Showing posts with label RCT. Show all posts
Showing posts with label RCT. Show all posts

Saturday, July 20, 2019

Diuretic treatment in high‐risk acute decompensation of advanced chronic heart failure—bolus intermittent vs. continuous infusion of furosemide: a randomized controlled trial

Link to Abstract

As a critical care doc, a good chunk of the consults I receive for acute hypoxemic respiratory failure are from pulmonary edema. So I do my thing, intubate when necessary, and place these patients on a BiPAP setting that’s comfortable for them. Airway, check! Now it’s time to diurese them to a potato chip. I know there are suggested dosing that you may find in the literature, and the fact the IV vs. PO dosing of #furosemide is different. Clinical practice is always an art, though, as using an exact flow every time can get your patient into trouble. Prior studies as to whether to give #lasix as a bolus or a drop were negative studies, but this one favored providing drip. The bolus arm used q12 dosing which raises my eyebrows, though, as I usually use q8 dosing in my practice. @codyperrigo and I used a drip on a pt the day after this study came out with some phenomenal results! That’s empiric data and is worthless, though 😉. Anyway, a big 🎩 tip to the authors.