Tolvaptan should be used very carefully in very elderly patients

Tolvaptan should be used very carefully in very elderly patients

We were very interested to read the article entitled ’The clinical utility of early use of tolvaptan in very elderly patients with acute decompensated heart failure’ by Niikura et al. (1) recently published in the Anatol J Cardiol 2017; 18: 206-12 and the editorial comment entitled 'Tolvaptan in the very elderly with acute decompensated heart failurea therapeutic option worth of consideration' ...

Etomidate Should be Used Carefully for Emergent Endotracheal Intubation in Patients with Septic Shock

Etomidate and midazolam are the most popular drugs among the induction agents for emergent endotracheal intubation. The purpose of this study was to compare the incidence of adrenal insufficiency and mortality between the septic shock patients who received etomidate (ETM group) and those who received midazolam (MDZ group). Between November 2004 and September 2006, 65 patients were analyzed in t...

Clinical utility of early use of tolvaptan in very elderly patients with acute decompensated heart failure

OBJECTIVE The establishment of an optimal strategy for elderly patients with acute decompensated heart failure (ADHF) is currently an important issue. Particularly in very elderly (VE) patients, ADHF is associated with a poor prognosis. We therefore aimed to evaluate the efficacy and safety of the early use of tolvaptan (TLV) in VE patients. METHODS Of 245 patients with ADHF admitted between ...

Nephrotic syndrome in very elderly: Should we treat aggressively?

Chronic kidney disease and acute kidney injury are being increasingly recognized in very elderly patients, aged 80 or more. In cases of suspected glomerulonephritis with or without nephrotic syndrome, the clinical decision-making of whether to obtain a renal biopsy and treat with immunosuppressive therapy should not be based on advanced age alone but take into consideration the patient's functi...

Tolvaptan in the very elderly with acute decompensated heart failure-a therapeutic option worth of consideration