Protocol of Diuretics Use in Congestive Therapy in Heart Failure

Inclusion Criteria:

• Adult patients hospitalized for chronic decompensated congestive heart failure withoutacute pulmonary edema and acute cardiac decompensation against a background ofhypertensive 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 / cardiactamponade / 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, orjudicial protection)