Impact of Compound Hypertonic Saline Solution on Decompensated Heart Failure

Int Heart J. 2017 Aug 3;58(4):601-607. doi: 10.1536/ihj.16-313. Epub 2017 Jul 13.

Abstract

The aim of the present study was to evaluate the effects of hypertonic saline solution (C-HSS) with high dose furosemide on hospitalization time, readmission, and mortality in patients with New York Heart Association (NYHA) class III heart failure.Decompensated heart failure patients (NYHA III) with chronic ischemic or nonischemic cardiomyopathy and ejection fraction < 40% were divided into 2 groups in an open-label random manner: the first group received a 1-hour intravenous infusion of furosemide (100 mg) plus compound C-HSS (100 mL) twice daily and underwent serious water restriction (500 mL/day); the second group received furosemide intravenous bolus (100 mg) twice a day and water restriction (500 mL/day), without C-HSS. Both groups had normal sodium (120 mmol sodium) intake. After discharge, the two groups continued to receive 120 mmol Na/day and 500-1000 mL water/day.The first group (132 C-HSS patients) had an increase in urination, a reduction in hospitalization time (4 ± 2 versus 7 ± 2 days, P < 0.01), and a reduction in hospitalization costs (2210 RMB versus 3506 RMB, P < 0.01) compared with the second group (132 without C-HSS patients). During the follow-up period (36 ± 12 months), the first group had a significantly higher average readmission time (31.84 ± 7.58 months versus 15.60 ± 6.25 months, P < 0.01) and lower mortality rate (16.5% versus 31.9%, P < 0.01).The results suggest that periodical C-HSS administration, combined with serious water restriction and a normal sodium diet, significantly reduces the hospitalization time, readmission rate, and mortality in patients with NYHA class III HF.

Keywords: Diuretic; Electrolytes; Furosemide; Sodium.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • China / epidemiology
  • Diuretics / administration & dosage
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Furosemide / administration & dosage*
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Hospital Mortality / trends
  • Hospitalization / trends
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Retrospective Studies
  • Saline Solution, Hypertonic / administration & dosage*
  • Stroke Volume / physiology*
  • Survival Rate / trends
  • Treatment Outcome

Substances

  • Diuretics
  • Saline Solution, Hypertonic
  • Furosemide