May 4, 2026 · 42 min · 17 segments
When, how, and most importantly WHY we should be using diuretics. Also, checkout Rapid Sequence, our new choose-your-own-adventure resuscitation game at rapidsequence.org (coupon code for ICUedu…
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Now let's talk about what we actually wanna talk about today, which is intelligent use of diuretics.
As with basically all interventions in critical care, step number zero is always to have a working hypothesis about what's wrong with your patient and then a fairly specific idea about what you're trying to accomplish and/or what hypothesis you're trying to test with a particular intervention.
And this is so true when you're talking about diuretics because I often see people doing this thing when they're like, "Okay, the urine output is low", and they kinda just throw some fluids or furosemide or both at the same time, uh, just to kinda hope that it'll make that number better.
Now, the first issue here is really getting at the idea that making the number pretty doesn't necessarily mean that you've made the patient better.
Now, it makes us feel better to have a good-looking hourly urine output, of course, and, you know, the attending or the surgeon is less likely to be upset if it looks better, but the very first question you have to ask yourself in this situation is whether a low urine output is actually a problem in the first place.
Now let's talk about what we actually wanna talk about today, which is intelligent use of diuretics.
As with basically all interventions in critical care, step number zero is always to have a working hypothesis about what's wrong with your patient and then a fairly specific idea about what you're trying to accomplish and/or what hypothesis you're trying to test with a particular intervention.
And this is so true when you're talking about diuretics because I often see people doing this thing when they're like, "Okay, the urine output is low", and they kinda just throw some fluids or furosemide or both at the same time, uh, just to kinda hope that it'll make that number better.
Now, the first issue here is really getting at the idea that making the number pretty doesn't necessarily mean that you've made the patient better.
Now, it makes us feel better to have a good-looking hourly urine output, of course, and, you know, the attending or the surgeon is less likely to be upset if it looks better, but the very first question you have to ask yourself in this situation is whether a low urine output is actually a problem in the first place.
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