Coadministração de Albumina e Furosemida na Insuficiência Cardíaca Aguda com Resistência aos Diuréticos
DOI:
https://doi.org/10.20344/amp.17714Palavras-chave:
Albuminas, Diuréticos, Furosemida, Inibidores de Simportadores de Cloreto de Sódio e Potássio, Insuficiência Cardíaca, Resistência a MedicamentosResumo
A insuficiência cardíaca aguda é uma causa frequente de internamento hospitalar em Portugal, com tendência a aumentar devido ao envelhecimento da população. Apesar de a maioria dos internamentos por insuficiência cardíaca aguda ser motivada por quadros congestivos, nem todos os doentes apresentam um fenótipo congestivo, o que reflecte a complexidade de um processo com múltiplas vias fisiopatológicas. A utilização de diuréticos, habitualmente diuréticos de ansa, constitui a base do tratamento da congestão. No entanto, muitos doentes desenvolvem resistência, constituindo assim um desafio sem solução consensual até à data, apesar do extenso debate ao longo dos anos. Apesar da sua utilização frequente na prática clínica, a coadministração de albumina e furosemida permanece controversa na gestão de doentes com insuficiência cardíaca aguda, hipoalbuminémia e resistência aos diuréticos. Esta revisão aborda os mecanismos fisiopatológicos da congestão nesses doentes e explora a base teórica que suporta a coadministração de albumina e furosemida no respectivo contexto clínico. Pretende-se clarificar o potencial benefício da estratégia combinada nesta
população específica e identificar possíveis lacunas na literatura que possam ser alvo de estudos futuros.
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