Document Detail

Beyond diuretics: management of volume overload in acute heart failure syndromes.
MedLine Citation:
PMID:  17113399     Owner:  NLM     Status:  MEDLINE    
Diuretics are an established foundation of therapy for patients with chronic heart failure (HF) as well as for those hospitalized for treatment of acute HF syndromes. Despite the accepted use of diuretics in acute HF syndromes, treatment patterns with diuretics vary widely, and there are no data from randomized studies on the benefit of diuretics on morbidity or mortality in patients hospitalized with acute HF syndromes. Additional pharmacologic therapies that complement or replace diuretics in this setting, especially in patients with diuretic resistance, include positive inotropes, nitrovasodilators, and natriuretic peptides, but data are likewise lacking on important clinical outcomes. Ultrafiltration has also been used as a nonpharmacologic strategy to treat patients with acute HF syndromes who exhibit resistance to diuretics. Effective monitoring of volume status with newer modalities may allow more selective use of diuretics and diuretic-like modalities, but additional randomized trial data are clearly needed to establish ideal strategies to promote volume removal in acute HF syndromes.
James A Hill; Clyde W Yancy; William T Abraham
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  119     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-20     Completed Date:  2007-06-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S37-44     Citation Subset:  AIM; IM    
Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
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MeSH Terms
Acute Disease
Blood Volume / drug effects
Cardiotonic Agents / therapeutic use*
Diuretics / adverse effects,  therapeutic use
Drug Resistance
Drug Therapy, Combination
Heart Failure / complications*,  drug therapy*
Vasodilator Agents / therapeutic use*
Water-Electrolyte Balance / drug effects*
Reg. No./Substance:
0/Cardiotonic Agents; 0/Diuretics; 0/Vasodilator Agents
Comment In:
Am J Med. 2006 Dec;119(12 Suppl 1):S1-2   [PMID:  17113394 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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