{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T20:47:30Z","timestamp":1774558050732,"version":"3.50.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To estimate the effects of diuretic use during the first 24 hours of an ICU stay on in-hospital mortality and other clinical outcomes including acute kidney injury and duration of mechanical ventilation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Urban, academic medical center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Adult patients admitted to medical or cardiac ICUs between 2001 and 2012, excluding those on maintenance dialysis or with ICU length of stay less than 24 hours.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>None.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Measurements and Main Results:<\/jats:title>\n            <jats:p>We included 13,589 patients: 2,606 with and 10,983 without early diuretic use (loop diuretic exposure during the first 24\u2009hr of an ICU stay). Propensity score matching generated 2,523 pairs with well-balanced baseline characteristics. Early diuretic use was unassociated with in-hospital mortality (risk ratio, 1.01; 99.5% CI, 0.83\u20131.22). We found no evidence of associations with ICU or hospital length of stay, or duration or provision of mechanical ventilation. Early diuretic use was associated with higher rates of subsequent acute kidney injury (risk ratio, 1.41; 99.5% CI, 1.25\u20131.59) and electrolyte abnormalities. Results were not materially different in subgroups of patients with heart failure, chronic kidney disease, or acute lung injury.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Early diuretic use in critical illness was unassociated with in-hospital mortality, ICU or hospital length of stay, or duration of mechanical ventilation, but risks of acute kidney injury and electrolyte abnormalities were higher.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/cce.0000000000000021","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T21:51:52Z","timestamp":1562881912000},"page":"e0021","source":"Crossref","is-referenced-by-count":3,"title":["Estimated Effects of Early Diuretic Use in Critical Illness"],"prefix":"10.1097","volume":"1","author":[{"given":"Ian E.","family":"McCoy","sequence":"first","affiliation":[{"name":"All authors: Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria E.","family":"Montez-Rath","sequence":"additional","affiliation":[{"name":"All authors: Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn M.","family":"Chertow","sequence":"additional","affiliation":[{"name":"All authors: Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara I.","family":"Chang","sequence":"additional","affiliation":[{"name":"All authors: Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,7]]},"reference":[{"key":"R1-20230728","first-page":"361","article-title":"Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: A systematic review with suggestions for clinical practice.","volume":"46","author":"Roberts","year":"2014","journal-title":"Anestezjol Intens Ter"},{"key":"R2-20230728","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1097\/CCM.0000000000003276","article-title":"Deresuscitation of patients with iatrogenic fluid overload is associated with reduced mortality in critical illness.","volume":"46","author":"Silversides","year":"2018","journal-title":"Crit Care Med"},{"key":"R3-20230728","doi-asserted-by":"crossref","first-page":"966","DOI":"10.2215\/CJN.08781010","article-title":"Fluid balance, diuretic use, and mortality in acute kidney injury.","volume":"6","author":"Grams","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"R4-20230728","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1186\/s13054-015-1085-4","article-title":"Fluid balance and mortality in critically ill patients with acute kidney injury: A multicenter prospective epidemiological study.","volume":"19","author":"Wang","year":"2015","journal-title":"Crit Care"},{"key":"R5-20230728","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1038\/ki.2009.159","article-title":"Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury.","volume":"76","author":"Bouchard","year":"2009","journal-title":"Kidney Int"},{"key":"R6-20230728","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13054-019-2309-9","article-title":"Early diuretic use and mortality in critically ill patients with vasopressor support: A propensity score-matching analysis.","volume":"23","author":"Shen","year":"2019","journal-title":"Crit Care"},{"key":"R7-20230728","doi-asserted-by":"crossref","first-page":"2547","DOI":"10.1001\/jama.288.20.2547","article-title":"Diuretics, mortality, and nonrecovery of renal function in acute renal failure.","volume":"288","author":"Mehta","year":"2002","journal-title":"JAMA"},{"key":"R8-20230728","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jcrc.2017.04.045","article-title":"Effect of high-dose furosemide on the prognosis of critically ill patients.","volume":"41","author":"Lee","year":"2017","journal-title":"J Crit Care"},{"key":"R9-20230728","doi-asserted-by":"crossref","first-page":"2564","DOI":"10.1056\/NEJMoa062200","article-title":"Comparison of two fluid-management strategies in acute lung injury.","volume":"354","author":"Wiedemann","year":"2006","journal-title":"N Engl J Med"},{"key":"R10-20230728","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1159\/000102089","article-title":"Diuretics in the management of acute kidney injury: A multinational survey.","volume":"156","author":"Bagshaw","year":"2007","journal-title":"Contrib Nephrol"},{"key":"R11-20230728","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1097\/CCM.0000000000001135","article-title":"Can we trust observational studies using propensity scores in the critical care literature? A systematic comparison with randomized clinical trials.","volume":"43","author":"Kitsios","year":"2015","journal-title":"Crit Care Med"},{"key":"R12-20230728","doi-asserted-by":"crossref","first-page":"160035","DOI":"10.1038\/sdata.2016.35","article-title":"MIMIC-III, a freely accessible critical care database.","volume":"3","author":"Johnson","year":"2016","journal-title":"Sci Data"},{"key":"R16-20230728","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/BF01709751","article-title":"The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction\/failure. On behalf of the Working Group on sepsis-related problems of the European Society of Intensive Care Medicine.","volume":"22","author":"Vincent","year":"1996","journal-title":"Intensive Care Med"},{"key":"R17-20230728","first-page":"1","article-title":"KDIGO clinical practice guideline for acute kidney injury.","volume":"2","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"R18-20230728","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ekir.2017.08.011","article-title":"Acute kidney injury ascertainment is affected by the use of first inpatient versus outpatient baseline serum creatinine.","volume":"3","author":"Liu","year":"2018","journal-title":"Kidney Int Rep"},{"key":"R20-20230728","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/S0895-4356(00)00321-8","article-title":"Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: A matched analysis using propensity scores.","volume":"54","author":"Normand","year":"2001","journal-title":"J Clin Epidemiol"},{"key":"R22-20230728","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1053\/j.ajkd.2014.10.018","article-title":"Risk factors for acute kidney injury in older adults with critical illness: A retrospective cohort study.","volume":"65","author":"Kane-Gill","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"R23-20230728","doi-asserted-by":"crossref","first-page":"3365","DOI":"10.1681\/ASN.2004090740","article-title":"Acute kidney injury, mortality, length of stay, and costs in hospitalized patients.","volume":"16","author":"Chertow","year":"2005","journal-title":"J Am Soc Nephrol"},{"key":"R24-20230728","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1002\/sim.2328","article-title":"A comparison of propensity score methods: A case-study estimating the effectiveness of post-AMI statin use.","volume":"25","author":"Austin","year":"2006","journal-title":"Stat Med"},{"key":"R25-20230728","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1093\/jamia\/ocx084","article-title":"The MIMIC code repository: Enabling reproducibility in critical care research.","volume":"25","author":"Johnson","year":"2018","journal-title":"J Am Med Inform Assoc"}],"container-title":["Critical Care Explorations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/02107256-201907000-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T04:09:39Z","timestamp":1690517379000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/02107256-201907000-00003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":20,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1097\/cce.0000000000000021","relation":{},"ISSN":["2639-8028"],"issn-type":[{"value":"2639-8028","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}