Lasix-albumin drip

 Q: Albumin-furosemide infusion is usually more efficacious than furosemide (Lasix) infusion alone? 

A) True

B) False

Answer: B

Although this is a very common practice in ICUs to add albumin with furosemide, popularly known as Lasix-albumin drip, to increase the diuresis. This is done with the hope that as these patients usually have low albumin, and the addition of albumin will bring the extracellular fluid within the vascular space and keep furosemide within the vascular space, and so will increase efficacy of the diuresis and natriuresis. 

Unfortunately, this practice lacks any evidence. There is no extra net sodium loss. This has been demonstrated in both nephrotic syndrome and cirrhotic patients.

#nephrology

References:

1. Fliser D, Zurbrüggen I, Mutschler E, et al. Coadministration of albumin and furosemide in patients with the nephrotic syndrome. Kidney Int 1999; 55:629. 

2. Chalasani N, Gorski JC, Horlander JC Sr, et al. Effects of albumin/furosemide mixtures on responses to furosemide in hypoalbuminemic patients. J Am Soc Nephrol 2001; 12:1010.