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Heart Failure Reviews

, Volume 24, Issue 1, pp 17–30 | Cite as

Loop diuretics in chronic heart failure: how to manage congestion?

  • Justas SimonavičiusEmail author
  • Christian Knackstedt
  • Hans-Peter Brunner-La Rocca
Article
  • 754 Downloads

Abstract

Loop diuretics remain the cornerstone of congestion management in contemporary chronic heart failure care. However, their use is not supported by high quality data, and there is doubt about the safety in the outpatient heart failure setting. Still, congestion is related to a worse outcome, and there is general consensus among experts that congestion should not be tolerated in heart failure patients. Recommendations in international guidelines, regarding decongestion strategies in chronic heart failure, are limited. Thus, there is an emerging need for clinical decision-making support about the best strategy for using loop diuretics and decongestion in the chronic setting. The present review provides a comprehensive overview over the evidence of chronic loop diuretic use. Strategies for the assessment of congestion in the outpatient setting and decongestion algorithm are provided to assist health care specialists in delivering high-quality heart failure care.

Keywords

Chronic heart failure Volume overload Decongestion Loop diuretic Diuretic therapy Diuretic resistance 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10741_2018_9735_MOESM1_ESM.docx (18 kb)
ESM 1 (DOCX 17 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of MedicineVilnius UniversityVilniusLithuania
  2. 2.Centre of Cardiology and AngiologyVilnius University Hospital Santaros KlinikosVilniusLithuania
  3. 3.Department of CardiologyMaastricht University Medical CentreMaastrichtThe Netherlands

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