How to diurese a diuretic resistant patient ?

Diuretic resistance can reduce the effectiveness of loop diuretics. In this lecture we will evaluate reasons for diuretic resistance and how to overcome it using evidence available in the literature. This lecture is meant for hemodynamically stable CHF patients with volume overload/congestion. References : 1. Principles of pharmacology. Pathophysiologic basis of drug therapy. David Golan. Lippincott Williams Wilkins. 2. Pathophysiology of Diuretic Resistance and Its Implications for the Management of Chronic Heart Failure. Hypertension. 2020;76:1045–1054 3. Diuretic Resistance. Ewout J. Hoorn. Am J Kidney Dis. 2017 Jan;69(1):136-142. 4. Diuretic Treatment in Heart Failure .David H. Ellison . N Engl J Med 2017;377:1964-75. 5. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines 6. The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the ESC. European Journal of Heart Failure (2019) 21, 137–155 7. Physiology and Pathophysiology of Potassium Homeostasis: Core Curriculum 2019. Biff F. Palmer and Deborah J. Clegg. Am J Kidney Dis. 2019 Nov;74(5):682-695 8. Clinical physiology of acid base and electrolyte disorders. Burton Rose & Theodore Post. fifth edition. You will find following useful. 1. Metabolic alkalosis – pathophysiology :    • Metabolic alkalosis - pathophysiology.   2. How to use loop diuretics ?    • Understanding pharmacokinetics to bet...   3. How to dose loop diuretics ?    • How to dose loop diuretics ?   4. Non anion gap metabolic acidosis :    • Non Anion Gap Metabolic Acidosis (NAG...   Disclaimer: This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only. Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional. Unless otherwise specified, these lectures are intended only for adult population and may not apply to pediatric/neonates.

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