Comparison of different diuretic regimens in heart failure

Furosemide is an essential component of therapy for patients with acute decompensated heart failure. But there are few data to guide their use.We assigned 43 patients with acute decompensated heart failure who refered to Cardiology Department of Gazi University Medical Faculty. Fifteen patients received 160 mg furosemide administered intravenously continuous infusion through 16 hours. Fourteen patients received 80 mg furosemide administered twice a day as a bolus intravenous treatment with twelve-hour intervals. Fourteen patients treated with 160 mg furosemide plus HSS (150 cc %1,95 NaCl) for 30 minutes. All of these treatment regimes were continued for 48 hours. At the end of this period the protocol allowed specified dose adjustments.We evaluated the changing in the serum creatinine level from baseline to 48 hours, changing in the serum creatinine level from baseline to patients after becoming compensated, length of hospitalization and loss of body weight. After treatment, there were no significiant differences in patients? serum creatinine level at the end of 48 hours (infusion group 0,16 ± 0,21 mg/dl, bolus group 0,04 ± 0,15 mg/dl, HSS group 0,20 ± 0,21 mg/dl; p= 0,08). Patients after becoming compensated, we observed a nonsignificiant lower renal impairment with bolus treatment (infusion group 0,36 ± 0,42 mg/dl, bolus group 0,10 ± 0,28 mg/dl, HSS group 0,30 ± 0,42 mg/dl; p= 0,18). There were no differences among the body weight loss of the three groups (infusion group 4,6 ± 5,2 kg, bolus group 4,1 ± 2,7 kg, HSS group 5,7 ± 3,6 kg; p= 0,66). As well as a significiantly shorter length of hospitalization was observed in patients treated with HSS (infusion group 6,6 ± 3,4 days, bolus group 7,9 ± 4,1 days, HSS group 3,7 ± 1,3 days; p< 0,01).Treatment of furosemide plus HSS shortened the length of hospital stay in patients with heart failure. This treatment modality can be an effective method to reduce the cost of treatment.