Effects of hypertonic saline solution on body weight and serum creatinine in patients with acute decompensated heart failure

Gabrielle Lafrenière, Patrick Béliveau, Jean-Yves Bégin, David Simonyan, Sylvain Côté, Valérie Gaudreault, Zeev Israeli, Shahar Lavi, Rodrigo Bagur, Gabrielle Lafrenière, Patrick Béliveau, Jean-Yves Bégin, David Simonyan, Sylvain Côté, Valérie Gaudreault, Zeev Israeli, Shahar Lavi, Rodrigo Bagur

Abstract

Aim: To test the safety and effectiveness of hypertonic saline solution (HSS + F) as a strategy for weight loss and prevention of further deterioration of renal function.

Methods: Patients admitted with acute decompensated heart failure (ADHF) who received HSS + F were included in the study. After a period of a standard ADHF treatment, our patients received an intravenous infusion of furosemide (250 mg) combined with HSS (150 mL of 3% NaCl) twice a day for a mean duration of 2.3 d. Our primary outcomes were weight loss and a change in serum creatinine per day of treatment. The parameters of the period prior to treatment with HSS + F were compared with those of the period with HSS + F.

Results: A total of 47 patients were included. The mean creatinine on admission was 155 μmol/L ± 65 μmol/L, the ejection fraction was 40% ± 17%. The experimental treatment (HSS + F) resulted in greater weight loss per day of treatment than the standard treatment (-1.4 kg/d ± 1.4 kg/d vs -0.4 kg/d ± 1.0 kg/d, P = 0.0168). Importantly, the change in creatinine was not significantly different.

Conclusion: This study supports the effectiveness of HSS + F on weight loss in patients with ADHF. The safety profile, particularly with regard to renal function, leads us to believe that HSS + F may be a valuable option for those patients presenting with ADHF who do not respond to conventional treatment with intravenous furosemide alone.

Keywords: Decompensated; Fluid overload; Heart failure; Hypertonic saline; Renal failure.

Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.

Figures

Figure 1
Figure 1
Study protocol. ADHF: Acute decompensated heart failure; HSS: Hypertonic saline solution.
Figure 2
Figure 2
Data collection protocol and observation periods.
Figure 3
Figure 3
Flow diagram of participants in the study. HSS: Hypertonic saline solution.

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