Effect of chronic furosemide administration on acid-base balance in patients with chronic hypercapnic respiratory failure.
We quantitatively analyzed the effect of long-term administration of oral furosemide on the PaCO2 - H+ relationship in patients with chronic hypercapnic respiratory failure. In this study we measured arterial blood gases of eighteen outpatients (mean duration of visits, 7.6 years; mean rise of PaCO2, 15.4 mmHg). We obtained linear regression lines for PaCO2 - H+, and determined their Y-axis intercepts and slopes. The results indicated that an increase in the administered dose of furosemide decreased linearly the Y-axis intercept of the regression line [(Y-intercept) = - 6.9(dose of furosemide) + 30.9, r = 0.81], and increased linearly the slope of the regression line [(slope) = 0.094(dose of furosemide) + 0.22, r = 0.74]. Thus, the regression line of the PaCO2 - H+ relationship moved downward and became steeper at higher doses of furosemide. The regression lines for each dose of furosemide crossed at a PaCO2 of 75 mmHg. We concluded that there is a mutual interaction between the renal and respiratory mechanisms for acid-base balance in chronic hypercapnia and the effect of furosemide on the PaCO2 - H+ relationship is negligible in severe hypercapnia.
Urano
T
T
Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Kondo
T
T
Oh-Hori
K I
KI
Kumagai
M
M
Miyairi
A
A
Ohta
Y
Y
D000136:Acid-Base Equilibrium / Q000187:drug effects; D000368:Aged; D001784:Blood Gas Analysis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005665:Furosemide / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D006935:Hypercapnia / Q000188:drug therapy*; D008137:Longitudinal Studies; D008875:Middle Aged; D011659:Pulmonary Gas Exchange; D012131:Respiratory Insufficiency / Q000188:drug therapy*; D013997:Time Factors
D005665:Furosemide