Joe Cuthbert
@jjcuthbert.bsky.social
Senior Lecturer in Cardiology at HYMS. Heart failure researcher. Doubt is not a pleasant condition, but certainty is absurd.
March 31, 2025 at 5:43 AM
We need to know more about hospitalised patients. A priori, if your targeting net fluid loss, then restriction makes sense. But the more you drink, the more you pee - might liberal fluid be beneficial in patients with congestion?? Trend toward quicker diuresis here:
onlinejcf.com/article/S107...
onlinejcf.com/article/S107...
Fluid Restriction in the Management of Decompensated Heart Failure: No Impact on Time to Clinical Stability
To examine the clinical effect of fluid restriction in patients admitted to the hospital
with class IV heart failure (HF).
onlinejcf.com
March 31, 2025 at 5:37 AM
We need to know more about hospitalised patients. A priori, if your targeting net fluid loss, then restriction makes sense. But the more you drink, the more you pee - might liberal fluid be beneficial in patients with congestion?? Trend toward quicker diuresis here:
onlinejcf.com/article/S107...
onlinejcf.com/article/S107...
At least liberal fluid does not appear to be harmful if you’re well (except serum natriuretic peptide concentrations tend to be higher - link.springer.com/article/10.1...)
Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure - Herz
Background The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many pati...
link.springer.com
March 31, 2025 at 5:37 AM
At least liberal fluid does not appear to be harmful if you’re well (except serum natriuretic peptide concentrations tend to be higher - link.springer.com/article/10.1...)
Open label trial so can’t read to much into the “positive” findings for liberal fluid - if you tell people to limit what they drink, they’re going to want a drink and feel thirsty, and be more discontent generally.
March 31, 2025 at 5:37 AM
Open label trial so can’t read to much into the “positive” findings for liberal fluid - if you tell people to limit what they drink, they’re going to want a drink and feel thirsty, and be more discontent generally.
Other opinions are available. And, ultimately, that’s all we have when it comes to diuretics - opinion-based medicine - despite these “positive” urinary Na trials.
onlinejcf.com/article/S107...
onlinejcf.com/article/S107...
March 3, 2025 at 6:22 AM
Other opinions are available. And, ultimately, that’s all we have when it comes to diuretics - opinion-based medicine - despite these “positive” urinary Na trials.
onlinejcf.com/article/S107...
onlinejcf.com/article/S107...
That there are so many techniques and so little agreement (rather like different markers of diastolic dysfunction) suggests we have a long way to go before the US probe can replace the stethoscope
February 28, 2025 at 10:37 PM
That there are so many techniques and so little agreement (rather like different markers of diastolic dysfunction) suggests we have a long way to go before the US probe can replace the stethoscope
I’m not a POCUS enthusiast but it can be useful when uncertainty reigns…as it so often does in patients presenting with breathlessness.
February 28, 2025 at 10:37 PM
I’m not a POCUS enthusiast but it can be useful when uncertainty reigns…as it so often does in patients presenting with breathlessness.
Time from discovery of X-rays to first clinical use was ~3 years.
By comparison, lung ultrasound (for eg) as a means of identifying congestion has been around for ~40 years yet is not widely used.
By comparison, lung ultrasound (for eg) as a means of identifying congestion has been around for ~40 years yet is not widely used.
February 28, 2025 at 10:37 PM
Time from discovery of X-rays to first clinical use was ~3 years.
By comparison, lung ultrasound (for eg) as a means of identifying congestion has been around for ~40 years yet is not widely used.
By comparison, lung ultrasound (for eg) as a means of identifying congestion has been around for ~40 years yet is not widely used.