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Continuous versus bolus dosing of Furosemide for patients hospitalized for heart failure.

Publication ,  Journal Article
Allen, LA; Turer, AT; Dewald, T; Stough, WG; Cotter, G; O'Connor, CM
Published in: Am J Cardiol
June 15, 2010

Intravenous diuretics are the cornerstone of management for patients hospitalized for heart failure. Physiologic data suggest that intermittent high-dose furosemide promotes neurohormonal activation, which a slow continuous infusion might remediate. However, the limited clinical data comparing dosing schemes are confounded. This study was a randomized, open-label, single-center trial of twice-daily bolus injection versus continuous infusion furosemide in patients hospitalized with heart failure and volume overload. The primary outcome was change in creatinine from admission to hospital day 3 or discharge. Twenty-one patients were randomized to bolus injection and 20 patients to continuous infusion. Baseline characteristics were balanced between study arms except for gender, with a mean age of 60 +/- 15 years, a mean ejection fraction of 35 +/- 19%, and a mean creatinine level of 1.9 +/- 1.2 mg/dl. The mean doses of furosemide were similar between arms over the first 48 hours (162 +/- 48 and 162 +/- 52 mg/24 hours). None of the outcomes differed significantly between bolus and continuous dosing from admission to hospital day 3 or discharge (mean change in creatinine -0.02 vs 0.13 mg/dl, p = 0.18; urine output 5,113 vs 4,894 ml, p = 0.78; length of stay 8.8 vs 9.9 days, p = 0.69). All patients survived to discharge. In conclusion, there were no substantial differences between bolus injection and continuous infusion of equal doses of furosemide for the treatment of patients hospitalized with heart failure. Given the high prevalence of heart failure hospitalization and the disparate results of small studies regarding optimal dosing of loop diuretics to treat these patients, larger multicenter blinded studies are needed.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

June 15, 2010

Volume

105

Issue

12

Start / End Page

1794 / 1797

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stroke Volume
  • Prospective Studies
  • Middle Aged
  • Male
  • Inpatients
  • Injections, Intravenous
  • Infusions, Intravenous
  • Humans
  • Heart Failure
 

Citation

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Allen, L. A., Turer, A. T., Dewald, T., Stough, W. G., Cotter, G., & O’Connor, C. M. (2010). Continuous versus bolus dosing of Furosemide for patients hospitalized for heart failure. Am J Cardiol, 105(12), 1794–1797. https://doi.org/10.1016/j.amjcard.2010.01.355
Allen, Larry A., Aslan T. Turer, Tracy Dewald, Wendy Gattis Stough, Gadi Cotter, and Christopher M. O’Connor. “Continuous versus bolus dosing of Furosemide for patients hospitalized for heart failure.Am J Cardiol 105, no. 12 (June 15, 2010): 1794–97. https://doi.org/10.1016/j.amjcard.2010.01.355.
Allen LA, Turer AT, Dewald T, Stough WG, Cotter G, O’Connor CM. Continuous versus bolus dosing of Furosemide for patients hospitalized for heart failure. Am J Cardiol. 2010 Jun 15;105(12):1794–7.
Allen, Larry A., et al. “Continuous versus bolus dosing of Furosemide for patients hospitalized for heart failure.Am J Cardiol, vol. 105, no. 12, June 2010, pp. 1794–97. Pubmed, doi:10.1016/j.amjcard.2010.01.355.
Allen LA, Turer AT, Dewald T, Stough WG, Cotter G, O’Connor CM. Continuous versus bolus dosing of Furosemide for patients hospitalized for heart failure. Am J Cardiol. 2010 Jun 15;105(12):1794–1797.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

June 15, 2010

Volume

105

Issue

12

Start / End Page

1794 / 1797

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stroke Volume
  • Prospective Studies
  • Middle Aged
  • Male
  • Inpatients
  • Injections, Intravenous
  • Infusions, Intravenous
  • Humans
  • Heart Failure