Basic Concepts of Fluid and Electrolyte Therapy
Basic Concepts of Fluid and Electrolyte Therapy
Basic Concepts of Fluid and Electrolyte Therapy
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Diuretics<br />
A common clinical question with oliguric AKI is whether the administration<br />
<strong>of</strong> loop diuretics (furosemide, bumetanide) improves renal<br />
recovery by increasing urine output. Studies have demonstrated that<br />
the use <strong>of</strong> high-dose loop diuretic to increase urine output in patients<br />
with established AKI does not decrease the need for renal replacement<br />
therapy or improve survival.<br />
Loop diuretics may have a short-term role in managing fluid overload<br />
<strong>and</strong> pulmonary oedema. In these patients intravenous loop diuretics<br />
may be used cautiously to try <strong>and</strong> establish a diuresis <strong>and</strong> treat the<br />
pulmonary oedema. If the patient fails to respond, referral to the renal<br />
team is recommended. It must be remembered that high-dose loop<br />
diuretics are not without side-effects <strong>and</strong> may cause permanent hearing<br />
loss.<br />
77
Change language