Frusemide in pulmonary oedema: continuous versus intermittent

Makhoul, Nicola; Riad, T.; Friedstrom, Scott; Zveibil, Fabio

doi:10.3109/tcic.8.6.273.276

Cited by 15 publications

(13 citation statements)

References 4 publications

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“…The clinical characteristics of all included RCTs comparing the outcomes of continuous infusion and bolus injection of furosemide in heart failure are presented in Table . Out of the eight studies, three studies were double‐blind , two studies were single‐blind , two studies were unblinded and one study was rated as ‘unclear’ due to insufficient information given in the manuscript. Two studies were of the heart failure population in intensive care , one study was of the heart failure population in the emergency department , and the rest of the included studies were of the heart failure population in hospital wards.…”

Section: Resultsmentioning

confidence: 99%

“…Out of the eight studies, three studies were double‐blind , two studies were single‐blind , two studies were unblinded and one study was rated as ‘unclear’ due to insufficient information given in the manuscript. Two studies were of the heart failure population in intensive care , one study was of the heart failure population in the emergency department , and the rest of the included studies were of the heart failure population in hospital wards. Overall, the majority of the included studies had low risk of bias, with the exception of two studies in which all patients received a bolus injection of furosemide 40 mg before random allocation to either continuous infusion or intermittent bolus injection of furosemide (see also Supporting Information, Table S4).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were of the heart failure population in intensive care , one study was of the heart failure population in the emergency department , and the rest of the included studies were of the heart failure population in hospital wards. Overall, the majority of the included studies had low risk of bias, with the exception of two studies in which all patients received a bolus injection of furosemide 40 mg before random allocation to either continuous infusion or intermittent bolus injection of furosemide (see also Supporting Information, Table S4). No studies were commercially sponsored, and there were no conflicts of interest, so no studies were excluded on this basis.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies investigated total urine output in the first 24 h after random allocation of patients into either continuous or bolus i.v. furosemide groups.…”

Section: Resultsmentioning

confidence: 99%

“…Several recent randomised controlled trials (RCTs) have investigated the efficacy and safety profiles of modes of administration (continuous infusion vs. bolus) of i.v. furosemide in heart failure populations, but results have been conflicting . Continuous infusion of furosemide is believed to confer additional benefits over bolus injection, with less variability in peak plasma furosemide concentration resulting in a consistent, predictable urine output and less risk of electrolyte disturbance.…”

Section: Introductionmentioning

confidence: 99%

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Continuous infusion vs. intermittent bolus injection of furosemide in acute decompensated heart failure: systematic review and meta‐analysis of randomised controlled trials

Yap

2017

Anaesthesia

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Loop diuretics remain a fundamental pharmacological therapy to remove excess fluid and improve symptom control in acute decompensated heart failure. Several recent randomised controlled trials have examined the clinical benefit of continuous vs. bolus furosemide in acute decompensated heart failure, but have reported conflicting findings. The aim of this review was to compare the effects of continuous and bolus furosemide with regard to mortality, length of hospital stay and its efficacy profile in acute decompensated heart failure. All parallel-arm randomised controlled trials from MEDLINE, EMBASE, PubMed and the Cochrane Database of Systematic Reviews from inception until May 2017 were included. Cross-over randomised controlled trials, observational studies, case reports, case series and non-systematic reviews that involved children were excluded. Eight trials (n = 669) were eligible for inclusion. There was no difference between furosemide continuous infusion and bolus administration for all-cause mortality (four studies; n = 491; I = 0%; OR 1.65; 95%CI 0.93-2.91; p = 0.08) or duration of hospitalisation (six studies; n = 576; I = 71%; mean difference 0.27; 95%CI -1.35 to 1.89 days; p = 0.74). Continuous infusion of intravenous furosemide was associated with increased weight reduction (five studies; n = 516; I = 0%; mean difference 0.70; 95%CI 0.12-1.28 kg; p = 0.02); increased total urine output in 24 h (four studies; n = 390; I = 33%; mean difference 461.5; 95%CI 133.7-789.4 ml; p < 0.01); and reduced brain natriuretic peptide (two studies; n = 390; I = 0%; mean difference 399.5; 95%CI 152.7-646.3 ng.l ; p < 0.01), compared with the bolus group. There was no difference in the incidence of raised creatinine and hypokalaemia between the two groups. In summary, there was no difference between continuous infusion and bolus of furosemide for all-cause mortality, length of hospital stay and electrolyte disturbance, but continuous infusion was superior to bolus administration with regard to diuretic effect and reduction in brain natriuretic peptide.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Five studies investigated total urine output in the first 24 h after random allocation of patients into either continuous or bolus i.v. furosemide groups.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Continuous infusion vs. intermittent bolus injection of furosemide in acute decompensated heart failure: systematic review and meta‐analysis of randomised controlled trials

Yap

2017

Anaesthesia

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Hypoalbuminaemia and heart failure: A practical review of current evidence

Biancucci,

Barbiero,

Pennella

et al. 2024

European J of Heart Fail

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Hypoalbuminaemia (serum albumin levels ≤3.5 g/dl) is associated with poor outcomes among patients with heart failure (HF). This narrative review includes original articles and reviews published over the past 20 years and retrieved from PubMed using the following search terms (or their combination): ‘heart failure’, ‘hypoalbuminaemia’, ‘heart failure with reduced ejection fraction’, ‘heart failure with preserved ejection fraction’, ‘all‐cause mortality’, ‘in‐hospital mortality’, ‘hospitalization’, ‘prognosis’. The aims of this review are to provide an overview on the prevalence of hypoalbuminaemia in HF, its impact on clinical outcomes, and potential mechanisms that may suggest future therapeutic strategies. Hypoalbuminaemia is frequent in HF patients, especially among the elderly. However, data about the exact epidemiology of hypoalbuminaemia are scant due to different definitions, and prevalence is estimated between 5% and 70% across the whole spectrum of ejection fraction. Current evidence points to hypoalbuminaemia as a marker of poor outcomes in HF, irrespective of the ejection fraction, and in other cardiovascular diseases. Among patients who suffered from acute coronary syndrome, those with hypoalbuminaemia had an increased risk of new‐onset HF and in‐hospital mortality. Albumin, however, might also play a role in the natural history of such diseases due to its antioxidant, anti‐inflammatory, and antithrombotic properties. Whether albumin supplementation or nutritional support in general would be beneficial in improving clinical outcomes in HF is not completely clear and should be evaluated in adequately designed studies.

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