Acetazolamide + Furosemide: Boosting Diuretic Response & Fighting Alkalosis in the ICU

In this episode, we dive into a new pilot RCT exploring the addition of acetazolamide to furosemide in critically ill patients. We break down the study’s methods, findings, and practical implications for fluid management in the ICU. Could this inexpensive, decades-old drug be the key to sustaining diuresis and preventing metabolic alkalosis? Tune in to find out.

The Vasopressor & Inotrope Handbook

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Citation:

Maeda A, Brown A, Spano S, Chaba A, Phongphithakchai A, Hikasa Y, Pattamin N, Kitisin N, Nübel J, Nielsen B, Holmes J, Peck L, Young H, Eastwood G, Bellomo R, Neto AS. Furosemide with adjunctive acetazolamide vs furosemide only in critically ill patients: A pilot two-center randomized controlled trial. J Crit Care. 2025 Apr;86:155002. doi: 10.1016/j.jcrc.2024.155002. Epub 2024 Dec 16. PMID: 39689380.