Improved decongestion with the addition of acetazolamide to intravenous loop diuretics for acute heart failure

Clinical Question

Can the addition of acetazolamide to intravenous diuretics lead to faster decongestion in hospitalized patients with acute decompensated heart failure?

Bottom line

For patients with chronic heart failure who are hospitalized with acute volume overload, the addition of acetazolamide to intravenous loop diuretics leads to faster decongestion. You would need to treat 9 patients with acetazolamide to have one additional patient achieve this outcome. Of note, this trial was initiated prior to the use of SGLT-2 inhibitors for the treatment of heart failure and had a population that was predominantly white. The results may not be generalizable to all populations. 1b

Study design: Randomized controlled trial (double-blinded)

Funding: Government

Setting: Inpatient (any location)


Nita Shrikant Kulkarni, MD
Assistant Professor in Hospital Medicine
Northwestern University
Chicago, IL

Discuss this POEM




Good information in the battle against CHF


Insuffisance cardiaque

Article pertinent dans le contexte de l’hospitalisation pour l’insuffisance cardiaque aiguë et pour une période de temps courte


acetazolamide in acute chf

good addition to iv diuretics