Severity of congestion and hypoperfusion determine guide our treatments in acute decompensated heart failure. Goals of therapy for admitted patients include addressing reversible factors, optimize euvolemia, and advance gold drug medication therapy.
Patients with signs of acute fluid overload should receive intravenous loop diuretics. This improves symptoms and reduces morbidity. Cardiogenic shock and flash pulmonary edema are severe forms of heart failure; requiring more aggresive therapies. Patients presents with congestion should receive diuresis, furosemide IV 40 - 80 mg are general initial doses but some patients may need up to double their home dose. Diuresis should be seen within 30 minutes and consider redosing in two hours.
Volume depletion and electrolyte disturbances can be secondary to overdiuresis. High doses should be diluted due to risk of ototoxicity. Let me know if you have questions in the comments below. Hit the like and follow button for more. and I hope you learned something new.
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