Evidence mapPaperPMID 35787494Full record

ArticleBMJ case reports2022

Benefit of natriuresis and cardiac resynchronisation therapy in acute decompensated heart failure with cardiorenal syndrome and hypernatraemia.

Abdulrahman Tawfiq Khojah, Emma Katz, Romina Pace, Rajkumar Rajendram

Open access · greenAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 51% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Abdulrahman Tawfiq KhojahHeart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Central Region, Saudi Arabia.
Emma KatzDepartment of Medicine, McGill University, Montreal, Quebec, Canada.
Romina PaceCentre for Outcomes Research and Evaluation, Department of Medicine, McGill University, Montreal, Quebec, Canada.
Rajkumar RajendramCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Al Riyadh Province, Saudi Arabia rajkumarrajendram@doctors.org.uk.ORCID http://orcid.org/0000-0001-7790-4591
McGill University · CAKing Faisal Specialist Hospital & Research Centre · SAKing Saud bin Abdulaziz University for Health Sciences · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A man in his eighties with acute heart failure and cardiorenal syndrome developed severe hypernatraemia with diuresis. In this situation, palliation is often considered when renal replacement therapy is inappropriate. The literature to guide treatment of dysnatraemia in this setting is limited. Diuretics often worsen hypernatraemia and fluid replacement exacerbates heart failure. We describe a successful approach to this clinical Catch-22: sequential nephron blockade with intravenous 5% dextrose. Seemingly counterintuitive, the natriuretic effect of this combination had not previously been compared with diuretic monotherapy for heart failure. Yet this immediately effective strategy generated a high natriuresis-to-diuresis ratio and functioned as a bridge to cardiac resynchronisation therapy (CRT). In conjunction with a low salt diet, CRT facilitated the maintenance of sodium homeostasis and fluid balance. Thus, by improving the underlying pathophysiology (ie, inadequate cardiac output), CRT may enhance the outcomes of patients with cardiorenal syndrome and hypernatraemia.

Indexed as

Cardio-Renal SyndromeHeart FailureHypernatremiaDiureticsHumansMaleNatriuresisDiureticsCardiovascular medicineCardiovascular systemFluid electrolyte and acid-base disturbancesHeart failurePacing and electrophysiology

Identifiers

PMID35787494
PMCPMC9255421
OpenAlexW4283797808

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.