INTRAVENOUS TORSEMIDE AS ADJUNCTIVE THERAPY IN PATIENTS WITH ACUTE PULMONARY-EDEMA

The safety and efficacy of intravenous (IV) torsemide as adjunctive th erapy for acute cardiogenic pulmonary edema was evaluated. Thirteen pa tients were treated with IV torsemide and six patients, with IV furose mide, as a positive control. Doses of torsemide, 20 mg or 40 mg, and f urosemide, 40 mg or 80 mg, were administered initially. The dose was t itrated as necessary over the next 24 hours. In patients who received IV torsemide, median fractional sodium excretion significantly increas ed from 2.88% (0.04-10.1%) at baseline to 6.76% (0.71-11.6%) at peak ( P = 0.0342). Hourly urine volume increased from 134 mL (25-400 mL) to 375 mL (145-790 mL) (P = 0.0034). Torsemide administration resulted in a significant improvement in both pulmonary rales and orthopnea. None of the patients experienced serious adverse events or required withdr awal from the study. These results suggest that IV torsemide is an eff ective and well-tolerated diuretic in patients with acute cardiogenic pulmonary edema.