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[PMID]: 29188952 [Au] Autor: Arkkila P; Nordin A [Ti] Título: Treatment of ascites and its complications. [So] Source: Duodecim;132(18):1719-25, 2016. [Is] ISSN: 0012-7183 [Cp] País de publicação: Finland [La] Idioma: eng [Ab] Resumo: The underlying cause of ascites should always be treated if possible. Adhering to a low-salt diet is most important in the treatment of ascites. Diuretics are used in the treatment of clinically established and abundant ascites. The first-line drug in diuretic therapy is spironolactone, when necessary in combination with furosemide. The most important complications of ascites are hepatorenal syndrome and spontaneous bacterial peritonitis. The development of ascites lowers the quality of life, and is associated with significant mortality. Although new groundbreaking therapies are not available, prognosis of the patients is expected to be improved through optimization of current therapies. [Mh] Termos MeSH primário: Ascite/complicações Ascite/terapia [Mh] Termos MeSH secundário: Ascite/mortalidade Dieta Hipossódica Diuréticos/uso terapêutico Furosemida/uso terapêutico Síndrome Hepatorrenal/etiologia Seres Humanos Peritonite/etiologia Prognóstico Qualidade de Vida Espironolactona/uso terapêutico [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Diuretics); 27O7W4T232 (Spironolactone); 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180108 [Lr] Data última revisão: 180108 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171201 [St] Status: MEDLINE

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[PMID]: 29202262 [Au] Autor: Shann F [Ad] Endereço: Royal Children's Hospital, Melbourne, VIC, Australia. frank.shann@rch.org.au. [Ti] Título: Pharmacodynamics of intravenous frusemide bolus in critically ill patients. [So] Source: Crit Care Resusc;19(4):355, 2017 12. [Is] ISSN: 1441-2772 [Cp] País de publicação: Australia [La] Idioma: eng [Mh] Termos MeSH primário: Estado Terminal Furosemida [Mh] Termos MeSH secundário: Seres Humanos Infusões Intravenosas Injeções Intravenosas [Pt] Tipo de publicação: LETTER; COMMENT [Nm] Nome de substância: 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171221 [Lr] Data última revisão: 171221 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171205 [St] Status: MEDLINE

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[PMID]: 29223430 [Au] Autor: da Rosa PR; Rohde LE; Doebber M; Ribeiro ALP; Prado DP; Bertoldi EG; Figueiredo Neto JA; Kohler I; Beck-da-Silva L; Danzmann LC; Moura LZ; Rover M; Simões MV; Sant'Anna RT; Biolo A [Ad] Endereço: Hospital de Clínicas de Porto Alegre e Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, (RS), Brazil; Hospital Moinhos de Vento, Porto Alegre, (RS), Brazil. [Ti] Título: Rational and design of a randomized, double-blind, multicenter trial to evaluate the safety and tolerability of furosemide withdrawal in stable chronic outpatients with heart failure: The ReBIC-1 trial. [So] Source: Am Heart J;194:125-131, 2017 Dec. [Is] ISSN: 1097-6744 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: AIMS: Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evaluate the safety and tolerability of withdrawing furosemide in stable, euvolemic, chronic HF outpatients. This multicenter initiative is part of the Brazilian Research Network in Heart Failure (ReBIC) created to develop clinical studies in HF and composed predominantly by university tertiary care hospitals. METHODS: The ReBIC-1 trial is currently enrolling HF patients in NYHA functional class I-II, left ventricular ejection fraction ≤45%, without a HF-related hospital admission within the last 6 months, receiving a stable dose of furosemide (40 or 80 mg per day) for at least 6 months. Eligible patients will be randomized to maintain or withdraw furosemide in a double-blinded protocol. The trial has two co-primary outcomes: (1) dyspnea assessment using a visual-analogue scale evaluated at 4 time points and (2) the proportion of patients maintained without diuretics during the follow-up period. Total sample size was calculated to be 220 patients. Enrolled patients will be followed up to 90 days after randomization, and diuretic will be restarted if clinical deterioration or signs of congestion are detected. Pre-defined sub-group analysis based on NT-proBNP levels at baseline is planned. PERSPECTIVE: Evidence-based strategies aiming to simplify HF pharmacotherapy are needed in clinical practice. The ReBIC-1 trial will determine the safety of withdrawing furosemide in stable chronic HF patients. [Mh] Termos MeSH primário: Tolerância a Medicamentos Furosemida/administração & dosagem Insuficiência Cardíaca/tratamento farmacológico Pacientes Ambulatoriais [Mh] Termos MeSH secundário: Idoso Biomarcadores/sangue Deterioração Clínica Diuréticos/administração & dosagem Relação Dose-Resposta a Droga Método Duplo-Cego Feminino Insuficiência Cardíaca/sangue Insuficiência Cardíaca/diagnóstico Seres Humanos Masculino Meia-Idade Peptídeo Natriurético Encefálico/sangue Fragmentos de Peptídeos/sangue Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Biomarkers); 0 (Diuretics); 0 (Peptide Fragments); 0 (pro-brain natriuretic peptide (1-76)); 114471-18-0 (Natriuretic Peptide, Brain); 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171215 [Lr] Data última revisão: 171215 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171211 [St] Status: MEDLINE

