{"id":"https://openalex.org/W4415917088","doi":"https://doi.org/10.1186/s13054-025-05707-x","title":"Protocolized natriuresis-guided diuretic therapy in acute heart failure: a systematic review and meta-analysis","display_name":"Protocolized natriuresis-guided diuretic therapy in acute heart failure: a systematic review and meta-analysis","publication_year":2025,"publication_date":"2025-11-05","ids":{"openalex":"https://openalex.org/W4415917088","doi":"https://doi.org/10.1186/s13054-025-05707-x","pmid":"https://pubmed.ncbi.nlm.nih.gov/41194267","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12587620"},"language":"en","primary_location":{"id":"doi:10.1186/s13054-025-05707-x","doi":"https://doi.org/10.1186/s13054-025-05707-x","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s13054-025-05707-x","pdf_url":"https://ccforum.biomedcentral.com/counter/pdf/10.1186/s13054-025-05707-x","source":{"id":"https://openalex.org/S191417626","display_name":"Critical Care","issn_l":"1364-8535","issn":["1364-8535","1466-609X","1574-4280","1875-7081"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-b","doyens","jufo-3","ki-jl-3","medline","norway-2","oarl","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://ccforum.biomedcentral.com/counter/pdf/10.1186/s13054-025-05707-x","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5108243311","display_name":"Alonzo Armani Prata","orcid":"https://orcid.org/0009-0009-3040-8772","observed_orcids":["https://orcid.org/0009-0009-3040-8772"]},"institutions":[{"id":"https://openalex.org/I51235708","display_name":"Universidade Federal do Esp\u00edrito Santo","ror":"https://ror.org/05sxf4h28","country_code":"BR","type":"education","lineage":["https://openalex.org/I51235708"]}],"countries":["BR"],"is_corresponding":true,"raw_author_name":"Alonzo Armani Prata","raw_affiliation_strings":["Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil. alonzo.prata@edu.ufes.br","Higher School of Sciences of the Holy House of Mercy of Vit\u00f3ria, Vit\u00f3ria, Brazil","Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil. alonzo.prata@edu.ufes.br","institution_ids":["https://openalex.org/I51235708"]},{"raw_affiliation_string":"Higher School of Sciences of the Holy House of Mercy of Vit\u00f3ria, Vit\u00f3ria, Brazil","institution_ids":[]},{"raw_affiliation_string":"Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil","institution_ids":["https://openalex.org/I51235708"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086161452","display_name":"Annie Armani Prata","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I51235708","display_name":"Universidade Federal do Esp\u00edrito Santo","ror":"https://ror.org/05sxf4h28","country_code":"BR","type":"education","lineage":["https://openalex.org/I51235708"]}],"countries":["BR"],"is_corresponding":true,"raw_author_name":"Annie Armani Prata","raw_affiliation_strings":["Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil. alonzo.prata@edu.ufes.br","Higher School of Sciences of the Holy House of Mercy of Vit\u00f3ria, Vit\u00f3ria, Brazil"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil. alonzo.prata@edu.ufes.br","institution_ids":["https://openalex.org/I51235708"]},{"raw_affiliation_string":"Higher School of Sciences of the Holy House of Mercy of Vit\u00f3ria, Vit\u00f3ria, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":null,"display_name":"Ana Carolina Covre Coan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I51235708","display_name":"Universidade Federal do Esp\u00edrito Santo","ror":"https://ror.org/05sxf4h28","country_code":"BR","type":"education","lineage":["https://openalex.org/I51235708"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Ana Carolina Covre Coan","raw_affiliation_strings":["Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Federal University of Esp\u00edrito Santo (UFES) - Campus Maru\u00edpe, Avenida Marechal Campos, 1468, Maru\u00edpe, Vit\u00f3ria, ES, 29043-900, Brazil","institution_ids":["https://openalex.org/I51235708"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5095091343","display_name":"Pedro Gabriel Scardini","orcid":"https://orcid.org/0009-0007-6323-5711","observed_orcids":["https://orcid.org/0009-0007-6323-5711"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Pedro Gabriel Scardini","raw_affiliation_strings":["Higher School of Sciences of the Holy House of Mercy of Vit\u00f3ria, Vit\u00f3ria, Brazil"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Higher School of Sciences of the Holy House of Mercy of Vit\u00f3ria, Vit\u00f3ria, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111676950","display_name":"Julia Marques