Hypertonic Saline in Conjunction with High-Dose Furosemide Improves Dose–Response Curves in Worsening Refractory Congestive Heart Failure

42 consecutively hospitalized patients with refractory congestive heart failure (CHF). Group 1 (n=14): mean age 77 ± 17 years, 43% male, 43% HFpEF, 64% NYHA class IV. Group 2 (n=14): mean age 80 ± 8.1 years, 15% male, 38% HFpEF, 84% NYHA class IV. Group 3 (n=14): mean age 73 ± 12 years, 54% male, 46% HFpEF, 69% NYHA class IV.

Intravenous furosemide (125 mg, 250 mg, or 500 mg) diluted in 150 ml of hypertonic saline solution (1.4%) administered during the 24-48 hour period.

The same dose of intravenous furosemide diluted in 150 ml of normal saline (0.9%) administered during the initial 0-24 hour period.

Diuresis (urine output), sodium excretion, osmolality, and furosemide concentration evaluated from urine samples collected at 30, 60, and 90 min, and 3, 4, 5, 6, 8, and 24 h after infusion.surrogate