Related Experiment Video
Updated: Oct 19, 2025
07:59
Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
11.4K
Loop diuretic use following fluid resuscitation in the critically ill
Mashael A Alaskar1,2, Joshua D Brown1, Stacy A Voils3
1Department of Pharmaceutical Outcomes and Policy, Center for Drug Evaluation & Safety, University of Florida, College of Pharmacy , Gainesville, FL, USA.
Summary
Loop diuretics are frequently initiated for sepsis patients in the intensive care unit (ICU). Continuation after ICU discharge is common, influenced by factors like acute kidney injury and fluid resuscitation volume.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Nephrology
Background:
- Loop diuretic initiation is common in intensive care unit (ICU) patients with sepsis receiving intravenous fluid resuscitation.
- Understanding the patterns and predictors of loop diuretic continuation is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To determine the incidence of new loop diuretic initiation during ICU stays for sepsis.
- To identify the rate of loop diuretic continuation upon transition from the ICU to the hospital ward.
- To investigate factors associated with loop diuretic continuation after ICU discharge.
Main Methods:
- A single-center retrospective study utilizing electronic health records.
- Inclusion of adult sepsis patients admitted to the ICU between January 1, 2014, and June 30, 2019.
- Analysis of loop diuretic use during ICU stay, transition of care, and hospital discharge, along with associated clinical factors.
Main Results:
- 39.4% of sepsis patients received new loop diuretic prescriptions during their ICU stay.
- 33% of patients continued loop diuretics after transitioning from the ICU.
- Factors associated with continuation included liver disease, acute kidney injury, vasopressor use, blood product transfusion, and high-volume fluid resuscitation (>90 mL/kg).
Conclusions:
- New loop diuretic initiation is a frequent practice for sepsis patients post-fluid resuscitation in the ICU.
- Further research is warranted to evaluate the impact of this practice on patient outcomes and healthcare resource utilization.
Related Concept Videos
01:22Heart Failure Drugs: Diuretics
537
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
537
01:22Acute Kidney Injury VI: Nursing Management
117
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
117
01:20Acute Kidney Injury V: Interprofessional Care
74
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
74
01:30Heart Failure V: Medical Management
52
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
52
01:25Hemodialysis III: Nursing Management
293
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
293
01:28Antihypertensive Drugs: Potassium-Sparing Diuretics
1.7K
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
1.7K