Crit Care Nurs Clin North Am. 2026 Dec;38(4):609-619. doi: 10.1016/j.cnc.2026.07.010. Epub 2026 Aug 19.
ABSTRACT
Fluid and sodium restrictions have traditionally been central to heart failure management, yet emerging evidence questions the benefit of rigid limits. The current research has revealed no significant differences in mortality or rehospitalization between restrictive and liberal strategies in New York Heart Association class II or III patients, while restriction is consistently linked to increased thirst, and poorer quality of life and adherence. Modest sodium liberalization may enhance natriuresis and reduce neurohormonal activation without worsening symptoms. These findings support individualized, symptom-guided, patient-centered fluid and sodium management.
PMID:42933956 | DOI:10.1016/j.cnc.2026.07.010