ICU Nephrology Secrets:
1. The definition of insanity* is to give bolus iv 40 mg of Lasix (furosemide) without seeing any effect and then starting Lasix drip at 10 mg/hr hoping for a brisk diuretic response... 🤷♂️
#foamed #foamcc #meded #medtwitter #medstudent
1. The definition of insanity* is to give bolus iv 40 mg of Lasix (furosemide) without seeing any effect and then starting Lasix drip at 10 mg/hr hoping for a brisk diuretic response... 🤷♂️
#foamed #foamcc #meded #medtwitter #medstudent
Along the same lines:
2. Switching the ineffective Lasix drip to Bumex (bumetanide) drip at 1 mg/hr and keep hoping to see this:
2. Switching the ineffective Lasix drip to Bumex (bumetanide) drip at 1 mg/hr and keep hoping to see this:
There is more:
3. Checking serial labs (BUN / creat / electrolytes) because the patient is on continuous infusion of a diuretic...
3. Checking serial labs (BUN / creat / electrolytes) because the patient is on continuous infusion of a diuretic...
*insanity = a clinical practice that makes no sense but is hard to let go...
This is not a tweet pro- or against CRRT/HD
I am more interested in basic pharmacology; in the case of loop diuretics, it's all about the sigmoid dose-response curve. If the “threshold dose” is not administered, diuresis cannot begin...
rk.md
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