Fernandes","orcid":"https://orcid.org/0009-0007-5894-7714","observed_orcids":["https://orcid.org/0009-0007-5894-7714"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Julia Marques Fernandes","raw_affiliation_strings":["Albert Einstein Hospital and Faculty of Medicine, S\u00e3o Paulo, Brazil"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Albert Einstein Hospital and Faculty of Medicine, S\u00e3o Paulo, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5046212874","display_name":"Wilson Falco Neto","orcid":"https://orcid.org/0000-0002-8292-0526","observed_orcids":["https://orcid.org/0000-0002-8292-0526"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Wilson Falco Neto","raw_affiliation_strings":["FAMECA University Center, Catanduva, Brazil"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FAMECA University Center, Catanduva, Brazil","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5048844200","display_name":"Luciana Gioli\u2010Pereira","orcid":"https://orcid.org/0000-0002-4682-8095","observed_orcids":["https://orcid.org/0000-0002-4682-8095"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Luciana Gioli-Pereira","raw_affiliation_strings":["Albert Einstein Hospital and Faculty of Medicine, S\u00e3o Paulo, Brazil"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Albert Einstein Hospital and Faculty of Medicine, S\u00e3o Paulo, Brazil","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5086161452","https://openalex.org/A5108243311"],"corresponding_institution_ids":["https://openalex.org/I51235708"],"apc_list":{"value":4190,"currency":"USD","value_usd":4190},"apc_paid":{"value":4190,"currency":"USD","value_usd":4190},"fwci":0.7341,"has_fulltext":true,"cited_by_count":5,"citation_normalized_percentile":{"value":0.58973394,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":97,"max":98},"biblio":{"volume":"29","issue":"1","first_page":"474","last_page":"474"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10198","display_name":"Heart Failure Treatment and Management","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10198","display_name":"Heart Failure Treatment and Management","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11967","display_name":"Electrolyte and hormonal disorders","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10821","display_name":"Cardiovascular Function and Risk Factors","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/acute-heart-failure","display_name":"acute heart failure","score":0.949999988079071},{"id":"https://openalex.org/keywords/loop-diuretics","display_name":"loop diuretics","score":0.9509999752044678},{"id":"https://openalex.org/keywords/diuretic-titration","display_name":"diuretic titration","score":0.9070000052452087},{"id":"https://openalex.org/keywords/fluid-overload","display_name":"fluid overload","score":0.7749999761581421},{"id":"https://openalex.org/keywords/serum-creatinine","display_name":"serum creatinine","score":0.6899999976158142},{"id":"https://openalex.org/keywords/hypokalemia","display_name":"hypokalemia","score":0.7919999957084656},{"id":"https://openalex.org/keywords/hypotension","display_name":"hypotension","score":0.8539999723434448},{"id":"https://openalex.org/keywords/heart-failure-readmission","display_name":"heart failure readmission","score":0.8220000267028809},{"id":"https://openalex.org/keywords/all-cause-mortality","display_name":"all-cause mortality","score":0.8550000190734863},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.8569999933242798},{"id":"https://openalex.org/keywords/weight-loss","display_name":"weight loss","score":0.8809999823570251},{"id":"https://openalex.org/keywords/diuresis","display_name":"diuresis","score":0.7419999837875366},{"id":"https://openalex.org/keywords/risk-of-bias","display_name":"risk of bias","score":0.5490000247955322},{"id":"https://openalex.org/keywords/pellegrino","display_name":"Pellegrino","score":0.8140000104904175}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9607999920845032},{"id":"https://openalex.org/C2779547328","wikidata":"https://www.wikidata.org/wiki/Q584691","display_name":"Diuresis","level":3,"score":0.7376999855041504},{"id":"https://openalex.org/C174459258","wikidata":"https://www.wikidata.org/wiki/Q6980232","display_name":"Natriuresis","level":3,"score":0.7185999751091003},{"id":"https://openalex.org/C2779918671","wikidata":"https://www.wikidata.org/wiki/Q200656","display_name":"Diuretic","level":2,"score":0.6420000195503235},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.6419000029563904},{"id":"https://openalex.org/C2780472472","wikidata":"https://www.wikidata.org/wiki/Q424337","display_name":"Acute kidney