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    Lasix resistance


    A 50-year-old man is transferred from an outside hospital after being intubated for pneumonia. He had been receiving maintence fluid for the past week and is now grossly edematous. Aggressive diuresis is desired to help wean him from the ventilator. For two days he is diuresed with furosemide, during which time he has a net fluid balance of negative four liters. Ultimately, over the first four days of his ICU course his fluid balance ends up being net (he was diuresed initially, and then received free water). He continued to require the same amount of ventilator support. Although the term dehydration is often used loosely, the medical definition of dehydration is (1). However, it is subsequently noticed that he is hypernatremic with a sodium of 150 m Eq/L. This is common in the ICU, usually from failure to replace daily water losses. Normally, hypernatremia triggers thirst and water intake, but this is impossible among intubated patients. Hypernatremia should generally be aggressively corrected. Hypernatremia may make patients miserable, manifesting as “agitation” and leading to increased sedative administration (imagine being thirstier than you've ever been in your life yet unable to drink). valacyclovir 1 g In order to use Medscape, your browser must be set to accept cookies delivered by the Medscape site. Medscape uses cookies to customize the site based on the information we collect at registration. The cookies contain no personally identifiable information and have no effect once you leave the Medscape site.

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    Understanding the tubular location of diuretic resistance DR in heart failure HF is critical to developing targeted treatment strategies. Rodents chronically. duloxetine hydrochloride Purpose Diuretic resistance is common in patients with acute heart failure, although a clinically useful definition is lacking. Little is known abou. PulmCrit- Overcoming occult diuretic resistance Achieving diuresis without dehydration. Furosemide blocks sodium reabsorption by the descending loop of Henle.

    We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising. For further information, including about cookie settings, please read our Cookie Policy . By continuing to use this site, you consent to the use of cookies. Purpose: Diuretic resistance is common in patients with acute heart failure, although a clinically useful definition is lacking. Little is known about its prevalence, predictors and clinical outcome. Methods: We examined diuretic response (Δ weight kg/40mg furosemide) and diuretic resistance (diuretic response ≥0) in 1745 hospitalized AHF patients from the PROTECT trial. Day 4 response was used for the best signal-to-noise ratio. We investigated predictors of diuretic response and resistance and their relationship with outcome. Results: Mean diuretic response was -0.6±0.8 kg/40 mg furosemide and 226 (13%) patients were resistant. A history of Diabetes (p Conclusion: Worse diuretic response was associated with more advanced heart failure, renal impairment, metabolic and atherosclerotic disease, and is a predictor in-hospital worsening heart failure, mortality and rehospitalization.

    Lasix resistance

    Diuretic Resistance and Strategies to Overcome Resistance, Diuretic resistance in acute heart failure - clinical characteristics and.

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  5. Strategies to overcome diuretic resistance include sodium intake restriction, changes in diuretic dose and route of administration and.

    • A perspective on diuretic resistance in chronic congestive heart.
    • PulmCrit- Overcoming occult diuretic resistance Achieving.
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    Diuretic resistance may be caused by decreased renal function and reduced. Strategies to overcome diuretic resistance include restriction of sodium intake. cialis viagra dosage Continuous infusion of furosemide in the treatment of patients with congestive heart failure and diuretic resistance. J Intern Med. 1994 Apr; 235 4329–334. Dormans TP, van Meyel JJ, Gerlag PG, Tan Y, Russel FG, Smits P. Diuretic efficacy of high dose furosemide in severe heart failure bolus injection versus continuous infusion. Able fluid retention. The addition of hydrochlorothiazide and amiloride provided a prompt and effective remedy to relative furosemide resistance. Average weight.

     
  6. Kaimak New Member

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