+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Diuretic treatment in patients with acute pulmonary edema did not produces severe hyponatremia or hypokalemia

Diuretic treatment in patients with acute pulmonary edema did not produces severe hyponatremia or hypokalemia

Vnitrni Lekarstvi 62(4): 263-267

One of the risks of diuretic therapy for pulmonary edema is the development of hyponatremia and hypokalemia with pro-arrhythmic potential. The aim of our study was to analyze the incidence of hyponatremia and hypokalemia after the first day of treatment in a real clinical practice. We performed a retrospective analysis of data obtained from medical records. We included all patients with pulmonary edema admitted to the coronary care unit, only patients which died within the first day of treatment were excluded. Absolute dose of administered furosemide, total fluid intake and urine output, saline and pottasium intake were analyzed. Nonparametric paired Wilcoxon test was used to compare natrium and pottasium levels changes. 37 patients were included into analysis. The median dose of furosemide administered during the first day of treatment was 120 mg (IQR 20-300 mg). Median diuresis was 2 400 ml (IQR 1 425-3 225 ml). The median of difference between diuresis and total fluid intake was 315 ml (IQR 538-1 380 ml). Wilcoxon test confirmed a prevailing statistically significant trend of slight rise in serum sodium within the first day of treatment (serum sodium 138.0 IQR 132.8-139.6 vs 138.1 IQR 134,0-141,7 mmol/l, p = 0.0046). The difference in serum potassium was not statistically significant (serum potassium 4.2 IQR 3.9-4.8 vs 4.2, IQR 3.8-4.8 mmol/l). Results did not confirmed the need for a substitution of sodium and potassium losses during the first day of diuretic therapy to prevent hyponatriemia and hypokalemia in patients with pulmonary edema.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 057644134

Download citation: RISBibTeXText

PMID: 27250603

Related references

Severe diuretic induced hyponatremia and hypokalemia in the elderly. Harefuah 106(11): 500-502, 539-540, 1984

A friend of mine was diagnosed with pulmonary edema and was prescribed a diuretic. I'm a heart attack survivor and I currently take a diuretic (among other drugs). What exactly is pulmonary edema, and am I protected since I take a diuretic?. Heart Advisor 13(3): 8-8, 2012

Hypokalemia and arrhythmia during acute myocardial infarct in patients on long-term diuretic treatment. Tidsskrift for den Norske Laegeforening 96(24): 1257-1259, 1976

Severe hyponatremia with pulmonary and cerebral edema in an Ironman triathlete. Deutsche Medizinische Wochenschrift 132(36): 1829-1832, 2007

The gynecological TURP syndrome. Severe hyponatremia and pulmonary edema during hysteroscopy. Der Anaesthesist 58(1): 30-34, 2009

Severe diuretic-induced hyponatremia in the elderly. A series of eight patients. Archives of Internal Medicine 146(7): 1355-1357, 1986

Treatment of acute severe pulmonary edema. Les Cahiers de Medecine 13(1): 59-66, 1972

Clinical quiz. Diabetic ketoacidosis with severe dehydration, cerebral edema, and acute hypokalemia. Pediatric Nephrology 5(1): 99-101, 1991

Diuretic-inducd severe hyponatremia: Review and analysis of 129 reported patients. Chest 103(2): 601-606, 1993

Ecstasy-associated acute severe hyponatremia and cerebral edema: a role for osmotic diuresis?. Journal of Emergency Medicine 42(6): E137-E140, 2012

Treatment of severe acute pulmonary edema with hit for cardiac arrest. Coeur et Medecine Interne 11(1): 135-146, 1972

Indapamide-induced severe hyponatremia and hypokalemia. Annals of PharmacoTherapy 29(11): 1124-1128, 1995

Questioning diuretic use in acute negative-pressure pulmonary edema. Anesthesiology 114(2): 461, 2011

Noninvasive pressure support ventilation in non-COPD patients with acute cardiogenic pulmonary edema and severe community-acquired pneumonia: acute effects and outcome. Intensive Care Medicine 28(9): 1226-1232, 2002

Is helmet CPAP first line pre-hospital treatment of presumed severe acute pulmonary edema?. Intensive Care Medicine 35(4): 656-662, 2009