Evidence map›Paper›PMID 40918842›Full record

ReviewCureus2025

Early Versus Delayed Diuretic Administration and Urine-Guided Strategies in Acute Decompensated Heart Failure: A Systematic Review of Clinical Outcomes.

Rabeet Muzammil, Ahmad Mohammad, Muhammad Hammad, Adeel Ahmed, Aadil Hussain, Wardah Rashid, Rabia Yousaf, Shivam Singla, Bhavna Singla, Osatohanmwen Ekomwereren and 2 more

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rabeet MuzammilCardiology, Faisalabad Medical University, Faisalabad, PAK.
Ahmad MohammadInternal Medicine, Hurley Medical Center, Flint, USA.
Muhammad HammadEmergency Medicine, Aria Institute of Medical Sciences, Quetta, PAK.
Adeel AhmedInternal Medicine, DHQ Teaching Hospital, Gujranwala, PAK.
Aadil HussainInternal Medicine, Chandka Medical College, Larkana, PAK.
Wardah RashidInternal Medicine, Khawaja Muhammad Safdar Medical College, Lahore, PAK.
Rabia YousafInternal Medicine, Shifa International Hospitals Limited, Islamabad, PAK.
Shivam SinglaInternal Medicine, TidalHealth Peninsula Regional, Salisbury, USA.
Bhavna SinglaInternal Medicine, Erie County Medical Center, Buffalo, USA.
Osatohanmwen EkomwererenTrauma and Orthopaedics, Royal Shrewsbury Hospital, Shrewsbury, GBR.
Francis Asante BaaduInternal Medicine, Komfo Anokye Teaching Hospital, Kumasi, GHA.
Ahmad IrshadInternal Medicine, Combined Military Hospital, Muzaffarabad, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This systematic review explores the impact of diuretic timing and strategy on outcomes in patients with acute decompensated heart failure (ADHF). A total of seven studies were included, comprising randomized controlled trials (RCTs), pre-specified sub-analyses, and observational data. Early administration of intravenous loop diuretics, particularly within the first 60 to 90 minutes of hospital arrival, was generally associated with improved short-term outcomes, including reduced in-hospital and 30-day mortality. Furthermore, guided diuretic strategies using urine sodium or urinary biomarkers showed promise in enhancing decongestion efficiency and predicting therapeutic response, although long-term benefits remain uncertain. Despite some heterogeneity in study design, timing definitions, and outcome measures, this review underscores the clinical significance of prompt and tailored diuretic therapy. These findings highlight the need for timely intervention and more personalized management strategies in ADHF, while also identifying gaps for future large-scale trials.

Indexed as

acute decompensated heart failureclinical outcomesearly interventionloop diureticsnatriuresissystematic reviewurine-guided therapy

Identifiers

PMID40918842
PMCPMC12410032

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.