Rational use of diuretics in acute decompensated heart failure.
Curr Heart Fail Rep
; 5(3): 153-62, 2008 Sep.
Article
em En
| MEDLINE
| ID: mdl-18752765
ABSTRACT
Chronic heart failure poses an enormous health care burden to the United States and other developed countries. Acute decompensated heart failure (ADHF) accounts for nearly half of the morbidity and expense of treating this disease. Most patients presenting with ADHF have symptomatic vascular congestion. Diuretics, especially loop diuretics, are the primary pharmacologic intervention used in this population. Despite their widespread use, scant data from randomized clinical trials are available to guide therapeutic choices. In addition, data from several large registries examining weight loss during hospitalization for ADHF suggest that efficacy with diuretic treatment is far from universal. Aggressive diuresis carries a significant risk of electrolyte and volume depletion, with subsequent arrhythmias, hypotension, and worsening renal function. These complications often translate into worse prognosis. Diuretic regimens used to treat ADHF must be individualized based on general knowledge of potency and pharmacokinetic and pharmacodynamic considerations. This article summarizes older and more recent literature to provide a framework for making rational treatment choices in this difficult patient population.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diuréticos
/
Insuficiência Cardíaca
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Curr Heart Fail Rep
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2008
Tipo de documento:
Article