What is your approach to treating patients with decompensated heart failure when their hypervolemia is refractory to oral furosemide?

Depending on the oral dose, it may just be a problem of underdosing or even perhaps non-adherence. We would typically transition to intermittent IV Lasix dosing with close monitoring, if minimal response, we can double the dose to try and get to the ceiling effect of Lasix, depending on the renal fu...

I never do PO diuretics for decompensated heart failure.

Decompensated heart failure requires hospitalization and IV diuresis; dose is determined by home dose, urine output after the first dose, or urine sodium after the first dose. BID dose is usually sufficient.

Continuous infusion is sometimes us...

As a hospitalist, I most frequently treat patients who have already had escalating at-home dosing of PO diuretics and who have developed poor absorption due to gut edema. I would not treat someone with decompensated heart failure requiring admission with anything but IV. I try to dose q6 during waki...