Dr Divago

💧 Hypertonic saline + furosemide in fluid overload. Fluid overload remains a major driver of morbidity and mortality in critically ill patients and acute decompensated heart failure. A systematic review and meta analysis evaluating the combination of hypertonic saline solution with intravenous furosemide provides important insights into a potential strategy to enhance decongestion. 🔑 Key findings: • 11 randomized controlled trials • 2987 patients with acute decompensated heart failure • Compared with furosemide alone, the combination therapy was associated with: Reduced all cause mortality Reduced heart failure related readmissions Shorter hospital length of stay • Improved decongestion profile: Higher daily diuresis Greater weight loss Increased natriuresis Reduction in serum creatinine • Physiological interpretation: Hypertonic saline may improve intravascular refill and renal perfusion Enhances diuretic response and sodium excretion Potentially overcomes diuretic resistance 👉 Clinical perspective: This strategy may be particularly useful in patients with diuretic resistance and severe congestion However, evidence remains moderate and should be individualized 👉 Bottom line: Not just removing fluid Optimizing the intravascular compartment is key 📖 Reference Liu C, Peng Z, Gao X, et al. Simultaneous use of hypertonic saline and IV furosemide for fluid overload. Critical Care Medicine. 2021. doi:10.1097/CCM.0000000000005174

Nothing stopping us from changing “et al” to “and the fellas”

e essa mulher que decidiu fechar as costas com uma tatuagem numa única sessão

BREAKING: Volkswagen is in talks with Israel’s Iron Dome maker over a deal that would switch production at one of their factories from cars to missile defense, per FT. The German government is actively supporting the proposal.

I’m absolutely outraged!!! I’ve just found out that Cadbury are flattening Easter Eggs into some kind of bar and are selling them all year round in a further attack on Easter!! We are a Christian country!!