If a doctor didn’t order IV fluids for a patient with acute decompensated heart failure, this was probably a very smart move, even though it would seem—from an intuitive standpoint—that IV fluids would be beneficial.
A Yale study (Journal of the American College of Cardiology) says that IV fluids could be potentially harmful to those hospitalized with acute decompensated heart failure.
Not the Same As Diuretics
The standard is to treat ADHF patients with diuretics (e.g., Lasix) intravenously to fight off excess fluid buildup (fluid overload) in the body and hence, manage symptoms like trouble breathing.
The IV fluids in question, though, don’t involve diuresis. It is these fluids that the study says may worsen symptoms.
To Give IV Fluids or Not in Acute Heart Failure
• The Yale researchers looked at data from more than 130,000 ADHF hospitalizations involving IV fluids in the first two days.
• Eleven percent of patients received intravenous fluid treatment along with diuresis.
• Patients who got both treatments were more likely to suffer negative consequences such as higher rates of intubation, critical care admission, kidney dialysis and mortality, when compared to patients given only diuresis.
• The study did not establish cause and effect, only an association, between IV fluids and higher incidence of adverse outcomes.
• But an associative relationship is nevertheless concerning and calls for more studies.