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Hmmm.. well I appreciate the new perspective. I am not sure its enough for me to eliminate furosemide yet, but I will certainly give it more thought. I still feel that you are selectively choosing data to support your conclusion, for example your reference 6 seems to suggest furosemide may increase LV filling pressures in the short term. It was a study of 15 patients. A similar trial in 20 patients showed a decrease in LV filling pressures in a similar situation ( http:///doi/full//NEJM197305242882102 ). I agree the data supporting diuretics in ADHF is meager and flawed… but I am not sure the data against it is strong enough for me to go against consensus guidelines at this time.

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