Continuous Versus Intermittent Infusion of Furosemide in Acute Decompensated Heart Failure

Despite advances in the treatment of chronic ambulatory heart failure, hospitalization rates for acute decompensated heart failure (ADHF) remain high. Although loop diuretics are used in nearly all patients with ADHF to relieve congestive symptoms, optimal dosing strategies remain poorly defined. Th...

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Bibliographic Details
Published in:Journal of cardiac failure Vol. 16; no. 3; pp. 188 - 193
Main Authors: Thomson, Margaret R., Nappi, Jean M., Dunn, Steven P., Hollis, Ian B., Rodgers, Jo E., Van Bakel, Adrian B.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.03.2010
Subjects:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Cardiovascular
Chi-Square Distribution
Diuretics
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
furosemide
Furosemide - administration & dosage
Furosemide - adverse effects
heart failure
Heart Failure - diagnosis
Heart Failure - drug therapy
Humans
Infusions, Intravenous - methods
Injections, Intravenous - methods
Male
Middle Aged
Probability
Prospective Studies
Risk Assessment
Severity of Illness Index
Sodium Potassium Chloride Symporter Inhibitors - administration & dosage
Sodium Potassium Chloride Symporter Inhibitors - adverse effects
Treatment Outcome
Young Adult
Diuretics
furosemide
heart failure
ISSN:1071-9164, 1532-8414, 1532-8414
Online Access:Get full text
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Summary:Despite advances in the treatment of chronic ambulatory heart failure, hospitalization rates for acute decompensated heart failure (ADHF) remain high. Although loop diuretics are used in nearly all patients with ADHF to relieve congestive symptoms, optimal dosing strategies remain poorly defined. This was a prospective, randomized, parallel-group study comparing the effectiveness of continuous intravenous (cIV) with intermittent intravenous (iIV) infusion of furosemide in 56 patients with ADHF. The dose and duration of furosemide as well as concomitant medications to treat ADHF were determined by physician preference. The primary end point of the study was net urine output (nUOP)/24hours. Safety measures including electrolyte loss and hemodynamic instability were also assessed. Twenty-six patients received cIV and 30 patients received iIV dosing. The mean nUOP/24hours was 2098±1132mL in patients receiving cIV versus 1575±1100mL in the iIV group (P=.086). The cIV group had significantly greater total urine output (tUOP) with 3726±1121mL/24hours versus 2955±1267mL/24hours in the iIV group (P=.019) and tUOP/mg furosemide with 38.0±31.0mL/mg versus 22.2±12.5mL/mg (P=.021). Mean weight loss was not significantly different between the groups. The cIV group experienced a shorter length of hospital stay (6.9±3.7 versus 10.9±8.3 days, P=.006). There were no differences in safety measures between the groups. The cIV of furosemide was well tolerated and significantly more effective than iIV for tUOP. In addition, continuous infusion appears to provide more efficient diuresis.
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ISSN:1071-9164
1532-8414
1532-8414
DOI:10.1016/j.cardfail.2009.11.005