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Diuretic use in critical care.

R G Narins, P Chusid

    The American Journal of Cardiology
    |January 24, 1986
    PubMed
    Summary

    Diuretics like mannitol and loop diuretics are vital in critical care for conditions such as pulmonary edema and hypercalcemia. Their use in acute tubular necrosis requires careful consideration due to limited efficacy data.

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    Area of Science:

    • Critical Care Medicine
    • Nephrology
    • Pharmacology

    Background:

    • Diuretics are extensively used in critical care settings.
    • Mannitol and loop diuretics are common agents for various life-threatening conditions.

    Purpose of the Study:

    • To review the application of mannitol and loop diuretics in critical care.
    • To discuss their efficacy and rational use in specific disorders.

    Main Methods:

    • Review of existing literature on diuretic use in critical care.
    • Analysis of pharmacological effects and clinical applications of mannitol and loop diuretics.

    Main Results:

    • Loop diuretics (bumetanide, furosemide, ethacrynic acid) alleviate pulmonary edema through venodilatory and natriuretic effects.
    • Efficacy data for preventing or treating acute tubular necrosis with these diuretics are limited.
    • Loop diuretics are effective in managing hypercalcemia by inhibiting calcium reabsorption.
    • Loop diuretics can be utilized to manage hyperkalemia due to their kaliuretic effect.

    Conclusions:

    • Diuretics play a significant role in managing critical care conditions like pulmonary edema, hypercalcemia, and hyperkalemia.
    • Careful consideration and further research are needed regarding their role in acute tubular necrosis.
    • Understanding diuretic mechanisms is key to their rational application in critical care.

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