Murugan is quick to point out that his analysis shows association, not causation; until a clinical trial is performed to specifically test the effects of removing fluid faster versus slower, he cannot say for sure that removing fluid slowly is better for the patient. And, in some cases, such as imminent heart failure, Murugan says a more rapid removal of fluid might be warranted to prevent sudden death.
"You have to balance the pros and the cons, and decide how fast to remove fluid based on your patient's clinical condition," said Murugan, who also is a member of Pitt's Clinical Research, Investigation, and Systems Modeling of Acute Illness Center and the Center for Critical Care Nephrology. "But in a patient where I can't find an immediate need to get fluid out quickly, I'll be removing fluid at a slower rate until we get definitive results and guidance from a clinical trial."
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