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Wednesday, December 11, 2019

Hyperdiuresis

PulmCrit (EMCrit)
PulmCrit - December 09, 2019 - By Josh Farkas
"Summary Th Bullet:
  • Hyperdiuresis involves the combination of large doses of furosemide plus hypertonic saline to facilitate diuresis. Theoretically, the two agents may function synergistically to achieve decongestion while preserving renal function.
  • Hyperdiuresis remains a counterintuitive and controversial therapy. However, it is supported by a moderate amount of clinical evidence. Studies reviewed above suggest that hyperdiuresis is safe and effective across a variety of different contexts.
  • Additional evidence is needed to clarify the value of this therapy. In the interim, attempting hyperdiuresis may be reasonable for patients who have failed conventional therapies and don't have other great treatment options (e.g. hyperdiuresis versus ultrafiltration/hemodialysis versus palliative care). If hyperdiuresis is attempted, it must be monitored carefully and discontinued if patients don't respond favorably."