.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Multidisciplinary Approaches to Cardiovascular-Kidney-Metabolic Syndrome: Lessons from the Kidney-Heart Service.Kidney360 · 2026Article
- A rapid review and narrative synthesis of the evidence for oral sodium chloride supplements in the management of heart failure.European heart journal open · 2026Article
- Decongestion in heart failure: medical and device therapies.Nature reviews. Cardiology · 2025Review
- Pharmacological options to relieve congestion in acute heart failure.Heart failure reviews · 2025Review
- Safety and Efficacy of Salt Restriction Across the Spectrum of Heart Failure.Journal of cardiovascular development and disease · 2025Review
- Diuretic Use in Heart Failure.Reviews in cardiovascular medicine · 2025Review
- The Role of Chloride in Cardiorenal Syndrome: A Practical Review.Journal of clinical medicine · 2025Review
- Decongestion in patients with advanced chronic kidney disease coexisting with heart failure.Clinical kidney journal · 2025Review
- Renal Dysfunction Across the Spectrum of Cardiogenic Shock: Mechanisms, Clinical Implications, and Therapeutic Strategies.Current heart failure reports · 2025Review
- Diuretic strategies in acute decompensated heart failure.Heart failure reviews · 2025Review
- Impact of a structured educational intervention on attitudes and practice of heart failure in Latin America.Archivos de cardiologia de Mexico · 2025Article
- Targeting Sodium in Heart Failure.Journal of personalized medicine · 2024Review
- Should Hypertonic Saline Be Considered for the Treatment of Intracranial Hypertension? A Review of Current Evidence and Clinical Practices.Korean journal of neurotrauma · 2024Review
- Combinational Diuretics in Heart Failure.Current heart failure reports · 2024Review
- The Effect of Early Administration of Hypertonic Saline Solution İn Acute Decompensated Heart Failure.Arquivos brasileiros de cardiologia · 2024Article
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19 authors.
Funding
Abstract
objectivesThe 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.
backgroundHypertonic saline therapy has been described as a potential management strategy for refractory ADHF, but experience in the United States is limited.
methodsA 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.
resultsA 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.
conclusionsIn 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.
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