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Whole Body And Right Lung Bioimpedance Are More Sensitive Than Proximal Bioimpedance At Predicting Response To Intravenous Furosemide In Patients With Acute Pulmonary Oedema

Kam Chuen NG MJ  Lip GYH  MacFadyen RJ  Ferner RE

Abstract presented at the British Pharmacological Society Winter Meeting in December 2006

INTRODUCTION: Bioimpedance (Ω) analysis (BIA) provides a potential measure of body water (1). BIA may predict decompensation in systolic heart failure (2). We tested the utility of BIA in assessing the acute response to intravenous furosemide (ivF) in pulmonary oedema.

METHODS: We studied patients with florid pulmonary oedema treated with ivF (50-150 mg bolus). We compared Bodystat Quadscan 4000® BIA (extracellular (ECW), intracellular (ICW) and total body water (TBW), Ωat frequencies 5-200 KHz (Ω5KHz, Ω50KHz, Ω100KHz, Ω200KHz)) with electrodes positioned distally (whole body BIA), proximally (proximal BIA) and across the right lung (right lung BIA) 0, 0.5, 1, 2 and 3 hours after ivF.

RESULTS: 34 patients (n=34; male 21, female 13; age 72.1±11.5, range 30-86; body surface area 1.87±0.23 m2, range 1.37-2.36; 25 sinus rhythm, 9 atrial fibrillation; 13 ischaemia, 2 arrhythmia, 4 valvular heart disease, 4 lung disease, 5 renal disease, 2 non-ischaemic cardiomyopathy, 3 hypertension, 1 infection) were studied. TBW, ECW and ICW decreased, and Ω increased in response to ivF (table1). Whole body and right lung Ω were more sensitive indicators of acute response to ivF compared to proximal Ω.

CONCLUSION: Whole body and right lung Ω are relative markers of volume response to ivF in patients with acute pulmonary oedema, thus potentially providing an accurate, practical and non-invasive means of assessing response to treatment in this setting.

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