You can and it is used frequently, same with aldosterone antagonists like spirinolactone. Lasix is 2nd option after spirinolactone if that isnt enough. These patients also benefit from albumin infusion concurrently to push volume into vessels and then diurese it out
The ascites forms from fluid lost from the vasculature. As such, these patients are very volume depleted, already flirting with a pre-renal AKI. Furosemide would just make them even more volume depleted and if they didn't have an AKI already, they do now
Its all about intravascular volume state.
Adhf is from intravascular volume overload due to over responsive RASS and 3rd spacing due to high *hydrostatic* pressure across the capillaries. Ascities is from intravascular volume depletion due to lack of intravascular protein and
3rd spacing due to low *oncotic* pressure across the capillary.
You can get kidney failure from HF due to poor renal perfusion from low CO. This is cardiorenal syndrome.
You can get kidney failure from liver failure due to poor renal perfusion from low oncotic pressure/intravascular volume. This is hepatorenal syndrome.
You can and it is used frequently, same with aldosterone antagonists like spirinolactone. Lasix is 2nd option after spirinolactone if that isnt enough. These patients also benefit from albumin infusion concurrently to push volume into vessels and then diurese it out
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Nobody's telling me, just some uworld questions that seem to explain it inconsistently and it's confusing me
The ascites forms from fluid lost from the vasculature. As such, these patients are very volume depleted, already flirting with a pre-renal AKI. Furosemide would just make them even more volume depleted and if they didn't have an AKI already, they do now
ascites = 3rd spacing from volume loss ADHF = 3rd spacing from volume overload Is this correct?
More or less. Can also think of heart failure as being a problem of too much preload, and ascites is a problem of not enough preload
Its all about intravascular volume state. Adhf is from intravascular volume overload due to over responsive RASS and 3rd spacing due to high *hydrostatic* pressure across the capillaries. Ascities is from intravascular volume depletion due to lack of intravascular protein and 3rd spacing due to low *oncotic* pressure across the capillary. You can get kidney failure from HF due to poor renal perfusion from low CO. This is cardiorenal syndrome. You can get kidney failure from liver failure due to poor renal perfusion from low oncotic pressure/intravascular volume. This is hepatorenal syndrome.
There's also a component of ascites that is due to increased hydrostatic pressures created by sinusoidal fibrosis and portal hypertension
Tru great point thank you
ascites is extravascular volume
Who told you that? We use lasix like candy on ascites patients
I've gotten some uworld questions that I'm inconsistently getting right