All right, so welcome back to the Internet Book of Critical Care podcast.

Welcome to 2020. I'm here with Adam Thomas. We're going to talk about diureasus.

And what a way to kick off the new year, Josh, with what's going to be a bohemoth.

But I think one of my favorite posts you've ever done and one of my favorite podcasts because it covers everything.

Yeah, you've been, you've been asking for this one for a while.

I have been. This is my fault. So ladies and gentlemen, if you think this is too much, you can blame me.

So today what we'll cover is a brief introduction around diuretics, diuretic use, and maybe some bad reputations it's got. We'll go over specific agents and very

lightly talk about the mechanism of action, the indications and contraindications. And then

the meat and potatoes, the really important part of this post is we're going to talk about general

strategies to diureasus or dominating the diureas and problem shooting. So specifically, Josh, thank you. You've

covered volume removal from the pleurineum. We've covered large volume diuretisus, caloreciseus, diuretic

resistance, and the ferrosamide stress test. And then we got some specific troubleshooting in there.

Let's not belabor this because it's going to go long. So let's get straight into the introduction.

Other than me pestering the hell out of you, what is the rationale for this chapter?

As an internal medicine resident during my training, my understanding of diarocyst was pretty superficial.

You kind of like throw a furorosomite of people.

And if they didn't respond, you'd throw some more at them.

And then maybe you'd put them on an infusion. And that works most of the time if you're just trying to take

off a couple liters of fluid. But then once you're in the critical care unit and you're,

you encounter folks where you're pulling off like five or 10 or 15 liters of fluid, you realize

that that really falls apart and you start running into issues with hypochulemia, metabolic alkalosis, hypernatremia, and then over time you realize that you really need a more sophisticated approach.

So from that sophistication, we talk about the general approach to adding more than just

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