Kato Naoko P, Nagatomo Yuji, Kawai Fujimi, Kitai Takeshi, Mizuno Atsushi
Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health, Linköping University, 581 83 Linköping, Sweden.
Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan.
J Pers Med. 2024 Jul 11;14(7):741. doi: 10.3390/jpm14070741.
Fluid restriction has long been believed to benefit patients with heart failure by counteracting the activated renin-angiotensin aldosterone system and sympathetic nervous activity. However, its effectiveness remains controversial. In this paper, we summarized the current recommendations and reviewed the scientific evidence on fluid restriction in the setting of both acute decompensated heart failure and compensated heart failure. While a recent meta-analysis demonstrated the beneficial effects of fluid restriction on both all-cause mortality and hospitalization compared to usual care, several weaknesses were identified in the assessment of the methodological quality of the meta-analysis using AMSTAR 2. Further randomized controlled trials with larger sample sizes are needed to elucidate the benefits of fluid restriction for both clinical outcomes and patient-reported outcomes in patients with heart failure.
长期以来，人们一直认为限液通过对抗激活的肾素-血管紧张素-醛固酮系统和交感神经活动，对心力衰竭患者有益。然而，其有效性仍存在争议。在本文中，我们总结了当前的建议，并回顾了关于急性失代偿性心力衰竭和代偿性心力衰竭情况下限液的科学证据。虽然最近的一项荟萃分析表明，与常规治疗相比，限液对全因死亡率和住院率均有有益影响，但使用AMSTAR 2评估该荟萃分析的方法学质量时发现了几个弱点。需要进一步开展更大样本量的随机对照试验，以阐明限液对心力衰竭患者临床结局和患者报告结局的益处。
