Hemodynamic effects of diuresis by ethacrynic acid in normal subjects and in patients with congestive heart failure

Abstract

Hemodynamic effects of intravenous administration of ethacrynic acid, 1 or 2 mg/kg, were studied in five normal subjects and in five patients with advanced congestive heart failure. In normal subjects, the diuresis averaged 1.2 liters in 90 minutes, resulting in a reduction in plasma volume of 14%. Stroke index fell by a mean of 21%, arteriovenous oxygen difference widened by 13%, and orthostatic tolerance was decreased. Patients in congestive heart failure showed a mean diuresis of 1.8 liters and a decrease in plasma volume of 9%. Central venous pressure fell from a mean of 16 to 10 mm Hg. Cardiac index increased by 18% from a mean of 1.8 liters/min/sq m, and stroke index rose by 11%. The arteriovenous oxygen difference narrowed from 8 to 7.1 vol%. Orthostatic stress was tolerated well.