Effect of Chronic Furosemide Administration on Acid-base Balance in Patients with Chronic Hypercapnic Respiratory Failure

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We quantitatively analyzed the effect of long-term administration of oral furosemide on the PaCO_2-H^+ relationship in patients with chronic hypercapnic respiratory failure. In this study we measured arterial blood gases of eighteen outpatients (mean duration of visits, 7.6 years; mean rise of PaCO_2, 15.4 mmHg). We obtained linear regression lines for PaCO_2-H^+, and determined their Y-axis intercepts and slopes. The results indicated that an increase in the administered dose of furosemide decreased linearly the Y-axis intercept of the regression line [(Y-intercept)=-6.9 (dose of furosemide) +30.9, r=0.81], and increased linearly the slope of the regression line [(slope)=0.094(dose of furosemide)+0.22, r=0.74]. Thus, the regression line of the PaCO_2-H^+ relationship moved downward and became steeper at higher doses of furosemide. The regression lines for each dose of furosemide crossed at a PaCO_2 of 75 mmHg. We concluded that there is a mutual interaction between the renal and respiratory mechanisms for acid-base balance in chronic hypercapnia and the effect of furosemide on the PaCO_2-H^+ relationship is negligible in severe hypercapnia.
東海大学の論文