Frecuencia de depleción del volumen asociado al uso de furosemida como tratamiento de primera línea en crisis hipertensivas durante el periodo enero 2017 - agosto 2019 en el Hospital Básico IESS Durán.

Abstract

Backround: Hypertensive crises are one of the most important causes of morbimortality in the emergency room in Ecuador; its managemente and treatment in our media doesn’t always agree with the guidelines of cardiovascular societies worldwide, which provoques complications and bad prognosis in certain cases Objective: Stablish the frequency of volumen depletion associated to the use of furosemide as a first line agent in the treatment of hypertensive crises. Methodology: A retrospective cohort study was performed, of patients that were admitted to the emergency room of Duran’s IESS hospital in the period from january 2017 – august 2019. Results: A sample of 290 patients was obtained, of which 36.55% (n=106) were catalogued as hypertensive crisis and 63.44% (n=184) were not hypertensive crisis. A positive correlation was obtained from the development of hydroelectrolytic dissorders and recurrent applications of furosemide (P= 0.04) (OR 4.22 95% IC 1-17.7). The most frequent electrolyte imbalance was hiponatremia with 78.7%% of cases (n=37/47) with a higher prevalence and risk associated favoring the female sex 59.4%% (n=22) (OR 1.26 95% IC 0.40-3.91), with a possitive correlation and higher risk contrasted to the cohort who received regular furosemide dosage (P= 0.001 OR 8.25 95% IC 2.12-32) Conclusion: The frequent use of furosemide in the emergency department generates electrolyte imbalances in patients with hypertensive crisis, more frequently in the female sex, consequently increasing the need for hospitalization and elevating the mortality risk.