August 8, 2014Current Opinion in Critical Care
Fluid removal in acute heart failure
Why the study?
What are the optimal strategies for fluid removal and decongestion in patients with acute heart failure?
Population
Patients with acute heart failure requiring fluid removal and decongestion
Comparison
Fluid removal strategies including loop… vs Alternative fluid removal strategies or standard…
Design
Review
Authors
Discussion
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Implication
May favor high-dose diuretics over ultrafiltration in congested AHF with worsening renal function; leaves optimal decongestion strategies open for prospective trials.
Structured PICO
What are the optimal strategies for fluid removal and decongestion in patients with acute heart failure?
P
Population
Patients with acute heart failure requiring fluid removal and decongestion
I
Intervention
Fluid removal strategies including loop diuretics (continuous infusion vs intermittent bolus, high dose vs low dose) and ultrafiltration
C
Comparator
Alternative fluid removal strategies or standard medical therapy
O
Outcome
Decongestion, weight loss, and changes in renal function (serum creatinine)
Decongestion remains a major challenge in acute heart failure, with recent evidence highlighting the trade-offs between aggressive fluid removal strategies and risks of worsening renal function or adverse events.
Cite This Study
Krishnamoorthy et al. (2014) studied this question.