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Evaluating routine diuretics after coronary surgery: a prospective randomized controlled trial.

Eric Lim·Ziad A Ali·Robert Attaran·Graham Cooper
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Abstract

BACKGROUND: Routine diuretic administration after cardiopulmonary bypass is common despite the lack of evidence for its benefit. We performed a prospective study to evaluate if diuretics assist in weight loss or alter clinical outcome. METHODS: Seventy-nine patients undergoing primary elective coronary bypass surgery were randomized to either diuretic (fusemide and amiloride) or placebo (lactose) postoperatively until preoperative weight was achieved or for 5 days in total. Proportions were compared with chi2 or Fisher's exact test. RESULTS: Forty patients were randomized to diuretics and 39 to placebo. By day 5, 97% of patients (37 of 38) still in the diuretic arm, and 74% of patients (29 of 39) in the placebo arm, achieved preoperative weight (p = 0.02). There were no differences in clinical outcomes. CONCLUSIONS: Routine diuretics promote an earlier diuresis but no clinical benefits are apparent in low risk patients with normal renal function. Clinicians should reconsider routine diuretic prescription in this setting.

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AgedAmilorideCardiopulmonary BypassCoronary Artery BypassDiureticsDouble-Blind MethodFemaleFurosemideHumansMaleMiddle AgedProspective StudiesClinical TrialJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov't

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Eric Lim, Ziad A Ali, Robert Attaran, Graham Cooper. 2002. Evaluating routine diuretics after coronary surgery: a prospective randomized controlled trial.. https://doi.org/10.1016/s0003-4975(01)03311-2

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