title: Initial experience of use of tolvaptan in critically ill patients with fluid overload.
abstract: OBJECTIVE
  Positive volume balance is related with high mortality in critically ill patients. We describe our experience in the use of tolvaptan in patients with fluid overload.
  
  
  METHODS
  Six patients in the recovery phase from septic shock were included. All patients achieved an increase in diuresis after the first day, with a median fluid balance variation of -2362 (-485 to -3447) mL. At the end of treatment, median fluid balance variation was -9080 (-26,784 to -4395) mL.
  
  
  CONCLUSIONS
  Tolvaptan could be an option in critically ill patients with fluid overload and resistant or not treatable with conventional diuretics.
authors.affiliation: Intensive Care Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz-Ramos
authors.forename: M
authors.initials: M
authors.lastname: Gordon
authors.forename: M A
authors.initials: MA
authors.lastname: Cortes
authors.forename: M J
authors.initials: MJ
authors.lastname: Broch
authors.forename: P
authors.initials: P
authors.lastname: Ramirez
mesh_terms: D000368:Aged; D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D001826:Body Fluids / Q000187:drug effects; D016638:Critical Illness; D004231:Diuresis / Q000187:drug effects*; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000628:therapy*; D000077602:Tolvaptan; D016896:Treatment Outcome
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan
keywords: clinical pharmacy; drug utilisation; furosemide