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Continuous or bolus furosemide viable in acute heart failure

Christina Lau
21 Nov 2019

The choice between continuous and bolus furosemide in the treatment of acute heart failure (AHF) should be by physician’s preference as both regimens offer satisfactory outcomes, a recent systemic review and meta-analysis suggests.

Among 10 randomized controlled trials included for analysis, 371 patients were treated with intermittent bolus furosemide, while 364 received the diuretic via continuous infusion. The daily total furosemide dosage did not differ significantly between the two groups (weighted mean difference [WMD], 8.9 mg; 95 percent confidence interval [CI], -13.42 mg to 31.22 mg; p=0.43). [J Card Fail 2019, doi: 10.1016/j.cardfail.2019.11.013] 

Patients who received continuous furosemide had significantly higher mean daily urine output (WMD, 444.37 mL; 95 percent CI, 196.23 mL to 692.51 mL; p<0.001) and weight loss (WMD, 0.89 kg; 95 percent CI, 0.04 kg to 1.75 kg; p=0.04) compared with those who received bolus furosemide.

No significant differences were found in the length of hospital stay and in serum sodium, potassium and creatinine levels between the groups. Mortality and post-treatment brain natriuretic peptide (BNP) levels were not evaluated.

Based on the modest differences shown between the groups, the choice of furosemide regimen in AHF remains physician’s preference, according to the investigators from the Chinese University of Hong Kong.

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Most Read Articles
Roshini Claire Anthony, 20 hours ago

The presence of pulmonary arterial hypertension (PAH) in individuals with systemic sclerosis is associated with an increased mortality risk, a study from Singapore showed.

5 days ago
Individuals with post-traumatic stress disorder (PTSD) exhibit less healthy changes in overall diet quality over time, a study has found.
Pearl Toh, 13 Jan 2020
Obeticholic acid significantly improves fibrosis and disease activity in patients with nonalcoholic steatohepatitis (NASH), a chronic liver disease currently with no approved therapy, according to an interim analysis of the landmark REGENERATE* study.
11 Jan 2020
Prevention of glucocorticoid-induced osteoporosis (GIOP) and postmenopausal osteoporosis (PMOP) remains inadequate in patients with rheumatoid arthritis (RA), as shown in a study that evaluated the implementation of the 2003 and 2014 French guidelines on the prevention and treatment of GIOP and the 2012 update of the French guidelines for the treatment of PMOP.