Abstract:

In 23 mechanically ventilated anuric (six) or oliguric (17) patients (< 16 ml/h of urine output) with severe gas exchange abnormality, we investigated the effect of furosemide on intrapulmonary shunt (Q̇S/Q̇T). Before and after 0.5, 1, and 2 h of IV administration of 200 mg of furosemide, we assessed the intrapulmonary shunt and PaO2 while patients' hemodynamic measurements were monitored. Ventilatory parameters remained constant throughout the study. While the urine output was minimal and no alteration in hemodynamic values was found, the Q̇S/Q̇T decreased from 27.7 ± 2.3 percent (mean ± SEM) at control to 24.3 ± 2.1 percent (p < 0.01) at 0.5 h, 21.7 ± 2.1 percent (P < 0.001) at 1 h, and 18.1 ± 1.8 percent (p < 0.001) at 2 h. The PaO2 showed no significant difference at 0.5 h but rose significantly from 96 ± 14 to 105 ± 14 mm Hg (p < 0.05) and 111 ± 14 mm Hg (p < 0.01) at 1 and 2 h, respectively. Since we observed no changes in hemodynamics, we speculate a direct effect of furosemide in the pulmonary vasculature affecting the ventilation-perfusion mismatch and, therefore, the Q̇S/Q̇T and PaO2.

Notes:

Cited By :7Export Date: 21 February 2017

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