injury","level":2,"score":0.5128999948501587},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.35839998722076416},{"id":"https://openalex.org/C2778198053","wikidata":"https://www.wikidata.org/wiki/Q181754","display_name":"Heart failure","level":2,"score":0.32260000705718994},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.3059000074863434},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.29739999771118164},{"id":"https://openalex.org/C2778653478","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Kidney disease","level":2,"score":0.28290000557899475},{"id":"https://openalex.org/C2780091579","wikidata":"https://www.wikidata.org/wiki/Q9377","display_name":"Kidney","level":2,"score":0.2615000009536743},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.25850000977516174}],"mesh":[{"descriptor_ui":"D004232","descriptor_name":"Diuretics","qualifier_ui":"Q000494","qualifier_name":"pharmacology","is_major_topic":true},{"descriptor_ui":"D004232","descriptor_name":"Diuretics","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D006333","descriptor_name":"Heart Failure","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D006333","descriptor_name":"Heart Failure","qualifier_ui":"Q000503","qualifier_name":"physiopathology","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009318","descriptor_name":"Natriuresis","qualifier_ui":"Q000187","qualifier_name":"drug effects","is_major_topic":true},{"descriptor_ui":"D009318","descriptor_name":"Natriuresis","qualifier_ui":"Q000502","qualifier_name":"physiology","is_major_topic":true}],"locations_count":4,"locations":[{"id":"doi:10.1186/s13054-025-05707-x","doi":"https://doi.org/10.1186/s13054-025-05707-x","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s13054-025-05707-x","pdf_url":"https://ccforum.biomedcentral.com/counter/pdf/10.1186/s13054-025-05707-x","source":{"id":"https://openalex.org/S191417626","display_name":"Critical Care","issn_l":"1364-8535","issn":["1364-8535","1466-609X","1574-4280","1875-7081"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-b","doyens","jufo-3","ki-jl-3","medline","norway-2","oarl","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care","raw_type":"journal-article"},{"id":"pmh:oai:europepmc.org:11396704","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12587620","pdf_url":null,"source":{"id":"https://openalex.org/S4306400806","display_name":"Europe PMC (PubMed Central)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1303153112","host_organization_name":"European Bioinformatics Institute","host_organization_lineage":["https://openalex.org/I1303153112"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":null,"raw_type":"Text"},{"id":"pmid:41194267","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41194267","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical care (London, England)","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12587620","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12587620/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Crit Care","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1186/s13054-025-05707-x","doi":"https://doi.org/10.1186/s13054-025-05707-x","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s13054-025-05707-x","pdf_url":"https://ccforum.biomedcentral.com/counter/pdf/10.1186/s13054-025-05707-x","source":{"id":"https://openalex.org/S191417626","display_name":"Critical Care","issn_l":"1364-8535","issn":["1364-8535","1466-609X","1574-4280","1875-7081"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-b","doyens","jufo-3","ki-jl-3","medline","norway-2","oarl","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4415917088.pdf","grobid_xml":"https://content.openalex.org/works/W4415917088.grobid-xml"},"referenced_works_count":30,"referenced_works":["https://openalex.org/W1534181333","https://openalex.org/W1983902645","https://openalex.org/W2093536899","https://openalex.org/W2116825982","https://openalex.org/W2152753934","https://openalex.org/W2170892587","https://openalex.org/W2531269403","https://openalex.org/W2611341068","https://openalex.org/W2805115770","https://openalex.org/W2907983377","https://openalex.org/W2908201961","https://openalex.org/W2943375946","https://openalex.org/W2947972779","https://openalex.org/W2970684805","https://openalex.org/W2975424845","https://openalex.org/W2978795816","https://openalex.org/W3118615836","https://openalex.org/W3127372290","https://openalex.org/W3193598686","https://openalex.org/W4220837239","https://openalex.org/W4220984958","https://openalex.org/W4292851383","https://openalex.org/W4385606295","https://openalex.org/W4385790359","https://openalex.org/W4386225188