title: [The value of aggressive diuretic therapy in acute decompensated stage of chronic heart failure].
abstract: OBJECTIVE
  To evaluate both the efficacy, safety, length of stay in hospital and expenses of aggressive diuretic therapy in patients with acute decompensation of chronic heart failure (CHF).
  
  
  METHODS
  The retrospective analysis was conducted in the patients with acute decompensation CHF New York Heart Association (NYHA) class III or IV in department of cardiology of Fujian Medical University Union Hospital from January 1st 2006 to September 1st 2007. The 24-hour urine volume on the 2nd day was equivalent or over 2 400 ml was defined as aggressive diuretic therapy group, and those with less than 2 400 ml of urine as non-aggressive diuretic therapy group. The biochemical parameters and vital signs were compared before and after aggressive diuretic therapy, and the mortality, the length of stay and expenses were also compared between the two groups.
  
  
  RESULTS
  One hundred and ninety-five patients were enrolled in the study, there were 73 and 122 patients in aggressive diuretic therapy group and in non-aggressive diuretic therapy group respectively. The mortality in aggressive diuretic therapy group was lower than that in non-aggressive diuretic therapy group (1.4% vs. 9.8%, P<0.05). The length of stay, total expenses and average cost in aggressive diuretic therapy group were lower than those in non-aggressive diuretic therapy group respectively [the length of stay: 11 days vs. 16 days; total expenses: 8 483 yuan vs. 12 182 yuan; average expenseI: 721.1 yuan/d vs. 854.4 yuan/d; average expenseII (except for examination expenses): 580.0 yuan/d vs. 698.2 yuan/d, P<0.05 or P<0.01]. There were no significant changes in biochemical parameters and heart rate before and after aggressive diuretic therapy. The systolic pressure (SBP) and diastolic pressure (DBP) were reduced significantly after aggressive diuretic therapy [SBP: (118.2±16.9) mm Hg vs. (127.0±24.9) mm Hg; DBP: (67.2±4.5) mm Hg vs. (75.2±4.9) mm Hg, 1 mm Hg=0.133 kPa, P<0.05 and P<0.01]. No hypotension symptoms such as dizziness and chest distress were found in all patients.
  
  
  CONCLUSIONS
  Aggressive diuretic therapy in patients with acute decompensation CHF is a safe, effective mode of therapy. It can reduce the length of stay in hospital, expenses and the mortality during hospitalization.
authors.affiliation: Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, China.
authors.forename: Jia-bin
authors.initials: JB
authors.lastname: Li
authors.forename: Hua-shan
authors.initials: HS
authors.lastname: Hong
mesh_terms: D000368:Aged; D002908:Chronic Disease; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies
chemical_list: D004232:Diuretics