Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Hypertonic saline solution (HSS) has been proposed as an adjunct therapy to high-dose loop diuretics in patients with refractory acute decompensated heart failure (ADHF). Clinical benefit, safety, and optimal dosing of HSS in ADHF are unclear due to limitations of existing studies.
Research Question or Hypothesis: Does HSS administration strategy (1 dose or >1 dose in 24 hours) impact safety and efficacy of HSS use in patients admitted with ADHF?
Study Design: Retrospective, observational cohort study.
Methods: This was a single-center, retrospective chart review that included adult patients admitted with ADHF who received at least one dose of sodium chloride 2% or 3% between December 2015 through November 2023. Patients were excluded if the primary use of HSS was for a neurologic indication. Data extracted included patient demographics, baseline clinical data, concomitant diuretics, and characterization of HSS use, efficacy, and safety. Descriptive statistics were used to characterize use. Mann-Whitney U was used to assess differences in efficacy and safety. A p-value < 0.05 was considered statistically significant.
Results: Overall, 44 patients received HSS for ADHF during the study period. The most common dose used was 150 mL of sodium chloride 3%. 27 patients received 1 dose of HSS within 24 hours while 17 patients received >1 dose in 24 hours. There was no statistically significant difference in total urine output or net fluid loss at 24 hours in patients receiving 1 dose versus >1 dose at 24 hours post-HSS administration. Change in serum sodium was similar between groups at 6 and 24 hours post-HSS administration. No patients experienced an overcorrection of sodium (increase =12 mEq/L) at 24 hours.
Conclusion: No difference in safety or efficacy was found with a dosing strategy of 1 dose or >1 dose of HSS within 24 hours. Further studies are needed to elucidate the optimal dosing strategy of HSS in diuretic-refractory ADHF.
Presenting Author
Mallory Mouradjian Pharm.D., BCCPUniversity of Maryland
Authors
Manjula Ananthram MBBS
University of Maryland School of Medicine
Sandeep Devabhakthuni PharmD, BCPS, BCCP
University of Maryland School of Pharmacy
Jessica Schuchardt Biology, BS
University of Maryland School of Pharmacy