Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10722
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dc.contributor.authorApte, Yogeshen
dc.contributor.authorBellomo, Rinaldoen
dc.contributor.authorWarrillow, Stephen Jen
dc.contributor.authorGoldsmith, Donnaen
dc.contributor.authorGillies, Michaelen
dc.contributor.authorMcGain, Forbesen
dc.date.accessioned2015-05-16T00:15:49Z
dc.date.available2015-05-16T00:15:49Z
dc.date.issued2008-12-01en
dc.identifier.citationCritical Care and Resuscitation; 10(4): 306-11en
dc.identifier.govdoc19049481en
dc.identifier.otherPUBMEDen
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/10722en
dc.description.abstractHypernatraemia may develop during intravenous infusion of frusemide. Spironolactone is an aldosterone antagonist that promotes natriuresis and may attenuate such hypernatraemia, but its effect in this setting has not been previously studied.To assess whether the administration of spironolactone to ventilated patients receiving a frusemide infusion attenuates the increase in serum sodium concentration.Randomised, double-blind, placebo-controlled trial (January 2005 to December 2006).20 patients with a serum creatinine concentration < 300 micromol/L who were undergoing mechanical ventilation in the intensive care unit and had begun a frusemide infusion as treatment for fluid overload within the previous 24 hours.Patients were randomly allocated to receive either spironolactone (100 mg three times daily) or placebo by nasogastric tube for the duration of the frusemide infusion. Daily serum levels of urea and creatinine, 24-hour urine sodium and potassium levels, fluid balance and 24- hour blood levels of aldosterone, human atrial natriuretic peptide and plasma renin activity were measured throughout the period of frusemide infusion.Change in serum sodium concentration over 48 hours from baseline was 3.0 mmol/L for placebo versus 1.0 mmol/L for the spironolactone group (P = 0.08). Change in serum potassium concentration did not differ between the groups (0.125 mmol/L over 48 hours). There were no significant differences in total urinary sodium or potassium excretion. Serum creatinine, urea, urine volume, fluid balance, potassium requirements and hormone levels were similar in both groups.In this pilot study, the administration of high-dose spironolactone to ventilated critically ill patients receiving frusemide by infusion had no significant effects on serum sodium level, natriuresis or potassium balance when compared with placebo.en
dc.language.isoenen
dc.subject.otherAgeden
dc.subject.otherCritical Illnessen
dc.subject.otherDiuretics.administration & dosage.adverse effectsen
dc.subject.otherDouble-Blind Methoden
dc.subject.otherFemaleen
dc.subject.otherFurosemide.administration & dosage.adverse effectsen
dc.subject.otherHumansen
dc.subject.otherHypernatremia.chemically induced.prevention & controlen
dc.subject.otherInfusions, Intravenousen
dc.subject.otherIntensive Careen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherMineralocorticoid Receptor Antagonists.administration & dosageen
dc.subject.otherPilot Projectsen
dc.subject.otherRespiration, Artificialen
dc.subject.otherSpironolactone.administration & dosageen
dc.titlePilot randomised double-blind controlled trial of high-dose spironolactone in critically ill patients receiving a frusemide infusion.en
dc.typeJournal Articleen
dc.identifier.journaltitleCritical Care and Resuscitationen
dc.identifier.affiliationDepartment of Intensive Care, Austin Hospital, Melbourne, VIC.en
dc.description.pages306-11en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/19049481en
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