{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:24:52Z","timestamp":1753878292511,"version":"3.41.2"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intravenous loop diuretics are the cornerstone of acute heart failure treatment. Diuretic resistance limits the efficacy and reduces the effectiveness of decongestion, which is associated with increased mortality in AHF patients. We aim to investigate the effect of adding hypertonic saline solution (HSS) to intravenous loop diuretics in treating AHF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This protocol for a systematic review is conducted with guidance from the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analysis Protocols. We will systematically review randomised clinical trials (RCTs) comparing HSS with placebo or another control in patients hospitalised with AHF. The primary outcome is all\u2010cause mortality. The secondary outcomes will be all\u2010cause hospitalisation, change in body weight (kg), and volume of diuresis. Exploratory outcomes will be length of hospitalisation and serum creatinine.<\/jats:p><jats:p>A comprehensive search will be performed across major databases, and Covidence will be used to screen all results from the combined search by two authors independently. The search is planned to begin in May 2025. Meta\u2010analysis and trial sequential analysis will be conducted on eligible trials. Risk of bias will be evaluated using the cochrane risk of bias tool\u2014version 2. The certainty of the evidence will be assessed using the grading of recommendations, assessment, development and evaluations (GRADE) and confidence in network meta\u2010analysis (CINEMA) approach.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.70070","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T03:19:53Z","timestamp":1750389593000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Hypertonic Saline Solution With Loop Diuretics in Patients With Acute Heart Failure: A Protocol for Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1777-4056","authenticated-orcid":false,"given":"Sami","family":"Taleghani","sequence":"first","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital\u2010Amager\u2010Hvidovre Hospital  Copenhagen 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C.","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital\u2010Amager\u2010Hvidovre Hospital  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Cannata","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine Faculty of Life Science, King's College London  London UK"},{"name":"Cardiology Department King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janus C.","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Copenhagen Trial Unit, Centre for Clinical Intervention Research The Capital Region, Copenhagen University Hospital\u2010Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Regional Health Research The Faculty of Health Sciences, University of Southern Denmark  Odense 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