How do you think about using contraction alkalosis as a mark of achieving goal diuresis?

Thank you for your insightful question. Residual congestion at discharge for patients treated for decompensated heart failure is associated with increased rates of readmission and mortality. While I do occasionally use the development of metabolic alkalosis as a marker of decongestion, a review of t...

Thanks so much for this question, which comes up frequently as we care for patients with complex cardiac conditions. Contraction alkalosis is a good marker of achieving goal diuresis, and I use it frequently and confirm it with VBG. In order to promote ongoing diuresis and avoid bicarb retention, I ...