What is the correct approach for a patient who has significant fluid overload and requires urgent diuresis?

In the context of significant fluid overload requiring urgent diuresis, utilizing intravenous loop diuretics at up to 2.5 times their oral dose is the most effective approach. This strategy allows for rapid and potent diuresis, which is crucial for patients experiencing acute fluid overload, particularly in settings such as heart failure or acute kidney injury.

Intravenous loop diuretics, such as furosemide, work quickly compared to oral formulations, providing immediate relief from symptoms associated with fluid retention, such as dyspnea and peripheral edema. Dosing them at higher levels (up to 2.5 times the equivalent oral dosage) is often necessary in acute situations to achieve adequate diuresis, especially when rapid mobilization of excess fluid is essential.

Other approaches may not be appropriate under these urgent circumstances. For instance, starting low-dose diuretics may not provide sufficient diuresis in critically ill patients or those with severe overload. Switching to oral diuretics would delay the onset of action and may not effectively manage urgent fluid overload. Delaying treatment until renal function stabilizes can worsen outcomes by allowing the fluid overload condition to persist and potentially exacerbate heart or kidney function. Hence, the most appropriate and immediate approach is to use