Wednesday, March 2, 2011


This Week at March 3, 2011
In this issue of the Journal, Felker and colleagues report the results of the Diuretic Optimization Strategies Evaluation trial (DOSE; number, NCT00577135).
look at this for details.
basically they compaired high dose lasix vs. low dose. also compared intermittent q12 vs. continues.
high dose was not better. intermittentjust as good, transient Renal injury with high dose group

this is a direct qoute from the link below
"What are the implications of this trial? The DOSE trial has importantly identified a lack of greater benefit with the diuretic regimen of continuous infusion — a regimen that is used frequently — than with a regimen of intermittent boluses. It also showed that, despite theoretical concerns and the findings of prior observational studies, a high dose of loop diuretics, as compared with a low dose, did not substantially worsen renal function. Both of these findings should change current practice. Since a high-dose regimen may relieve dyspnea more quickly without adverse effects on renal function, that regimen is preferable to a low-dose regimen. Administration of boluses may be more convenient than continuous infusion and equally effective.

Comparative Effectiveness of Diuretic Regimens
G.C. Fonarow N Engl J Med 2011

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