This research looked at a natriuresis-guided diuretic protocol for patients with acute decompensated heart failure. The review combined data from studies involving 831 patients.
The analysis found that guiding diuretics by sodium output led to significantly more urine sodium and fluid output at 24 and 48 hours. Patients also lost more weight and had a shorter hospital stay. However, there was no significant difference in congestion scores, all-cause mortality, or heart failure re-hospitalization.
Safety events were not reported in the included studies. The main reason to be careful is that this is a meta-analysis of existing studies, which can only show links, not prove cause and effect.
From this, readers can take that natriuresis-guided care may help with fluid removal and hospital length of stay in acute heart failure, but it did not show a benefit for survival or readmission in this analysis.