Tolerability and efficacy of high-dose furosemide and small-volume hypertonic saline solution in refractory congestive heart failure.
Thirty patients aged 65-85 years, with refractory New York Heart Association (NYHA) class IV congestive heart failure (CHF) were treated with an intravenous infusion of furosemide (250-2000 mg/d) and small-volume hypertonic saline solution (150 mL of 1.4-4.6% NaCl) twice a day for 6 to 12 days. A daily fluid oral intake of 1000 mL and previous cardiac therapy were maintained. Clinical signs and symptoms of CHF, such as dyspnea, edema and weakness, improved, as did severity of illness as defined by NYHA class. The infusion was well tolerated. After a 12-month follow-up, 24 patients (80%) were alive and in the NYHA class assigned on discharge from the hospital. This therapeutic combination is effective and well tolerated and should represent an innovative approach to the management of refractory CHF.
Department of Internal Medicine, University of Palermo, Italy.
S
S
Paterna
G
G
Parrinello
P
P
Amato
L
L
Dominguez
A
A
Pinto
T
T
Maniscalchi
A
A
Cardinale
A
A
Licata
V
V
Amato
G
G
Licata
P
P
Di Pasquale
D000368:Aged; D000369:Aged, 80 and over; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007262:Infusions, Intravenous; D007558:Italy / Q000453:epidemiology; D008297:Male; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D015996:Survival Rate
D004232:Diuretics; D012462:Saline Solution, Hypertonic; D005665:Furosemide