Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/142362 |
Resumo: | Importance: The benefits of fluid and sodium restriction in patients hospitalized with acute decompensated heart failure (ADHF) are unclear. Objective: To compare the effects of a fluid-restricted (maximum fluid intake, 800 mL/d) and sodiumrestricted (maximum dietary intake, 800 mg/d) diet (intervention group [IG]) vs a diet with no such restrictions (control group [CG]) on weight loss and clinical stability during a 3-day period in patients hospitalized with ADHF. Design: Randomized, parallel-group clinical trial with blinded outcome assessments. Setting: Emergency room, wards, and intensive care unit. Participants: Adult inpatients with ADHF, systolic dysfunction, and a length of stay of 36 hours or less. Intervention: Fluid restriction (maximum fluid intake, 800 mL/d) and additional sodium restriction (maximum dietary intake, 800 mg/d) were carried out until the seventh hospital day or, in patients whose length of stay was less than 7 days, until discharge. The CG received a standard hospital diet, with liberal fluid and sodium intake. Main Outcomes and Measures: Weight loss and clinical stability at 3-day assessment, daily perception of thirst, and readmissions within 30 days. Results: Seventy-five patients were enrolled (IG, 38; CG, 37). Most weremale; ischemic heart disease was the predominant cause of heart failure (17 patients [23%]), and the mean (SD) left ventricular ejection fraction was 26% (8.7%). The groups were homogeneous in terms of baseline characteristics. Weight loss was similar in both groups (between-group difference in variation of 0.25 kg [95% CI, 1.95 to 2.45]; P=.82) as well as change in clinical congestion score (between-group difference in variation of 0.59 points [95% CI, 2.21 to 1.03]; P=.47) at 3 days. Thirst was significantly worse in the IG (5.1[2.9]) than the CG (3.44[2.0]) at the end of the study period (between-group difference, 1.66 points; time group interaction; P=.01). There were no significant betweengroup differences in the readmission rate at 30 days (IG, 11 patients [29%]; CG, 7 patients [19%]; P=.41). Conclusions and Relevance: Aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at 3 days and is associated with a significant increase in perceived thirst.Weconclude that sodium and water restriction in patients admitted for ADHF are unnecessary. |
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Aliti, Graziella BadinSilva, Eneida Rejane Rabelo daClausell, Nadine OliveiraRohde, Luis Eduardo PaimBiolo, AndreiaSilva Neto, Luís Beck da2016-06-09T02:08:05Z2013http://hdl.handle.net/10183/142362000883150Importance: The benefits of fluid and sodium restriction in patients hospitalized with acute decompensated heart failure (ADHF) are unclear. Objective: To compare the effects of a fluid-restricted (maximum fluid intake, 800 mL/d) and sodiumrestricted (maximum dietary intake, 800 mg/d) diet (intervention group [IG]) vs a diet with no such restrictions (control group [CG]) on weight loss and clinical stability during a 3-day period in patients hospitalized with ADHF. Design: Randomized, parallel-group clinical trial with blinded outcome assessments. Setting: Emergency room, wards, and intensive care unit. Participants: Adult inpatients with ADHF, systolic dysfunction, and a length of stay of 36 hours or less. Intervention: Fluid restriction (maximum fluid intake, 800 mL/d) and additional sodium restriction (maximum dietary intake, 800 mg/d) were carried out until the seventh hospital day or, in patients whose length of stay was less than 7 days, until discharge. The CG received a standard hospital diet, with liberal fluid and sodium intake. Main Outcomes and Measures: Weight loss and clinical stability at 3-day assessment, daily perception of thirst, and readmissions within 30 days. Results: Seventy-five patients were enrolled (IG, 38; CG, 37). Most weremale; ischemic heart disease was the predominant cause of heart failure (17 patients [23%]), and the mean (SD) left ventricular ejection fraction was 26% (8.7%). The groups were homogeneous in terms of baseline characteristics. Weight loss was similar in both groups (between-group difference in variation of 0.25 kg [95% CI, 1.95 to 2.45]; P=.82) as well as change in clinical congestion score (between-group difference in variation of 0.59 points [95% CI, 2.21 to 1.03]; P=.47) at 3 days. Thirst was significantly worse in the IG (5.1[2.9]) than the CG (3.44[2.0]) at the end of the study period (between-group difference, 1.66 points; time group interaction; P=.01). There were no significant betweengroup differences in the readmission rate at 30 days (IG, 11 patients [29%]; CG, 7 patients [19%]; P=.41). Conclusions and Relevance: Aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at 3 days and is associated with a significant increase in perceived thirst.Weconclude that sodium and water restriction in