Efficiency of Hypertonic Saline in the Management of Decompensated Heart Failure: A Systematic Review and Meta-Analysis
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SYSTEMATIC REVIEW
Efficiency of Hypertonic Saline in the Management of Decompensated Heart Failure: A Systematic Review and Meta‑Analysis of Clinical Studies Adrian Covic1 · Sidar Copur2 · Laura Tapoi3 · Baris Afsar4 · Carina Ureche3 · Dimitrie Siriopol1 · Ionut Nistor1,5,6 · Mehmet Kanbay7 Accepted: 5 November 2020 © Springer Nature Switzerland AG 2020
Abstract Introduction Acute decompensated heart failure (ADHF), with an incidence of 1–2%, is a clinical syndrome with significant morbidity and mortality despite therapeutic advancements and ongoing clinical trials. A recent therapeutic approach to patients with ADHF includes combination therapy with hypertonic saline solution (HSS) and furosemide, based on the hypothesis that resistance to loop diuretics occurs because of achievement of plateau in water and sodium excretion in patients receiving long-term loop diuretic therapy. Objective Our aim was to conduct a meta-analysis to evaluate the efficiency of combination HSS plus furosemide therapy in patients with ADHF in terms of mortality, readmissions, length of hospital stay, kidney function, urine output, body weight, and B-type natriuretic peptide (BNP). Methods A total of 14 studies—four observational and ten randomized studies (total 3398 patients)—were included in the meta-analysis. Results Our results demonstrate the superiority of combination HSS plus furosemide therapy over furosemide alone in terms of kidney function preservation (mean creatinine difference − 0.33 mg/dL; P
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