Document Detail


Discontinuation of furosemide decreases PaCO(2) in patients with COPD.
MedLine Citation:
PMID:  11834646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To evaluate whether the discontinuation of furosemide treatment resulted in a decrease in PaCO(2) and an increase in daytime and nocturnal oxygenation. BACKGROUND: Furosemide is widely prescribed in patients with COPD for the treatment of peripheral edema. It is known that furosemide causes a metabolic alkalosis. A diminished chemoreceptor stimulation may cause a decreased alveolar ventilation. DESIGN: Randomized, double-blind, placebo-controlled, crossover trial. SETTING: Department of Pulmonology, Rijnstate Hospital Arnhem, the Netherlands. PATIENTS: Twenty patients with stable COPD (10 men; median age, 70 years [range, 58 to 81 years]; FEV(1) 35% predicted [range, 19 to 70% predicted]). Subjects were included if they had received furosemide, 40 mg/d, for the treatment of peripheral edema for at least a month and if they had a mean nocturnal arterial oxygen saturation (SaO(2)) < 92%. Patients with cardiac left and/or right ventricular dysfunction, sleep apneas, and patients receiving other diuretics, angiotensin-converting enzyme inhibitors, potassium or chloride replacement therapy, or long-term oxygen treatment were excluded. INTERVENTION: Furosemide was discontinued for 1 week and replaced by placebo treatment in the first or the second week. MEASUREMENTS AND RESULTS: Ventilation, daytime arterial blood gas levels, and nocturnal SaO(2) were measured at baseline, after 1, and after 2 weeks. Sixteen subjects completed the study. Ventilation increased from 10.4 L/min (range, 6.7 to 15.4 L/min) at baseline to 11.6 L/min (range, 8.7 to 14.0 L/min) after discontinuation of furosemide (p < 0.05). PaCO(2) decreased from 45 mm Hg (range, 35 to 64 mm Hg) to 41 mm Hg (range, 32 to 61 mm Hg; p < 0.01). Daytime and nocturnal oxygenation did not improve. CONCLUSIONS: Although it does not improve oxygenation, the discontinuation of furosemide decreases PaCO(2) in patients with COPD.
Authors:
Folkert Brijker; Yvonne F Heijdra; Frank J J van den Elshout; Hans Th M Folgering
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  121     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-08     Completed Date:  2002-03-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  377-82     Citation Subset:  AIM; IM    
Affiliation:
Department of Pulmonary Diseases, Rijnstate Hospital Arnhem, The Netherlands. zonnebloem@compuserve.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Body Fluids / metabolism
Carbon Monoxide / analysis*
Cross-Over Studies
Diuretics / pharmacology*
Double-Blind Method
Edema / drug therapy
Female
Furosemide / pharmacology*
Hemostasis / drug effects
Humans
Male
Middle Aged
Oxygen Consumption / drug effects
Partial Pressure
Pulmonary Disease, Chronic Obstructive / physiopathology*
Respiratory Function Tests
Chemical
Reg. No./Substance:
0/Diuretics; 54-31-9/Furosemide; 630-08-0/Carbon Monoxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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