Intravenous Fluids in Acute Decompensated Heart Failure
Autor: | Nancy Kim, Leora I. Horwitz, Chohreh Partovian, Harlan M. Krumholz, Purav Mody, Behnood Bikdeli, Kumar Dharmarajan, Steven G. Coca, Kelly M. Strait, Jeffrey M. Testani, Shu-Xia Li |
---|---|
Rok vydání: | 2015 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Databases Factual Acute decompensated heart failure Hospitalized patients medicine.medical_treatment Article Cohort Studies Young Adult Sodium Potassium Chloride Symporter Inhibitors Interquartile range Intubation Intratracheal medicine Humans In patient Hospital Mortality Infusions Intravenous Saline Aged Retrospective Studies Aged 80 and over Heart Failure Saline Solution Hypertonic business.industry Retrospective cohort study Middle Aged medicine.disease United States Ringer's Solution Surgery Hospitalization Renal Replacement Therapy Intensive Care Units Anesthesia Heart failure Fluid Therapy Female Isotonic Solutions Cardiology and Cardiovascular Medicine business |
Zdroj: | JACC: Heart Failure. 3:127-133 |
ISSN: | 2213-1779 |
Popis: | This study sought to determine the use of intravenous fluids in the early care of patients with acute decompensated heart failure (HF) who are treated with loop diuretics.Intravenous fluids are routinely provided to many hospitalized patients.We conducted a retrospective cohort study of patients admitted with HF to 346 hospitals from 2009 to 2010. We assessed the use of intravenous fluids during the first 2 days of hospitalization. We determined the frequency of adverse in-hospital outcomes. We assessed variation in the use of intravenous fluids across hospitals and patient groups.Among 131,430 hospitalizations for HF, 13,806 (11%) were in patients treated with intravenous fluids during the first 2 days. The median volume of administered fluid was 1,000 ml (interquartile range: 1,000 to 2,000 ml), and the most commonly used fluids were normal saline (80%) and half-normal saline (12%). Demographic characteristics and comorbidities were similar in hospitalizations in which patients did and did not receive fluids. Patients who were treated with intravenous fluids had higher rates of subsequent critical care admission (5.7% vs. 3.8%; p 0.0001), intubation (1.4% vs. 1.0%; p = 0.0012), renal replacement therapy (0.6% vs. 0.3%; p 0.0001), and hospital death (3.3% vs. 1.8%; p 0.0001) compared with those who received only diuretics. The proportion of hospitalizations that used fluid treatment varied widely across hospitals (range: 0% to 71%; median: 12.5%).Many patients who are hospitalized with HF and receive diuretics also receive intravenous fluids during their early inpatient care, and the proportion varies among hospitals. Such practice is associated with worse outcomes and warrants further investigation. |
Databáze: | OpenAIRE |
Externí odkaz: |