الفهرس 
Exploring Diuretics Effective Management in Acute Decompensated Heart Failure “EDEMA”
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Abstract
Introduction and aim of work
Heart Failure is one of the most common causes of hospital admission all over the world. It represents a global health burden from repeated hospital admissions. In Egypt it shows around almost 3 million admissions annually. Admission mostly is with the diagnosis ADHF. The most used drug during this course are diuretics to help with decongestions and relieving symptoms. Diuretics are also used to maintain the euvolemic status out of the hospital to improve quality of life. One of the most important groups of diuretics are loop diuretics. Furosemide by name is Judged and tested in this article.
The route of administration of furosemide during an event of ADHF is intravenous maybe continuous infusion or bolus. This was tested in previous trials with some bias. In our study we aimed to measure the clinical and laboratory changes posed by each route.
Objectives
Assessing the time to clinical improvement , in terms on NYHA classifications. Assessing the daily changes as regards, urine out, weight loss, cumulative daily dose, diuretics’ efficiency, electrolytes level, kidney functions tests, worsening renal functions, acute kidney injury, and clinical improvement.
Methodology
Patients presenting to the Cardiology Department, Cairo University Hospitals with ADHF on top of chronic heart failure deemed by the attending physician to need hospital admission for IV diuretics. Clinical assessment, laboratory workup and imaging modalities were used and followed up during the hospital stat. There was 30-day follow up period.
Results
The p value was similar as regarded the time for NYHA improvement, hospital stay, resuming beta blocker dose and switching to oral diuretics. No difference was detected in the 30-day follow up. The significant difference was a higher risk of hypokalaemia with shots route. There was a statistical significance across the second day urine output levels.
Conclusion
Compared to IV shots, infusion of furosemide to patient admitted with ADHF was associated with excellent Hemodynamics, electrolytes, kidney function profile with similar periods to clinical improvement and hospital discharge, even with a larger dose and sicker patient profile