Acute treatment of uncompensated heart failure with 10% hypertonic saline and its subsequent effect on respiratory patterns

Uncompensated heart failure (UHF) is a leading cause of hospitalization. The available drugs to treat acute UHF include inotropes, diuretics and vasodilators. In recent years, hypertonic saline (HTS) has emerged as a new potential therapy for refractory heart failure, usually in association with high doses of diuretics. However, there have been no reports describing the use of HTS as a first-line treatment for UHF. Here, we report a case in which a 10% NaCl solution was used as the primary therapy for a patient with UHF. Almost immediately, hypertonic saline was able to restore the patient’s hemodynamic profile and to eliminate Cheyne-Stokes respiration (CSR), which is associated with a low cardiac output state.