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Patients in the hypertonic saline group experienced more effective diuresis, shorter hospital stays, and a reduced rate of re-admission: LaFreniere G 2017: Effects of hypertonic saline solution on body weight and serum creatinine in patient with acute decompensated heart failure This is a prospective cohort study describing 47 patients with refractory acute decompensated heart failure treated with hyperdiuresis at Quebec University Hospital Centre

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Extended protocols beyond typical 8-12 week durations appear safe based on available evidence