Liberal versus restricted fluid administration in heart failure patients. A systematic review and meta-analysis of randomized trials

International Heart Journal
Yang LiXiaoxian Qian

Abstract

Restrictive fluid intake is recommended, in addition to standard pharmacologic treatment, in the treatment of patients with chronic heart failure (CHF). However, this recommendation lacks firm scientific evidence. We conducted a systematic review and meta-analysis of published randomized controlled trials to estimate the effect of fluid restriction in patients with heart failure.Randomized controlled trials were identified in the MEDLINE, EMBASE, and Cochrane databases using the search-keywords "fluid" and "heart failure". Outcomes were compared in heart failure patients with liberal and restricted fluid intake. Pooled risk ratios (RR) and weighted mean differences (WMD) were calculated using random effects models. Studies focusing on decompensated heart failure were analyzed separately.Six small randomized trials comparing liberal and restricted fluid intake met the inclusion criteria. Significant heterogeneity was noted in the reported studies for several outcomes. There were no differences in readmission rate (5 studies, pooled RR = 1.32; 95% CI: 0.86 to 2.01; P = 0.2), mortality rate (5 studies, pooled RR = 1.50; 95% CI: 0.87 to 2.57; P = 0.14), perceived thirst (4 studies, WMD = -0.7; 95% CI: -2.58 to 1.17; P = 0.46), dura...Continue Reading

References

Mar 31, 2007·Journal of Cardiac Failure·Bronagh TraversKenneth McDonald
May 22, 2013·JAMA Internal Medicine·Graziella Badin AlitiLuis Beck-da-Silva
Jun 22, 2013·European Journal of Heart Failure·Henriette PhilipsonMaria Schaufelberger

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Citations

Jun 4, 2016·Journal of Palliative Medicine·April ZehmHaipeng Zhang
May 14, 2016·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Peter JohanssonTiny Jaarsma
Nov 23, 2019·International Journal of Behavioral Medicine·Dionne KessingNina Kupper
Dec 27, 2017·Current Opinion in Supportive and Palliative Care·James M Beattie
Dec 6, 2017·Current Opinion in Supportive and Palliative Care·Sabine M AllidaPhillip J Newton
Mar 17, 2017·Current Treatment Options in Cardiovascular Medicine·Eloisa Colin-RamirezJustin A Ezekowitz
Oct 10, 2020·Heart, Lung & Circulation·Sabine M AllidaPhillip J Newton

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