Pilot randomised double-blind controlled trial of high-dose spironolactone in critically ill patients receiving a frusemide infusion.

Abstract

BACKGROUND: Hypernatraemia may develop during intravenous infusion of frusemide. Spironolactone is an aldosterone antagonist that promotes natriuresis and may attenuate such hypernatraemia, but its effect in this setting has not been previously studied. OBJECTIVE: To assess whether the administration of spironolactone to ventilated patients receiving a frusemide infusion attenuates the increase in serum sodium concentration. DESIGN AND SETTING: Randomised, double-blind, placebo-controlled trial (January 2005 to December 2006). PATIENTS: 20 patients with a serum creatinine concentration < 300 micromol/L who were undergoing mechanical ventilation in the intensive care unit and had begun a frus..