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[PMID]: 29192005 [Au] Autor: Srivastava T; Jafri S; Truog WE; Sebestyen VanSickle J; Manimtim WM; Alon US [Ad] Endereço: Sections of Nephrology, Bone and Mineral Disorder Clinic, and. [Ti] Título: Successful Reversal of Furosemide-Induced Secondary Hyperparathyroidism With Cinacalcet. [So] Source: Pediatrics;140(6), 2017 Dec. [Is] ISSN: 1098-4275 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Secondary hyperparathyroidism (SHPT) is a rare complication of furosemide therapy that can occur in patients treated with the loop diuretic for a long period of time. We report a 6-month-old 28-weeks premature infant treated chronically with furosemide for his bronchopulmonary dysplasia, who developed hypocalcemia and severe SHPT, adversely affecting his bones. Discontinuation of the loop diuretic and the addition of supplemental calcium and calcitriol only partially reversed the SHPT, bringing serum parathyroid hormone level down from 553 to 238 pg/mL. After introduction of the calcimimetic Cinacalcet, we observed a sustained normalization of parathyroid hormone concentration at 27 to 63 pg/mL and, with that correction, of all biochemical abnormalities and healing of the bone disease. No adverse effects were noted. We conclude that in cases of SHPT due to furosemide in which traditional treatment fails, there may be room to consider the addition of a calcimimetic agent. [Mh] Termos MeSH primário: Calcimiméticos/uso terapêutico Cálcio/sangue Cloridrato de Cinacalcete/uso terapêutico Furosemida/efeitos adversos Hiperparatireoidismo Secundário/induzido quimicamente [Mh] Termos MeSH secundário: Seres Humanos Lactente Imagem por Ressonância Magnética Masculino Hormônio Paratireóideo/sangue [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Calcimimetic Agents); 0 (Parathyroid Hormone); 1K860WSG25 (Cinacalcet Hydrochloride); 7LXU5N7ZO5 (Furosemide); SY7Q814VUP (Calcium) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171211 [Lr] Data última revisão: 171211 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171202 [St] Status: MEDLINE

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[PMID]: 29111110 [Au] Autor: Tan VS; Nash DM; McArthur E; Jain AK; Garg AX; Juurlink DN; Weir MA [Ad] Endereço: Division of Nephrology, Western University, London, Ontario, Canada. [Ti] Título: Impact of Injectable Furosemide Hospital Shortage on Congestive Heart Failure Outcomes: A Time Series Analysis. [So] Source: Can J Cardiol;33(11):1498-1504, 2017 Nov. [Is] ISSN: 1916-7075 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Beginning in February 2012, there was a shortage of injectable furosemide in the province of Ontario, Canada. The objective of this study was to assess the effects of the furosemide shortage on heart failure outcomes in Ontario, Canada. METHODS: We determined which hospitals experienced a shortage of injectable furosemide using an online survey. We then used health administrative data to identify all patients who presented to those hospitals with congestive heart failure. Using 40 months of data from before the shortage, we determined the proportion of patients with heart failure expected to die each month. We then used time series analysis to forecast the 30-day mortality rate during the shortage period and compared it with the observed rate. Secondary outcomes included length of hospital stay, transfer to an intensive care unit, mechanical ventilation during the hospital stay, and risk of 30-day readmission for heart failure. RESULTS: Survey results were obtained for 82% of hospitals, 28 of which experienced a severe shortage of injectable furosemide in the year 2012. The 30-day mortality among patients presenting to these hospitals with congestive heart failure before the shortage period was 11.2%. We forecasted a mortality rate of 11.3% (95% confidence interval, 8.2-14.4) for the shortage period, which was not significantly different from the observed rate of 10.9%. Similarly, we found no significant effect of the shortage on secondary outcomes. CONCLUSIONS: A severe shortage of injectable furosemide did not increase the risk of adverse outcomes among patients who presented to the hospital with congestive heart failure. [Mh] Termos MeSH primário: Furosemida/provisão & distribuição Insuficiência Cardíaca/tratamento farmacológico [Mh] Termos MeSH secundário: Diuréticos/administração & dosagem Diuréticos/provisão & distribuição Feminino Furosemida/administração & dosagem Insuficiência Cardíaca/mortalidade Mortalidade Hospitalar/tendências Seres Humanos Tempo de Internação/estatística & dados numéricos Masculino Ontário/epidemiologia Estudos Retrospectivos Taxa de Sobrevida/tendências [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY [Nm] Nome de substância: 0 (Diuretics); 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171109 [Lr] Data última revisão: 171109 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171108 [St] Status: MEDLINE

