[Fluid redistribution between the extracellular medium and the cells in the diuretic therapy of cardiac insufficiency].

The antipyrine and thiosulphate spaces were measured in patients with circulatory insufficiency of the II B and III stages before and after medication with cardiac glycosides and diuretics, used in various combinations and in courses of different duration and also in 2-week long courses of treatment with ethacrine acid and aldactone in order to study the nature of changes in the water-electrolyte exchange in cardiac insufficiency following diminution of edemas occurring under the effect of an effective therapy. The main indication of cardiac insufficiency, the expansion of the extracellular space, was found to continue even after a clinically effective treatment and complete disappearance of edemas. When myocardial contractility continues to be at a low level and the aldosterone activity is high--the removal from the organism of a large quantity of fluid with the help of diuretics, while reducing the external clinical manifestations of the edematous conditions, aggravates at the same time the pathological nature of the fluid distribution between the extracellular medium and the cells, this being due, in the main, to the reduction in the amount of fluid in the cells. The differences between ethacrine acid and aldactone find their expression not only in a greater of smaller effectiveness of their diuretic action, but also in the influence which they exert on the regulation of water metabolism in cardiac insufficiency.