Protocol of Diuretics Use in Congestive Therapy in Heart Failure

Inclusion Criteria:

• Adult patients hospitalized for chronic decompensated congestive heart failurewithout acute pulmonary edema and acute cardiac decompensation against a backgroundof hypertensive crisis

• covered under a social security program

• with legal capacity to give voluntary informed consent to participate in the study

Exclusion Criteria:

• First episode of decompensated congestive heart failure

• Protocolized shock or hypotension (<90 mmHg blood pressure) managed or requiringnitrovasodilators or non-invasive ventilation

• One of the following cardiovascular pathologies: acute myocardial infarction /cardiac tamponade / aortic dissection / acute pulmonary embolism / heart transplant / ventricular assist device / acute pulmonary edema / hypertensive crisis

• More than 12h of intravenous diuretics administered prior to inclusion

• Generalized edema caused by cirrhosis or nephrotic syndrome

• Requiring pleural or peritoneal tap for therapeutic purposes

• Patient allergic or intolerant to furosemide and on long-term bumetanide use

• Patient in dialysis or end-stage chronic kidney disease (CKD-EPI-calculated GFR <15mL/min/1.73m²) or acute kidney injury of known non-cardiac cause

• Severe hypokalemia (< 3 mmol/L) on admission

• Patient who is pregnant, breastfeeding, or of childbearing age not on effectivecontraception

• Adult patient safeguarded under court protection measures (guardianship, wardship,or judicial protection)