Abstract 12149: Impact of Concomitant Administration Hypertonic Saline Solution and Daily Use Furosemide in Treatment of Acute Decompensated Heart Failure
Background While sodium infusion supplemented with furosemide is theoretically anticipated to promote diuresis in patients with acute decompensated heart failure (ADHF), there is little evidence to support this idea. The aim of this study was to investigate the effects of sodium infusion with daily use furosemide on ADHF. Methods Consecutive 44 patients with ADHF were enrolled in the study. Diagnosis of ADHF was performed on the basis of Framingham criteria. Forty four patients were alternately assigned to either the sodium infusion or the glucose infusion group. After hospitalization, patients were administered either continuous intravenous infusion of 500ml of 1.7%NaCl supplemented with furosemide 40mg (sodium infusion group) or continuous intravenous infusion of 500ml of 5% glucose supplemented with furosemide 40mg (glucose infusion group). All patients underwent physical examination of signs and symptoms for heart failure, measurement of supine blood pressure (BP) and heart rate (HR) at baseline and 24 hours after initiation of the treatment. In addition, multiple biomarkers for heart failure were measured. The total 24 hours urine volume was measured and urinalysis was performed. We performed a chest radiograph and echocardiography. The left ventricular ejection fraction was determined using the modified Simpson rule. Results There were no significant differences between the groups in the patients’ characteristics at baseline except for body weight and β-blocker use. Urinary volume and urinary sodium amount were greater in the sodium infusion group than in the glucose infusion group (2701±920ml vs 1777±797ml; P = <0.001 , 291.0±122.6mEq vs 182.1±115.8 mEq; P = 0.005). Body weight was significantly reduced in proportion to increased urinary volume in the sodium infusion group compared the glucose infusion group (from 63.6 to 62.5 kg; P = 0.001 vs from 56.4 to 56.5kg; P = 0.148). Sodium infusion provided rapid relief from dyspnea and systemic venous congestion compared with glucose infusion (86% vs 50%; P = 0.01). Conclusions Hypertonic saline enhanced the effect of diuretics, as ameliorated ADHF faster. This study provides a new approach for ADHF treatment.
- © 2012 by American Heart Association, Inc.