Heart failure
Conditions
Interventions
Intervention group: 32 patients will be given one capsule of hydrochlorothiazide 50 mg once daily (preferably in the morning), minimum 1 day, maximum 3 days (maximum duration of intervention). Adminis
Drug
Sponsors
Hospital de Clínicas de Porto Alegre
Hospital de Clínicas de Porto Alegre
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Diagnosis of acutely decompensated heart failure; age greater than 18 years; male and female; emergency admission for less than 18 hours; signs of congestion (lower limb edema, pulmonary crackles, chest X-ray with signs of congestion, jugular swelling or hepatojugular reflux, weight gain greater than 4.5 kg); endogenous creatinine clearance greater than 30 ml / min; serum potassium between 3.5 and 5.1 mEq / L; ejection fraction equal to or less than 45% in the last 12 months; to sign a free and informed consent form.
Exclusion criteria
Exclusion criteria: Hypernatremia; Bartter or Gitelman syndrome; renal tubular acidosis type IV; allergy to sulfa; validity of acute coronary syndrome; history of gout; gestation or lactation; septic shock; hepatic dysfunction (elevation of transaminases three times the reference value); inability to enteral intake.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Congestion reduction (weight loss of 1.8 kg) is expected to be achieved, with daily weighing machine, during administration of the medication or placebo, according to randomization), by comparing weight before intervention and after the end of it. | — |
Secondary
| Measure | Time frame |
|---|---|
| A loss of 1.8 kg or a reduction of 30% of the NT-proBNP will be evaluated through a laboratory kit, before and after the intervention, in 3 days.;We will evaluate variation of BNP in 3 days (or discharge, if before) and at the end of hospitalization, through a laboratory kit, compared to values before the start of the intervention.;A 3-day creatinine variation (or discharge, if earlier) will be evaluated and at the end of hospitalization, using a laboratory kit, compared to values before the start of the intervention.;The need to use vasoactive drugs (sodium nitroprusside, nitroglycerin, dobutamine, milrinone) will be assessed over the study intervention days.;The congestion score (composed of 6 variables, each with a value of 1 point, being jugular, hepatojugular reflux, peripheral edema, crackling, third bulge, orthopnea) between the groups, before and after the intervention, will be evaluated.;The dyspnea score (Likert scale and area on the curve between Likert scale and time) will be evaluated between the groups, before the intervention and after.;The weight variation will be evaluated before after the intervention between the groups, through a weighting machine;The hospitalization time between the control and intervention groups will be evaluated.;Variation of hematimetric parameters (hematocrit and hemoglobin, by laboratory measurement) will be evaluated, before and after 3 days of intervention.;Hepatic function (TGO, TGP, bilirubin, alkaline phosphatase, gamma-GT, by laboratory measurement) will be assessed before and after intervention in both groups.;Re-hospitalization for decompensated heart failure (defined by the inclusion criteria of the present study) will be evaluated in 30 days (through telephone contact and / or patient chart review) in both groups.;Subjective site scale will be evaluated (value from 0 (no thirst) to 10 (intense thirst), in area on the curve - thirst x time) in both groups, before and after the intervention.;It will be assessed mort | — |
Countries
Brazil
Contacts
Public ContactDiogo Piardi
Hospital de Clínicas de Porto Alegre
Outcome results
None listed