著者

Julien Ternacle Romain Gallet Armand Mekontso-Dessap Guy Meyer Bernard Maitre Alexandre Bensaid Priscille Jurzak Pascal Gueret Jean-Luc Dubois Randé Pascal Lim

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-13-0404, (Released:2013-07-13)

参考文献数

22

被引用文献数

16 19

---

Background: The benefit of load expansion is controversial in acute pulmonary embolism (PE). The aim of this study was to evaluate the benefit of furosemide in cases of normotensive acute PE. Methods and Results: We retrospectively included 70 consecutive normotensive patients (systolic blood pressure ≥90mmHg) admitted for acute PE with right ventricular dilation. Overall, 40 patients were treated during the first 24h by repeated bolus of furosemide (78±42mg, range 40–160mg) and 30 patients received isotonic saline solution (1.6±0.9L). Severity of hemodynamic status was similar in both groups, but patients in the furosemide group were older and had a greater creatinine level. At 24h, only the furosemide group had a decreased shock index (0.82±0.22 vs. 0.63±0.16, P<0.0001) with improved systolic blood pressure (118±18 vs. 133±17mmHg, P<0.0001), and creatinine levels. After treatment, there were fewer patients with simplified pulmonary embolism severity index ≥1 in the diuretic group (45% vs. 55%, P=0.03) than in the fluid expansion group (47% vs. 40%, P<0.0001). Finally, oxygen requirement at 24h decreased only in the diuretic group (75% to 47%, P=0.0004), and in-hospital survival without death and PE-related shock were similar between the 2 groups. Conclusions: In normotensive PE with RV dilatation, diuretics may improve hemodynamics and oxygenation requirement.

著者

Julien Ternacle Romain Gallet Armand Mekontso-Dessap Guy Meyer Bernard Maitre Alexandre Bensaid Priscille Jurzak Pascal Gueret Jean-Luc Dubois Randé Pascal Lim

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.77, no.10, pp.2612-2618, 2013 (Released:2013-09-25)

参考文献数

22

被引用文献数

4 19

---

Background: The benefit of load expansion is controversial in acute pulmonary embolism (PE). The aim of this study was to evaluate the benefit of furosemide in cases of normotensive acute PE. Methods and Results: We retrospectively included 70 consecutive normotensive patients (systolic blood pressure ≥90mmHg) admitted for acute PE with right ventricular dilation. Overall, 40 patients were treated during the first 24h by repeated bolus of furosemide (78±42mg, range 40–160mg) and 30 patients received isotonic saline solution (1.6±0.9L). Severity of hemodynamic status was similar in both groups, but patients in the furosemide group were older and had a greater creatinine level. At 24h, only the furosemide group had a decreased shock index (0.82±0.22 vs. 0.63±0.16, P<0.0001) with improved systolic blood pressure (118±18 vs. 133±17mmHg, P<0.0001), and creatinine levels. After treatment, there were fewer patients with simplified pulmonary embolism severity index ≥1 in the diuretic group (45% vs. 55%, P=0.03) than in the fluid expansion group (47% vs. 40%, P<0.0001). Finally, oxygen requirement at 24h decreased only in the diuretic group (75% to 47%, P=0.0004), and in-hospital survival without death and PE-related shock were similar between the 2 groups. Conclusions: In normotensive PE with RV dilatation, diuretics may improve hemodynamics and oxygenation requirement.  (Circ J 2013; 77: 2612–2618)