Division of Cardiology, Loma Linda University School of Medicine, 11234 Anderson Street, Schuman Pavilion, SP-1617, Loma Linda, CA, 92354, USA.
Centre for Cardiovascular Diseases, University Hospital Brussels, Brussels, Belgium.
Am J Cardiovasc Drugs. 2021 Nov;21(6):595-608. doi: 10.1007/s40256-020-00463-5. Epub 2021 Mar 12.
The inpatient treatment of acute heart failure (AHF) is aimed at achieving euvolemia, relieving symptoms, and reducing rehospitalization. Adequate treatment of AHF is rooted in understanding the pharmacokinetics and pharmacodynamics of select diuretic agents used to achieve decongestion. While loop diuretics remain the primary treatment of AHF, the dosing strategies of loop diuretics and the use of adjunct diuretic classes to augment clinical response can be complex. This review examines the latest strategies for diuretic management in patients with AHF, including dosing and monitoring strategies, interaction of diuretics with other medication classes, use adjunctive therapies, and assessing endpoints for diuretic. The goal of the review is to guide the reader through commonly encountered clinical scenarios and pitfalls in the diuretic management of patients with AHF.
急性心力衰竭（AHF）的住院治疗旨在实现血容量正常化、缓解症状和降低再住院率。充分治疗 AHF 的基础是了解用于实现利尿的特定利尿剂的药代动力学和药效学。虽然袢利尿剂仍然是 AHF 的主要治疗方法，但袢利尿剂的剂量策略以及使用辅助利尿剂类来增强临床反应可能会很复杂。本综述探讨了 AHF 患者利尿剂管理的最新策略，包括剂量和监测策略、利尿剂与其他药物类别的相互作用、辅助治疗的使用以及利尿剂的终点评估。本综述的目的是指导读者应对 AHF 患者利尿剂管理中常见的临床情况和陷阱。
