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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why Are CHF Palliative Patients Not Treatment With Lasix?

Why are CHF palliative patients not managed with Lasix right up to the end, or at least close to the end. I had a patient who was palliative with CHF, not eating, bed riden, only responding by making eye contant. This patient was SOB with morphine and oxygen therapy. I gave the patient Lasix IM, and within the hour the pt was resping easy and quite comfortable all night. This is not often done, and I always wonder why.
Fri, 23 Oct 2015
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Cardiologist 's  Response
Dear Sir/ Madam
Thanks for your query.
Lasix which is a diuretic is only indicated for the patients with overt fluid overload or when they had overt fluid overload and you suspect that they will develop it in the absence of diuretics. It is not a drug which prolongs life, hence is given for symptomatic relief only.
Sincerely
Sukhvinder
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Cardiologist Dr. Ilir Sharka's  Response
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that diuretics are the most widely prescribed medications in CHF, accounting for around 85% of patients in acutely decompensated conditions.
Use of diuretics is guided by symptomatic (dyspnea) and congestion relief outcomes. Furthermore, current clinical guidelines, do recommend their use in symptomatic patients.
But before, thinking of a diuretics strategy, it is better to maintain acceptable blood pressure values (to provide a steady kidney blood supply and assure for a beneficial diuretics effect). So, without a stable hemodynamics profile (avoidance of obvious hypotension) diuretics use wouls hardly yield a beneficial effect regarding symptomatic and congestion relief.

Hope to have been helpful to you! Greetings! Dr. Iliri
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Why Are CHF Palliative Patients Not Treatment With Lasix?

Dear Sir/ Madam Thanks for your query. Lasix which is a diuretic is only indicated for the patients with overt fluid overload or when they had overt fluid overload and you suspect that they will develop it in the absence of diuretics. It is not a drug which prolongs life, hence is given for symptomatic relief only. Sincerely Sukhvinder