patients admitted for ADHF are unnecessary.application/pdfengJAMA: Internal Medicine. Chicago. Vol. 173, no. 12 (June 2013), p. 1058-1064Insuficiência cardíacaSódio na dietaAggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trialEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL000883150.pdf000883150.pdfTexto completo (inglês)application/pdf368301http://www.lume.ufrgs.br/bitstream/10183/142362/1/000883150.pdf991bef68918fcbe05328df5525aea5acMD51TEXT000883150.pdf.txt000883150.pdf.txtExtracted Texttext/plain39719http://www.lume.ufrgs.br/bitstream/10183/142362/2/000883150.pdf.txtae315f2112f2ffc7c891799ce24fbbffMD52THUMBNAIL000883150.pdf.jpg000883150.pdf.jpgGenerated Thumbnailimage/jpeg2138http://www.lume.ufrgs.br/bitstream/10183/142362/3/000883150.pdf.jpg9e9a7540690c54f32a2abac71a8ea868MD5310183/1423622023-07-19 03:38:45.286396oai:www.lume.ufrgs.br:10183/142362Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-07-19T06:38:45Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial |
title |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial |
spellingShingle |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial Aliti, Graziella Badin Insuficiência cardíaca Sódio na dieta |
title_short |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial |
title_full |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial |
title_fullStr |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial |
title_full_unstemmed |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial |
title_sort |
Aggressive fluid and sodium restriction in acute decompensated heart failure : a randomized clinical trial |
author |
Aliti, Graziella Badin |
author_facet |
Aliti, Graziella Badin Silva, Eneida Rejane Rabelo da Clausell, Nadine Oliveira Rohde, Luis Eduardo Paim Biolo, Andreia Silva Neto, Luís Beck da |
author_role |
author |
author2 |
Silva, Eneida Rejane Rabelo da Clausell, Nadine Oliveira Rohde, Luis Eduardo Paim Biolo, Andreia Silva Neto, Luís Beck da |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Aliti, Graziella Badin Silva, Eneida Rejane Rabelo da Clausell, Nadine Oliveira Rohde, Luis Eduardo Paim Biolo, Andreia Silva Neto, Luís Beck da |
dc.subject.por.fl_str_mv |
Insuficiência cardíaca Sódio na dieta |
topic |
Insuficiência cardíaca Sódio na dieta |
description |
Importance: The benefits of fluid and sodium restriction in patients hospitalized with acute decompensated heart failure (ADHF) are unclear. Objective: To compare the effects of a fluid-restricted (maximum fluid intake, 800 mL/d) and sodiumrestricted (maximum dietary intake, 800 mg/d) diet (intervention group [IG]) vs a diet with no such restrictions (control group [CG]) on weight loss and clinical stability during a 3-day period in patients hospitalized with ADHF. Design: Randomized, parallel-group clinical trial with blinded outcome assessments. Setting: Emergency room, wards, and intensive care unit. Participants: Adult inpatients with ADHF, systolic dysfunction, and a length of stay of 36 hours or less. Intervention: Fluid restriction (maximum fluid intake, 800 mL/d) and additional sodium restriction (maximum dietary intake, 800 mg/d) were carried out until the seventh hospital day or, in patients whose length of stay was less than 7 days, until discharge. The CG received a standard hospital diet, with liberal fluid and sodium intake. Main Outcomes and Measures: Weight loss and clinical stability at 3-day assessment, daily perception of thirst, and readmissions within 30 days. Results: Seventy-five patients were enrolled (IG, 38; CG, 37). Most weremale; ischemic heart disease was the predominant cause of heart failure (17 patients [23%]), and the mean (SD) left ventricular ejection fraction was 26% (8.7%). The groups were homogeneous in terms of baseline characteristics. Weight loss was similar in both groups (between-group difference in variation of 0.25 kg [95% CI, 1.95 to 2.45]; P=.82) as well as change in clinical congestion score (between-group difference in variation of 0.59 points [95% CI, 2.21 to 1.03]; P=.47) at 3 days. Thirst was significantly worse in the IG (5.1[2.9]) than the CG (3.44[2.0]) at the end of the study period (between-group difference, 1.66 points; time group interaction; P=.01). There were no significant betweengroup differences in the readmission rate at 30 days (IG, 11 patients [29%]; CG, 7 patients [19%]; P=.41). Conclusions and Relevance: Aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at 3 days and is associated with a significant increase in perceived thirst.Weconclude that sodium and water restriction in patients admitted for ADHF are unnecessary. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013 |
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2016-06-09T02:08:05Z |
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JAMA: Internal Medicine. Chicago. Vol. 173, no. 12 (June 2013), p. 1058-1064 |
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