[Use of diuretics in acute decompensated heart failure]. / Einsatz von Diuretika bei der akut dekompensierten Herzinsuffizienz.
Praxis (Bern 1994)
; 99(12): 705-14, 2010 Jun 09.
Article
en De
| MEDLINE
| ID: mdl-20533230
Patients with acute heart failure usually present with dyspnoe and edema secondary to elevated intracardiac filling pressure resulting from volume overload. Despite significant progress in understanding heart failure, the treatment strategy for acute heart failure did not change in the same way. Diuretics, especially loop diuretics, are the most common therapy used in this setting. Intravenous diuretics act acutely by exerting a modest vasodilatory response and chronically by reducing circulating blood volume. Despite near universal use of diuretics in patients hospitalized with acute heart failure, nearly half of these patients are discharged from hospital without weight loss. This could be due to inadequate diuresis, overdiuresis with subsequent volume replacement and diuretic resistance. Aggressive diuresis carries a significant risk of electrolyte and volume depletion with subsequent arrythmias, hypotension, and worsening renal function. Actually there were scant data available from randomized clinical trials to guide therapeutic choice with diuretics. Thus, the choice and dosing of diuretic therapy must be individualized based on general knowledge of potency and pharmacokinetic and pharmacodynamic considerations.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Diuréticos
/
Insuficiencia Cardíaca
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
Límite:
Humans
Idioma:
De
Revista:
Praxis (Bern 1994)
Asunto de la revista:
MEDICINA
Año:
2010
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Suiza