Manejo de la insuficiencia cardíaca refractaria a diuréticos con suero salino hipertónico

Heart failure is one of the most prevalent diseases in our society, being a frequent cause of morbidity and mortality in elderly people. Treatment of acute heart failure is mainly based on the administration of intravenous loop diuretics; however, in some cases their use is not associated with an improvement of symptomatology or prognosis, frequently requiring readmission in a hospital. This is a case report about a patient who was admitted to San Juan de Alicante Home Hospitalization Unit. Despite a proper diuretic treatment, this patient had heart failure and refractory oedema in lower limbs. We initiate treatment with an infusion of hypertonic saline solution and high doses of furosemide, registering an improvement of the symptoms and reducing oedema maintaining renal function.