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[PMID]: 28834775 [Au] Autor: Machado AI; Dordio A; Fragoso R; Leitão AE; Duarte E [Ad] Endereço: Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisboa, Portugal. Electronic address: isabellmachado@gmail.com. [Ti] Título: Furosemide removal in constructed wetlands: Comparative efficiency of LECA and Cork granulates as support matrix. [So] Source: J Environ Manage;203(Pt 1):422-428, 2017 Dec 01. [Is] ISSN: 1095-8630 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: The removal efficiency of LECA and cork granulates as support matrix for pharmaceuticals active compounds in a constructed wetland system was investigated using the diuretic drug Furosemide. Kinetics studies were performed testing three different concentrations of Furosemide in an ultrapure water matrix, along seven days. LECA achieved higher removal values compared to cork granulates. However, cork granulates presented a higher removal in the first 24 h of contact time compared to the other adsorbent. The kinetic studies showed that LECA and cork granulates have different adsorption behaviours for Furosemide which is controlled by different adsorption mechanisms. Both materials showed good removal efficiencies and a combination of the two should be further explored in order to applied both materials as support matrix to cope with different furosemide concentrations. [Mh] Termos MeSH primário: Furosemida Poluentes Químicos da Água Zonas Úmidas [Mh] Termos MeSH secundário: Cinética Eliminação de Resíduos Líquidos Purificação da Água [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Water Pollutants, Chemical); 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171113 [Lr] Data última revisão: 171113 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170824 [St] Status: MEDLINE

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[PMID]: 28767577 [Au] Autor: Chae MS; Lee N; Park DH; Lee J; Jung HS; Park CS; Lee J; Choi JH; Hong SH [Ad] Endereço: Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. [Ti] Título: Influence of oxygen content immediately after graft reperfusion on occurrence of postoperative acute kidney injury in living donor liver transplantation. [So] Source: Medicine (Baltimore);96(31):e7626, 2017 Aug. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Acute kidney injury (AKI) is a common complication after living donor liver transplantation (LDLT). In this study, we investigated perioperative factors, including oxygen content, related to the postoperative development of AKI after LDLT. The perioperative data of 334 patients were reviewed retrospectively. We identified the postoperative development of AKI based on the Acute Kidney Injury Network criteria. Perioperative variables, including oxygen content, were compared between patients with and without AKI. Potentially significant variables in a univariate analysis were evaluated by multivariate analysis. Postoperative AKI developed in 76 patients (22.7%). Univariate analysis revealed that preoperative factors (body mass index [BMI], diabetes mellitus, C-reactive protein) and intraoperative factors (severe postreperfusion syndrome, packed red blood cell transfusion, furosemide, and oxygen content at the anhepatic phase, 5 minutes and 1 hour after graft reperfusion, and at peritoneal closure) of recipients were significant. The multivariate analysis showed that oxygen content 5 minutes after graft reperfusion, BMI, and furosemide administration were independently associated with postoperative AKI. In conclusion, postoperative AKI was independently associated with oxygen content 5 minutes after graft reperfusion, BMI, and furosemide administration. Meticulous ventilator care and transfusion should be required to maintain sufficient oxygen content immediately after graft reperfusion in patients who undergo LDLT. [Mh] Termos MeSH primário: Lesão Renal Aguda/sangue Transplante de Fígado Oxigênio/sangue Complicações Pós-Operatórias/sangue [Mh] Termos MeSH secundário: Lesão Renal Aguda/diagnóstico Lesão Renal Aguda/prevenção & controle Lesão Renal Aguda/terapia Índice de Massa Corporal Diuréticos/uso terapêutico Feminino Furosemida/uso terapêutico Seres Humanos Tempo de Internação Doadores Vivos Modelos Logísticos Masculino Meia-Idade Análise Multivariada Complicações Pós-Operatórias/diagnóstico Complicações Pós-Operatórias/prevenção & controle Complicações Pós-Operatórias/terapia Prognóstico Reperfusão Respiração Artificial Estudos Retrospectivos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Diuretics); 7LXU5N7ZO5 (Furosemide); S88TT14065 (Oxygen) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 171013 [Lr] Data última revisão: 171013 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170803 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000007626

