High Dose Of Furosemide Associated With Severe Acid-Base Disturbances In Treatment Of Critically Ill Patients: A Retrospective Observation Analysis

Objectives: The aim of this study was to investigate the effects of overusing furosemide on acid-base disturbances (ABD) in the treatment of critically ill patients. Methods: Clinical records were collected from 109 critical ill patients (CIPs), hospitalized at the Emergency Intensive Care Unit (EICU) in Yangpu District Central Hospital (Shanghai, China), from January to May of 2010. Based on use or nonuse of diuretics within 24 hours at admission, patients were divided into 4 groups. Arterial blood gas (ABG) analysis, concentration of potassium (K+), sodium (Na+), chlorine (Cl-), lactic acid, and glucose in serum were measured at 6, 12, and 24 similar to 48 hours after admission. Results: There were no significant differences in incidence of ABD among all groups at 6 hours after admission (P > 0.05). Percentages of non-ABD were significantly increased from about 20% at 6 hours to 35% at 24 hours (in groups A and B) and 40.5% or 55 % at 48 hours (groups A and B, respectively) after admission. Percentages of T-ABD type showed no changes at the 3 time points. In group D, percentages of No-ABD were significantly decreased from 20% at 6 hours to 4.2% at 24 hours and 8.3% at 48 hours after admission. Percentages of T-ABD were significantly increased from 12.5% at 6 hours to 33.3% at 24 hours and 58.3% at 48 hours after admission. Conclusion: These results demonstrate that high dose usage of furosemide is associated with ABD, especially T-ABD occurrence in CIPs.