Diuretic Efficiency And Effect Of Heart Function Of Continuous Infusion Of Furosemide In Severe Heart Failure

Purpose: Diuretic resistance, which refers to a decrease in the response to a diuretic , brings many troubles to use furosemide to treat severe heart failure. Increasing dosage is a common method to overcome this problem. This method not only has little effects, but also brings many severe advert effects. The physiologic research of diuretic resistance have found that the diuretic efficiency is decided not only by the dosage, but also by the time course of delivery of furosemide, which implicates that it is reasonable to continuous infuse of furosemide in severe heart failure. The clinical research have proved that this method can increase the mean daily urine volume and daily urine electrolyte of severe CHF. But there are no reports to implicate that whether continuous infusion of furosemide is superior to bolus injection in effect of heart function.Methods: 43 patients with severe congestive heart failure (stage III-IV according to the New York Heart Association) were randomly divided into two groups (continuous infusion 22 and bolus injection 21 ). After the base situation (daily urine volume, daily urine electrolyte and echographic heart function) was measured, the two groups went into trials. Every day, in infusion group 30mg furosemide was continuous infused after bolus injection lOmg furosemide, in injection group 40mg furosemide was bolus injected, both groups went continue three days,and daily urine volume, daily urine electrolyte was measured. After the trials, the base situation was measured again.Results: The both methods can improve echographic heart function, but only continuous infusion has statistical difference. Daily urine volume and daily urine electrolyte in infusion group are bigger than that in injection group. The blood electrolyte has no difference between two groups after trial.Conclusion: In treatment of severe CHF, continuous infusion of furosemide can delay diuretic resistance. Continuous infusion of furosemide is superior to bolus injection in pharmacodynamics. The effect of the blood electrolyte has no difference between two groups...