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A Randomized Controlled Pilot Study of Outcomes of Strict Allowance of Fluid Therapy in Hyponatremic Heart Failure (SALT-HF).
MedLine Citation:
PMID:  23273588     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Currently, fluid restriction recommendations in heart failure (HF) are based on expert opinion. After implementing a 1,000-mL/d fluid restriction for 60 days after discharge, outcomes were examined.
METHODS AND RESULTS: In a randomized controlled design, hyponatremic patients (serum sodium ≤137 mg/dL) received usual care (UC; n = 26) or 1,000 mL/d fluid restriction (n = 20) at discharge. Quality of life (QoL), thirst, difficulty following fluid recommendations, adherence to fluid restriction, HF emergency care, HF rehospitalization, and all-cause death were examined. Mean age was 62.8 ± 12.8 years; 46% were white. There were no differences by group in baseline demographics, comorbidities, and QoL, except that more UC patients had New York Heart Association (NYHA) functional class III/IV status (P = .019). Median [interquartile range] QoL scores were better in the 1,000 mL/d group for symptom burden (83.3 [68.8-91.7] vs 50 [29.2-79.2]; P = .018), total symptoms (77.1 [58.1-91.7] vs 54.2 [30.2-73.9]; P = .022), overall QoL summary (72.6 [52.2-86.3] vs 51.0 [37.7-68.5]; P = .038), and clinical QoL summary (75.5 [57.8-92.9] vs 59.1 [35.7-77.3]; P = .039). There were no group differences in thirst, difficulty adhering to fluid recommendations, adherence to fluid restriction, or health care consumption.
CONCLUSIONS: The 1,000 mL/d fluid restriction led to improved QoL at 60 days after discharge. Future research in a larger more heterogeneous sample is needed.
Authors:
Nancy M Albert; Benjamin Nutter; Jennifer Forney; Ellen Slifcak; W H Wilson Tang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  19     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Nursing Research and Innovation, Nursing Institute, Cleveland Clinic Foundation, Cleveland, Ohio; George M. and Linda L. Kaufman Center for Heart Failure, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address: albertn@ccf.org.
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