Adin Darcy B, Taylor Aaron W, Hill Richard C, Scott Karen C, Martin Frank G
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.
J Vet Intern Med. 2003 Sep-Oct;17(5):632-6. doi: 10.1111/j.1939-1676.2003.tb02493.x.
Several studies in human subjects have demonstrated greater diuresis with constant rate infusion (CRI) furosemide than intermittent bolus (IB) furosemide. This study was conducted to compare the diuretic efficacy of the same total dose of IB furosemide and CRI furosemide in 6 healthy, adult Greyhound dogs in a randomized crossover design with a 2-week washout period between treatments. For IB administration, dogs received 3 mg/kg at 0 and 4 hours. For CRI administration, dogs received a 0.66 mg/kg loading dose followed by 0.66 mg/kg/h over 8 hours. The same volume of fluid was administered for both methods. Urine output was quantified hourly. Urine electrolyte concentrations, urine specific gravity (USG), packed cell volume (PCV), total protein (TP), serum electrolyte concentrations, total carbon dioxide (TCO2), serum creatinine (sCr), and blood urea nitrogen (BUN) were determined every 2 hours. Urine production and water intake were greater (P < or = 0.05) for CRI than IB. Urine sodium and calcium losses were greater (P < 0.05) and urine potassium loss was less (P = 0.03) for CRI than IB, but there was no evidence of a difference between methods for urine magnesium and chloride losses. Serum chloride concentration was less (P < 0.001), sCr concentration greater (P = 0.04). TP greater (P = 0.01), and PCV greater (P = 0.003) for CRI than IB. No differences in USG, TCO2, BUN, or serum potassium, sodium, and magnesium concentrations were detected between methods. The same total dose of CRI furosemide resulted in more diuresis, natriuresis, and calciuresis and less kaliuresis than IB furosemide in these normal Greyhound dogs over 8 hours, suggesting that furosemide is a more effective diuretic when administered by CRI than by IB.
多项针对人类受试者的研究表明,持续静脉输注(CRI)呋塞米的利尿作用强于间歇性推注(IB)呋塞米。本研究采用随机交叉设计,在6只健康成年灵缇犬中比较相同总剂量的IB呋塞米和CRI呋塞米的利尿效果,治疗之间有2周的洗脱期。对于IB给药,犬在0小时和4小时接受3mg/kg。对于CRI给药,犬先接受0.66mg/kg的负荷剂量,然后在8小时内以0.66mg/kg/h的速度输注。两种方法输注的液体量相同。每小时定量尿量。每2小时测定尿电解质浓度、尿比重(USG)、红细胞压积(PCV)、总蛋白(TP)、血清电解质浓度、总二氧化碳(TCO2)、血清肌酐(sCr)和血尿素氮(BUN)。CRI组的尿量和水摄入量高于IB组(P≤0.05)。CRI组的尿钠和钙丢失量高于IB组(P<0.05),尿钾丢失量低于IB组(P = 0.03),但没有证据表明两种方法在尿镁和氯丢失方面存在差异。CRI组的血清氯浓度低于IB组(P<0.001),sCr浓度高于IB组(P = 0.04),TP高于IB组(P = 0.01),PCV高于IB组(P = 0.003)。两种方法在USG、TCO2、BUN或血清钾、钠和镁浓度方面未检测到差异。在这些正常灵缇犬中,相同总剂量的CRI呋塞米在8小时内比IB呋塞米产生更多的利尿、利钠和利钙作用,而钾利尿作用更小,这表明呋塞米通过CRI给药比通过IB给药是一种更有效的利尿剂。