High-dose furosemide in the treatment of refractory congestive heart failure.
Thirty-five patients with severe chronic congestive heart failure that was refractory to conventional therapy were given high dosages of furosemide (250 to 4000 mg/d) because of significantly reduced renal function (mean endogenous creatinine clearance, 0.53 mL/s/1.73 m2 [32 mL/min/1.73 m2]). Natriuresis, weight reduction (mean, 11 kg), and relief of symptoms were achieved in all patients. The mean survival after the start of the high-dose furosemide therapy was 11.3 months (range, 0.5 to 36 months) (n = 35). When this therapy eventually failed, long-term intermittent hemofiltration was performed in eight selected cases, further prolonging survival (mean, 3.0 months). High-dose furosemide therapy and hemofiltration improved the quality of life and prolonged survival. The use of diuretics in congestive heart failure should therefore include treatment with high-dose furosemide, which is effective and can be given over a long period without serious side effects.
Gerlag
P G
PG
Department of Internal Medicine, St Joseph Hospital, Eindhoven, the Netherlands.
van Meijel
J J
JJ
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003404:Creatinine / Q000652:urine; D004334:Drug Administration Schedule; D005260:Female; D005665:Furosemide / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000628:therapy; D006440:Hemofiltration; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects; D013997:Time Factors
D005665:Furosemide; D003404:Creatinine