Discontinuation of Furosemide Decreases co2 in COPDPatients

[gerald]

This study has been around a while but it is the first mention I hae seen about duretics increasing PaCO2.

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Discontinuation of Furosemide Decreases Paco2 in Patients With COPD

Folkert Brijker, Yvonne F. Heijdra, +1 author Hans T. M. Folgering

STUDY OBJECTIVE
To evaluate whether the discontinuation of furosemide treatment resulted in a decrease in PaCO(2) and an increase in daytime and nocturnal oxygenation.


BACKGROUND
Furosemide is widely prescribed in patients with COPD for the treatment of peripheral edema. It is known that furosemide causes a metabolic alkalosis. A diminished chemoreceptor stimulation may cause a decreased alveolar ventilation.


DESIGN
Randomized, double-blind, placebo-controlled, crossover trial.


SETTING
Department of Pulmonology, Rijnstate Hospital Arnhem, the Netherlands.


PATIENTS
Twenty patients with stable COPD (10 men; median age, 70 years [range, 58 to 81 years]; FEV(1) 35% predicted [range, 19 to 70% predicted]). Subjects were included if they had received furosemide, 40 mg/d, for the treatment of peripheral edema for at least a month and if they had a mean nocturnal arterial oxygen saturation (SaO(2)) < 92%. Patients with cardiac left and/or right ventricular dysfunction, sleep apneas, and patients receiving other diuretics, angiotensin-converting enzyme inhibitors, potassium or chloride replacement therapy, or long-term oxygen treatment were excluded.


INTERVENTION
Furosemide was discontinued for 1 week and replaced by placebo treatment in the first or the second week.


MEASUREMENTS AND RESULTS
Ventilation, daytime arterial blood gas levels, and nocturnal SaO(2) were measured at baseline, after 1, and after 2 weeks. Sixteen subjects completed the study. Ventilation increased from 10.4 L/min (range, 6.7 to 15.4 L/min) at baseline to 11.6 L/min (range, 8.7 to 14.0 L/min) after discontinuation of furosemide (p < 0.05). PaCO(2) decreased from 45 mm Hg (range, 35 to 64 mm Hg) to 41 mm Hg (range, 32 to 61 mm Hg; p < 0.01). Daytime and nocturnal oxygenation did not improve.


CONCLUSIONS
Although it does not improve oxygenation, the discontinuation of furosemide decreases PaCO(2) in patients with COPD.

www.semanticscholar.org/paper/Discontinuation-of-Furosemide-Decreases-Paco2-in-Brijker-Heijdra/04be574ba42b9a94f16472bbf232f40784a05dc4

[lavishgail]

I'm on this med? Hmmm.

[gerald]

I was in to see my Cardiologist today and I ask him about the furosemide and CO2. 

He said that as long as the kidneys were working properly to clear the fluids from the body there should not be any significant CO2 buildup.

[lavishgail]

Thank you Gerald, that good to know!