Diuretic strategies in patients with acute decompensated

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Warawut Ia

Saúde e medicina

Diuretic Strategies in Patients with Acute Decompensated Heart Failure G.Michael Felker, M.D. The New England Journal of Medicine March 2011 Warawut Suttison ,MD

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Method ,[object Object],[object Object],Low dose High dose (2.5 times) intravenous bolus every 12 hours continuous intravenous infusion

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[object Object],Results Bolus Infusion P-value require a dose increase at 48 hours 21% 11% 0.01 switch to oral diuretics at 48 hours 22% 26% 0.44 median total dose 592 mg 480 mg 0.06 primary efficacy end point no significant primary safety end point no significant secondary end points no significant Serum creatinine and cystatin C levels similar

Results ,[object Object],Low High P-value change to oral diuretics at 48 hours 17% 31% < 0.001 require a 50% increase in the dose at 48 hours 24% 9% 0.003 median total dose 358 mg 773 mg < 0.001 primary efficacy end point no significant primary safety end point no significant secondary end points 23% 14% 0.04 Serum creatinine and cystatin C levels no significant

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