Details

Autor(en) / Beteiligte

• Thomson, Margaret R., PharmD, BCPS
• Nappi, Jean M., PharmD, BCPS
• Dunn, Steven P., PharmD, BCPS
• Hollis, Ian B., PharmD, BCPS
• Rodgers, Jo E., PharmD, BCPS
• Van Bakel, Adrian B., MD, PhD

Titel

Continuous Versus Intermittent Infusion of Furosemide in Acute Decompensated Heart Failure

Ist Teil von

• Journal of cardiac failure, 2010-03, Vol.16 (3), p.188-193

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2010

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Abstract Background 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. Methods and Results 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)/24 hours. 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/24 hours was 2098 ± 1132 mL in patients receiving cIV versus 1575 ± 1100 mL in the iIV group ( P = .086). The cIV group had significantly greater total urine output (tUOP) with 3726 ± 1121 mL/24 hours versus 2955 ± 1267 mL/24 hours in the iIV group ( P = .019) and tUOP/mg furosemide with 38.0 ± 31.0 mL/mg versus 22.2 ± 12.5 mL/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. Conclusions 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.