What question did this study set out to answer?

To assess the diuretic efficacy and renal clearance of furosemide across moderate and advanced congestive heart failure, and to determine whether hydralazine enhances furosemide response in advanced disease.

August 1, 1981Clinical Pharmacology & Therapeutics

Effect of furosemide in congestive heart failure

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Why the study?

Does the addition of hydralazine to furosemide improve diuresis and sodium excretion in patients with advanced congestive heart failure?

Population

18 patients with congestive heart failure (8 with moderate and 10 with advanced congestive heart failure)

Comparison

Furosemide 40 mg bolus injection, with or… vs Moderate vs advanced heart failure; and…

Design

Cohort

Follow-up

6 hours

Authors

ANA NomuraHokkaido Orthopedic Surgery Memorial Hospital HYHisakazu YasudaMedisch Spectrum Twente MMMasaru MinamiHealth Sciences University of Hokkaido

Discussion

Member takes

Implication

May support adjunctive hydralazine for enhanced diuresis in advanced HF; leaves open randomized confirmation of clinical outcomes.

Key Points

To assess the diuretic efficacy and renal clearance of furosemide across moderate and advanced congestive heart failure, and to determine whether hydralazine enhances furosemide response in advanced disease.
Assessed 18 patients with congestive heart failure stratified into moderate (group I, n=8) and advanced (group II, n=10) disease following a 40 mg intravenous bolus of furosemide.
Evaluated the impact of adding hydralazine (0.2 mg/kg) to furosemide compared to furosemide alone over a 6-hour period in eight patients with advanced heart failure.
Six hours post-furosemide, moderate CHF patients exhibited greater urinary sodium excretion (120.5 ± 36.7 vs 68.2 ± 25.8 mEq, p < 0.01), urine volume (1,100 ± 281 vs 764 ± 257 ml, p < 0.05), and furosemide renal clearance (73.4 ± 16.6 vs 42.3 ± 11.5 ml/min, p < 0.001) than advanced CHF patients.
In advanced CHF, coadministering hydralazine significantly increased 6-hour urinary sodium excretion (from 77.2 ± 31.0 to 122.8 ± 42.5 mEq, p < 0.01), urine volume (from 854 ± 278 to 1,279 ± 359 ml, p < 0.001), and furosemide renal clearance (from 46.3 ± 12.2 to 62.5 ± 18.6 ml/min, p < 0.01).

Structured PICO

Does the addition of hydralazine to furosemide improve diuresis and sodium excretion in patients with advanced congestive heart failure?

Population

18 patients with congestive heart failure (8 with moderate and 10 with advanced congestive heart failure)

Intervention

Furosemide 40 mg bolus injection, with or without hydralazine (0.2 mg/kg)

Comparator

Moderate vs advanced heart failure; and furosemide alone vs furosemide plus hydralazine in a subset of advanced heart failure patients

Outcome

Urinary sodium excretion and urine volume at 6 hourssurrogate

The addition of hydralazine to furosemide enhances renal clearance, diuresis, and sodium excretion in patients with advanced congestive heart failure.

Cite This Study

Nomura et al. (1981) studied this question.

synapsesocial.com/papers/6a987e736103091a1ad742e2 https://doi.org/10.1038/clpt.1981.145

Topics

Heart failure HFrEF treatment

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Effect of furosemide in congestive heart failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Effect of furosemide in congestive heart failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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