","https://openalex.org/W4390614173","https://openalex.org/W4394920305","https://openalex.org/W4401412377","https://openalex.org/W4401585016","https://openalex.org/W4404964275"],"related_works":["https://openalex.org/W4386225188","https://openalex.org/W4390614173","https://openalex.org/W4415714283","https://openalex.org/W7127612464","https://openalex.org/W3210631187","https://openalex.org/W3212883125","https://openalex.org/W7166465723","https://openalex.org/W7117460494","https://openalex.org/W7168271083","https://openalex.org/W4401585016"],"abstract_inverted_index":{"BACKGROUND:":[0],"Volume":[1],"overload":[2],"is":[3],"the":[4,37,118,167,234,250,268,271,337,351],"primary":[5],"pathophysiological":[6],"mechanism":[7],"underlying":[8],"signs":[9],"and":[10,25,32,39,57,89,134,152,183,280,300,316,321,340,360],"symptoms":[11],"in":[12,48,70,108,166,200,356],"acute":[13,333],"heart":[14,207],"failure":[15,208],"(AHF).":[16],"However,":[17],"evidence-based":[18],"strategies":[19],"for":[20,44,60,86,90,297],"optimal":[21],"loop":[22],"diuretic":[23,46,65],"dosing":[24],"monitoring":[26],"remain":[27],"limited.":[28],"This":[29],"systematic":[30],"review":[31],"meta-analysis":[33,306],"aimed":[34],"to":[35,144,181,190,230,292,349],"evaluate":[36,350],"efficacy":[38,299,341],"safety":[40,301,339],"of":[41,127,161,204,221,236,247,278,307,332],"natriuresis-guided":[42,64,168,312],"protocols":[43],"titrating":[45],"therapy":[47,66,169,172,214,313],"patients":[49,71,308,361],"with":[50,72,111,217,309,318],"AHF.":[51],"METHODS:":[52],"We":[53,80,137],"searched":[54],"Cochrane,":[55],"PubMed,":[56],"Embase":[58],"databases":[59],"studies":[61,119,155,265],"that":[62],"compared":[63],"versus":[67],"standard":[68],"management":[69],"AHF":[73],"from":[74,106,117],"their":[75],"inception":[76],"until":[77],"June":[78],"2025.":[79],"computed":[81],"pooled":[82,96,121],"risk":[83,220,235,246,277,331],"ratio":[84,103],"(RR)":[85],"binary":[87],"outcomes,":[88,92],"continuous":[91],"we":[93],"calculated":[94],"either":[95],"mean":[97,102],"difference":[98],"(MD)":[99],"or":[100,210,238],"geometric":[101],"(GMR)":[104],"derived":[105],"differences":[107,197],"log-means,":[109],"all":[110,298],"95%":[112,178,187,227],"confidence":[113],"intervals":[114],"(CIs).":[115],"Data":[116],"were":[120,156,165,198,242],"using":[122,131,267],"R":[123],"version":[124],"4.4.1.":[125],"Risk":[126],"bias":[128,248],"was":[129,215,258,314],"assessed":[130,266],"RoB":[132,251],"2":[133,252],"ROBINS-I":[135,269],"tools.":[136],"also":[138],"performed":[139],"a":[140,218,275,284,329],"sensitivity":[141,289],"analysis":[142],"restricted":[143],"randomized":[145],"controlled":[146],"trials":[147],"(RCTs).":[148],"RESULTS:":[149],"Three":[150],"RCTs":[151,241,346],"two":[153],"observational":[154],"included,":[157],"encompassing":[158],"933":[159],"patients,":[160],"which":[162],"404":[163],"(43%)":[164],"group.":[170],"Protocolized":[171,213],"significantly":[173],"increased":[174],"natriuresis":[175,322],"(GMR:":[176,185],"1.30;":[177],"CI:":[179,188,228],"1.14":[180],"1.49)":[182],"diuresis":[184,320],"1.21;":[186],"1.09":[189],"1.35)":[191],"after":[192,323],"48":[193,324],"h.":[194],"No":[195],"significant":[196],"observed":[199],"weight":[201],"loss,":[202],"length":[203],"hospital":[205],"stay,":[206],"rehospitalization,":[209],"all-cause":[211],"mortality.":[212],"associated":[216,317],"lower":[219],"doubling":[222],"serum":[223],"creatinine":[224],"(RR:":[225],"0.52;":[226],"0.28":[229],"0.98),":[231],"without":[232],"increasing":[233],"hypokalemia":[237],"hypotension.":[239],"Two":[240],"deemed":[243],"at":[244],"\"low\"":[245],"by":[249],"tool,":[253,270],"while":[254],"Bayat":[255],"et":[256,282],"al.":[257,283],"rated":[259],"as":[260,326,328],"having":[261],"\"some":[262],"concerns.\"":[263],"For":[264],"ENACT-HF":[272],"study":[273],"presented":[274],"\"moderate\"":[276],"bias,":[279],"Pellegrino":[281],"\"serious\"":[285],"risk.":[286],"Nevertheless,":[287],"our":[288,295],"analysis,":[290],"limited":[291],"RCTs,":[293],"confirmed":[294],"findings":[296],"endpoints.":[302],"CONCLUSION:":[303],"In":[304],"this":[305],"AHF,":[310],"protocolized":[311],"safe":[315],"improved":[319],"h,":[325],"well":[327],"reduced":[330],"kidney":[334],"injury.":[335],"While":[336],"short-term":[338],"are":[342,347],"promising,":[343],"further":[344],"large":[345],"needed":[348],"effects":[352],"on":[353],"clinical":[354],"endpoints":[355],"diverse":[357],"healthcare":[358],"settings":[359],"worldwide.":[362]},"counts_by_year":[{"year":2026,"cited_by_count":5}],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2025-11-05T00:00:00"}