Heart Failure and Transplant Unit, La Fe University and Polytechnic Hospital, Number 106, Fernando Abril Martorell Av, 46026, Valencia, Spain.
Cardiology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
High Blood Press Cardiovasc Prev. 2021 Nov;28(6):589-596. doi: 10.1007/s40292-021-00476-4. Epub 2021 Oct 1.
The most common symptom in heart failure (HF) is congestion, which can be refractory to diuretic treatment.
To verify whether, in patients with advanced HF and diuretic resistance, subcutaneous furosemide or furosemide in an oral solution can improve the clinical-analytical status.
From 2018 to 2020, 27 consecutive outpatients with diuretic resistance, not candidates for other alternatives, were recruited. Patients were treated either with subcutaneous furosemide in elastomeric pump (n: 10) or with oral solution (n: 17) for 5 days.
The functional status (NYHA) improved with subcutaneous administration (predose: 3.8 ± 0.5 vs. postdose: 3.1 ± 0.7; p: 0.02) and oral solution (predose: 3.7 ± 0.3 vs. postdose: 2.5 ± 0.7; p: 0.0001). Weight loss was greater with the oral solution (predose: 85.5 ± 19.5 vs. postdose: 81.3 ± 18.8Kg; p: 0.0001) than subcutaneous (predose: 81.6 ± 15.9 vs. postdose: 80.4 ± 15.1kg; p: 0.16). Creatinine showed a non-significant increase in both groups. The number of hospital visits showed no difference between both options.
The administration of furosemide, both subcutaneously by elastomeric pump or drinking the oral solution, is effective for the treatment of congestion in advanced HF refractory to diuretic treatment.
心力衰竭（HF）最常见的症状是充血，利尿剂治疗可能对此无效。
验证在利尿剂抵抗的晚期 HF 患者中，皮下呋塞米或呋塞米口服溶液是否能改善临床分析状况。
2018 年至 2020 年，共招募了 27 名连续的利尿剂抵抗门诊患者，他们没有其他替代方案的候选资格。患者接受皮下弹性泵呋塞米治疗（n=10）或口服溶液治疗（n=17），为期 5 天。
皮下给药后患者的功能状态（NYHA）得到改善（给药前：3.8±0.5 比给药后：3.1±0.7；p=0.02），口服溶液也得到改善（给药前：3.7±0.3 比给药后：2.5±0.7；p<0.0001）。口服溶液的体重减轻更明显（给药前：85.5±19.5 比给药后：81.3±18.8kg；p<0.0001），而皮下注射则不明显（给药前：81.6±15.9 比给药后：80.4±15.1kg；p=0.16）。两组肌酐均有升高，但无统计学意义。两种选择的住院次数均无差异。
弹性泵皮下给予呋塞米或口服溶液均可有效治疗利尿剂抵抗的晚期 HF 充血。
