The acute haemodynamic effect of nebulised frusemide in stable, advanced heart failure

Abstract

Purpose: To assess the acute haemodynamic effects of nebulised frusemide in a stable advanced heart failure population. In this randomised, double blind, placebo controlled trial, people with stable, advanced heart failure under-going right heart catheterisation were randomised to receive either 40 mg (4 ml) of nebulised frusemide or 4 ml of normal saline. Following inhalation of the study medication, subjects pulmonary pressures were recorded every 15 min for 1 h. There were no significant changes in the weighted average time course data of the subjects (n = 32) in either group over the study period, in particular no differences were observed in haemodynamic parameters between the two groups. Weighted average pulmonary capillary wedge pressure after 60 min in the frusemide group was 22.5 (SD 6.5) mmHg (n = 14) compared to the placebo group's 24.0 (SD 7.3) mmHg (n = 18), p = 0.55. The frusemide group had a significantly greater change in the median volume of urine in the bladder over the study period (186 ml IQR 137.8-260.8) compared to the placebo group (76 ml IQR 39.0-148.0) p = 0.02. This study showed that nebulised frusemide had no significant clinical effect on the haemodynamic characteristics of the subjects.