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[PMID]: 28701670 [Au] Autor: Wan Y; Li L; Niu H; Ma X; Yang J; Yuan C; Mu G; Zhang J [Ad] Endereço: Department of Cardiology, Cangzhou Central Hospital, Hebei Medical University. [Ti] Título: Impact of Compound Hypertonic Saline Solution on Decompensated Heart Failure. [So] Source: Int Heart J;58(4):601-607, 2017 Aug 03. [Is] ISSN: 1349-3299 [Cp] País de publicação: Japan [La] Idioma: eng [Ab] Resumo: The aim of the present study was to evaluate the effects of hypertonic saline solution (C-HSS) with high dose furosemide on hospitalization time, readmission, and mortality in patients with New York Heart Association (NYHA) class III heart failure.Decompensated heart failure patients (NYHA III) with chronic ischemic or nonischemic cardiomyopathy and ejection fraction < 40% were divided into 2 groups in an open-label random manner: the first group received a 1-hour intravenous infusion of furosemide (100 mg) plus compound C-HSS (100 mL) twice daily and underwent serious water restriction (500 mL/day); the second group received furosemide intravenous bolus (100 mg) twice a day and water restriction (500 mL/day), without C-HSS. Both groups had normal sodium (120 mmol sodium) intake. After discharge, the two groups continued to receive 120 mmol Na/day and 500-1000 mL water/day.The first group (132 C-HSS patients) had an increase in urination, a reduction in hospitalization time (4 ± 2 versus 7 ± 2 days, P < 0.01), and a reduction in hospitalization costs (2210 RMB versus 3506 RMB, P < 0.01) compared with the second group (132 without C-HSS patients). During the follow-up period (36 ± 12 months), the first group had a significantly higher average readmission time (31.84 ± 7.58 months versus 15.60 ± 6.25 months, P < 0.01) and lower mortality rate (16.5% versus 31.9%, P < 0.01).The results suggest that periodical C-HSS administration, combined with serious water restriction and a normal sodium diet, significantly reduces the hospitalization time, readmission rate, and mortality in patients with NYHA class III HF. [Mh] Termos MeSH primário: Furosemida/administração & dosagem Insuficiência Cardíaca/tratamento farmacológico Solução Salina Hipertônica/administração & dosagem Volume Sistólico/fisiologia [Mh] Termos MeSH secundário: China/epidemiologia Diuréticos/administração & dosagem Relação Dose-Resposta a Droga Quimioterapia Combinada Feminino Seguimentos Insuficiência Cardíaca/mortalidade Insuficiência Cardíaca/fisiopatologia Mortalidade Hospitalar/tendências Hospitalização/tendências Seres Humanos Infusões Intravenosas Masculino Meia-Idade Estudos Retrospectivos Taxa de Sobrevida/tendências Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Diuretics); 0 (Saline Solution, Hypertonic); 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170810 [Lr] Data última revisão: 170810 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170714 [St] Status: MEDLINE [do] DOI: 10.1536/ihj.16-313

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[PMID]: 28651510 [Au] Autor: Huang A; Luethi N; Mårtensson J; Bellomo R; Cioccari L [Ad] Endereço: Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia. luca.cioccari@gmail.com. [Ti] Título: Pharmacodynamics of intravenous frusemide bolus in critically ill patients. [So] Source: Crit Care Resusc;19(2):142-149, 2017 Jun. [Is] ISSN: 1441-2772 [Cp] País de publicação: Australia [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. DESIGN, SETTING AND PATIENTS: A prospective observational study of 21 critically ill patients in a tertiary intensive care unit in Australia. INTERVENTIONS: We collected information on urine output (UO), fluid balance, serum and urinary electrolyte levels, serum biochemical levels and haemodynamics. We compared data from the 6-hour period before administration of a single IV bolus of frusemide 40 mg with data from the 6-hour period after administration. RESULTS: We studied 21 patients (12 of whom were women) with a median age of 73 years (interquartile range [IQR], 64-80 years). The IV bolus induced a > 1000 mL increase in UO in six patients (28.6%); a 500-1000 mL increase in six patients (28.6%) and a < 500 mL increase in nine patients (42.8%). The median difference in UO before and after frusemide was 590 mL (IQR, 290-1111 mL). The 6-hour fluid balance became negative in 15 patients (71.4%) and positive in six patients (28.6%), with a median change of -595 mL (IQR, -880 to 98 mL). Frusemide significantly increased urinary sodium, potassium and chloride losses and decreased blood chloride levels. There were no detectable changes in haemodynamics. On linear regression analysis, sodium excretion and UO correlated with higher mean arterial pressure (MAP) and age, and with lower albumin and creatinine levels. CONCLUSIONS: In a cohort of critically ill patients without chronic renal impairment, frusemide increased UO and urinary sodium, potassium and chloride losses, and induced hypochloraemia and metabolic alkalosis. However, its diuretic effects were extremely variable and were modified by age, MAP and creatinine and albumin levels. [Mh] Termos MeSH primário: Estado Terminal/terapia Furosemida/farmacologia Furosemida/farmacocinética Inibidores de Simportadores de Cloreto de Sódio e Potássio/farmacologia Inibidores de Simportadores de Cloreto de Sódio e Potássio/farmacocinética [Mh] Termos MeSH secundário: Idoso Estudos de Coortes Relação Dose-Resposta a Droga Eletrólitos/sangue Feminino Furosemida/administração & dosagem Seres Humanos Infusões Intravenosas Masculino Meia-Idade Estudos Prospectivos Inibidores de Simportadores de Cloreto de Sódio e Potássio/administração & dosagem Urodinâmica/efeitos dos fármacos Equilíbrio Hidroeletrolítico/efeitos dos fármacos [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Electrolytes); 0 (Sodium Potassium Chloride Symporter Inhibitors); 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170901 [Lr] Data última revisão: 170901 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170628 [St] Status: MEDLINE

