{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:46:58Z","timestamp":1793083618061,"version":"4.5.0"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Cardiol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>De-resuscitation practices in septic patients with heart failure (HF) are not well characterized. This study aimed to determine if diuretic initiation within 48\u2009hours of intensive care unit (ICU) admission was associated with a positive fluid balance and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This single-center, retrospective cohort study included adult patients with an established diagnosis of HF admitted to the ICU with sepsis or septic shock. The primary outcome was the incidence of positive fluid balance in patients receiving early (&lt;48\u2009hours) versus late (&gt;48\u2009hours) initiation of diuresis. Secondary outcomes included hospital mortality, ventilator-free days, and hospital and ICU length of stay. Continuous variables were assessed using independent t-test or Mann-Whitney U, while categorical variables were evaluated using the Pearson Chi-squared test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 101 patients were included. Positive fluid balance was significantly reduced at 72\u2009hours (\u2212139\u2009mL vs 4370\u2009mL, P\u2009&lt;\u2009.001). The duration of mechanical ventilation (4 vs 5\u2009days, P\u2009=\u2009.129), ventilator-free days (22 vs 18.5\u2009days, P\u2009=\u2009.129), and in-hospital mortality (28 (38%) vs 12 (43%), P\u2009=\u2009.821) were similar between groups. In a subgroup analysis excluding patients not receiving renal replacement therap (RRT) (n\u2009=\u200976), early diuretics was associated with lower incidence of mechanical ventilation (41 [73.2%] vs 20 (100%), P\u2009=\u2009.01) and reduced duration of mechanical ventilation (4 vs 8\u2009days, P\u2009=\u2009.018).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Diuretic use within 48\u2009hours of ICU admission in septic patients with HF resulted in less incidence of positive fluid balance. Early diuresis in this unique patient population warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795468221095875","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T19:20:24Z","timestamp":1652901624000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Early Diuretics for De-resuscitation in Septic Patients With Left Ventricular Dysfunction"],"prefix":"10.1177","volume":"16","author":[{"given":"Timothy W","family":"Jones","sequence":"first","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5891-4492","authenticated-orcid":false,"given":"Aaron M","family":"Chase","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA"},{"name":"Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Bruning","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naphun","family":"Nimmanonda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5171-8405","authenticated-orcid":false,"given":"Susan E","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Athens, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2020-0571","authenticated-orcid":false,"given":"Andrea","family":"Sikora","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA"},{"name":"Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,13]]},"reference":[{"key":"bibr1-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4683-6"},{"key":"bibr2-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1177\/0885066620928299"},{"key":"bibr3-11795468221095875","first-page":"1181","volume":"47","author":"Evans L","year":"2021","journal-title":"Crit Care Med"},{"key":"bibr4-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.115.002922"},{"key":"bibr5-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-2706"},{"key":"bibr6-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.09.029"},{"key":"bibr7-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002184"},{"key":"bibr8-11795468221095875","first-page":"A7048","author":"Duttuluri M","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"bibr9-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201507-1489OC"},{"key":"bibr10-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703058"},{"key":"bibr11-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003960"},{"key":"bibr12-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2020.05.008"},{"key":"bibr13-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0256368"},{"key":"bibr14-11795468221095875","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.171356"},{"key":"bibr15-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1692-3"},{"key":"bibr16-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.508"},{"key":"bibr17-11795468221095875","first-page":"1","volume":"8","author":"Wang MP","year":"2021","journal-title":"Mil Med Res"},{"key":"bibr18-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1177\/0897190019853979"},{"key":"bibr19-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-020-00679-3"},{"key":"bibr20-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0402-x"},{"key":"bibr21-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-02900-y"},{"key":"bibr22-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-2795-9"},{"key":"bibr23-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2019.09.025"},{"key":"bibr24-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.09.012"},{"key":"bibr25-11795468221095875","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacc.2013.05.020","volume":"62","author":"Yancy CW","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"bibr26-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2309-9"},{"key":"bibr27-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0909392"},{"key":"bibr28-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"bibr29-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1177\/0897190021100826"},{"key":"bibr30-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1177\/2050312120979464"},{"key":"bibr31-11795468221095875","first-page":"001857872110163","author":"Gamble KC","year":"2021","journal-title":"Hosp Pharm"},{"key":"bibr32-11795468221095875","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2015.1.2.90"},{"key":"bibr33-11795468221095875","first-page":"897190021999792","author":"Olney WJ","year":"2021","journal-title":"J Pharm Pract"},{"key":"bibr34-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062200"},{"key":"bibr35-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1111\/chf.12020"},{"key":"bibr36-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03108-w"},{"key":"bibr37-11795468221095875","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.2.525"}],"container-title":["Clinical Medicine Insights: Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795468221095875","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795468221095875","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795468221095875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:13:46Z","timestamp":1777389226000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795468221095875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":37,"alternative-id":["10.1177\/11795468221095875"],"URL":"https:\/\/doi.org\/10.1177\/11795468221095875","relation":{},"ISSN":["1179-5468","1179-5468"],"issn-type":[{"value":"1179-5468","type":"print"},{"value":"1179-5468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"article-number":"11795468221095875"}}