FLUIDS IN CONGESTIVE HEART FAILURE

Abstract

Increased knowledge of water and electrolyte metabolism and a demonstration of the ill effects of clinical dehydration have revolutionized preoperative and postoperative therapy;¹ the treatment of kidney disease,² burns,³ toxemias of pregnancy,⁴ shock⁵ and a variety of surgical and medical conditions.⁶ Concomitantly, attention has been directed to fluid therapy in congestive heart failure with a resulting diversity of opinion as to the optimum therapy to be employed. Currently most clinician, restrict salt intake and limit fluids to 1,000 to 1,500 cc. daily as an integral part of their cardiac regimen.⁷ Many are now permitting as liberal an intake as desired, while sodium is restricted to an absolute minimum;⁸ still others advocate forcing fluids as a physiologically sound and frequently necessary measure in treating congestive failure.⁹ Those advocating fluid restriction attempt to allow the average intake advocated in health and feel that