Publication:

Analysis of usage of diuretics in medical intensive care unit of SIMS-Shimoga a tertiary care hospital

Background Patients are admitted in the intensive care unit (ICU) with a history of various acute and chronic clinical conditions associated with organ failures. Compared to the patients admitted in the general wards the mortality and morbidity are high in ICU patients. The patients in ICU are subjected to multiple drugs; diuretic agents are liberally and deliberately used in this setup despite the lack of evidence supporting their benefits.

Methods The main aim of the study was to know the extent of use of diuretics in the ICU set up, to categorize the use of diuretics in different clinical conditions and different classes of diuretics used. The study also tried to determine adverse events and outcome in critically ill patients. The study was a retrospective cross-sectional of 3 months duration conducted in all patients admitted in the medical ICU of the tertiary care center. The study mainly concentrated on the usage of diuretics and related aspects.

Results Loop diuretics (54.81%) composed the major class, thiazides (30.84%). Potassium sparing diuretics (7%) and osmotic diuretics (7%) and carbonic anhydrase inhibitors (1%) were the other class of diuretics. The classes of drugs used in ICU along with diuretics were antibiotics (30%), analgesics (9.5%), anti-inflammatory (6.36%), and drugs acting on blood (10.18%) of total drugs used in ICU. Antacids/laxatives (7.3%) and antiemetic (4.8%), the rest of drugs (15%) of drugs used in ICU.

Conclusion In almost 95% of cases, the combination of other drugs along with diuretics was considered to be rational.