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[PMID]: 28641794 [Au] Autor: Matsue Y; Damman K; Voors AA; Kagiyama N; Yamaguchi T; Kuroda S; Okumura T; Kida K; Mizuno A; Oishi S; Inuzuka Y; Akiyama E; Matsukawa R; Kato K; Suzuki S; Naruke T; Yoshioka K; Miyoshi T; Baba Y; Yamamoto M; Murai K; Mizutani K; Yoshida K; Kitai T [Ad] Endereço: Department of Cardiology, Kameda Medical Center, Chiba, Japan; University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: yuya8950@gmail.com. [Ti] Título: Time-to-Furosemide Treatment and Mortality in Patients Hospitalized With Acute Heart Failure. [So] Source: J Am Coll Cardiol;69(25):3042-3051, 2017 Jun 27. [Is] ISSN: 1558-3597 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Acute heart failure (AHF) is a life-threatening disease requiring urgent treatment, including a recommendation for immediate initiation of loop diuretics. OBJECTIVES: The authors prospectively evaluated the association between time-to-diuretic treatment and clinical outcome. METHODS: REALITY-AHF (Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure) was a prospective, multicenter, observational cohort study that primarily aimed to assess the association between time to loop diuretic treatment and clinical outcome in patients with AHF admitted through the emergency department (ED). Door-to-furosemide (D2F) time was defined as the time from patient arrival at the ED to the first intravenous furosemide injection. Patients with a D2F time <60 min were pre-defined as the early treatment group. Primary outcome was all-cause in-hospital mortality. RESULTS: Among 1,291 AHF patients treated with intravenous furosemide within 24 h of ED arrival, the median D2F time was 90 min (IQR: 36 to 186 min), and 481 patients (37.3%) were categorized as the early treatment group. These patients were more likely to arrive by ambulance and had more signs of congestion compared with the nonearly treatment group. In-hospital mortality was significantly lower in the early treatment group (2.3% vs. 6.0% in the nonearly treatment group; p = 0.002). In multivariate analysis, earlier treatment remained significantly associated with lower in-hospital mortality (odds ratio: 0.39; 95% confidence interval: 0.20 to 0.76; p = 0.006). CONCLUSIONS: In this prospective multicenter, observational cohort study of patients presenting at the ED for AHF, early treatment with intravenous loop diuretics was associated with lower in-hospital mortality. (Registry focused on very early presentation and treatment in emergency department of acute heart failure syndrome; UMIN000014105). [Mh] Termos MeSH primário: Furosemida/administração & dosagem Insuficiência Cardíaca/tratamento farmacológico Pacientes Internados Sistema de Registros Tempo para o Tratamento [Mh] Termos MeSH secundário: Doença Aguda Idoso Diuréticos/administração & dosagem Feminino Seguimentos Insuficiência Cardíaca/mortalidade Mortalidade Hospitalar/tendências Seres Humanos Injeções Intravenosas Masculino Razão de Chances Estudos Prospectivos Taxa de Sobrevida/tendências Fatores de Tempo [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Diuretics); 7LXU5N7ZO5 (Furosemide) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170816 [Lr] Data última revisão: 170816 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170624 [St] Status: MEDLINE

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1			PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
2	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
3	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2

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