Analysis of the efficacy and prognosis of different diuretic infusion methods in the treatment of acute heart failure

Guo Hao; Qi Ming; Wang Yingzhong; Gao Bo; Chang Jianhua

doi:10.3969/j.issn.1674-4055.2019.10.10

Abstract：study the therapeutic effect and adverse prognosis of patients with acute heart failure (AHF) treated with loop diuretics under different infusion modes. Methods The medical records of AHF patients treated in the hospital of Yan'an University from September 2016 to September 2017 were retrospectively analyzed. According to different diuretic infusion methods, patients were divided into continuous infusion pump group (group A) and vein. In the injection group (group B), the differences in treatment indexes and adverse events between the two groups were compared by t-test. The Cox layered model was used to analyze the influencing factors of the first adverse events. Results A total of 102 patients (49 patients in group A, 53 patients in group B) were enrolled in the study. After 120 hours of diuretic treatment, the daily average urine volume of group A (2224.9±664) ml, group B (1935±369.5) ml, the difference was statistically significant. Significance (P=0.008); the differences in creatinine, glomerular filtration rate (eGFR) and urea nitrogen (BUN) between the two groups were statistically significant. At discharge, serum creatinine in group A and group B was (75.3±32.6)μmmol/L, (-71.3±32.3)μmmol/L (P<0.001). Cox multivariate analysis showed diuretic infusion and discharge eGFR levels. Changes in discharge weight can significantly affect the timing of the first adverse events. Conclusion As for short-term diuretic effect, continuous infusion of loop diuretic is better than intravenous injection. But it is more likely to cause impaired renal function. Patients of intravenous injection, eGFR≥60 ml/min/1.73m2 after discharge, weight loss≥ 2kg had a later occurrence time of adverse event.