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Frusemide administration in critically ill patients by continuous compared to bolus therapy
Marlies Ostermann1, George Alvarez, Michael D Sharpe
1Program in Critical Care, University of Western Ontario, London Health Sciences Centre, London, Ontario, Canada. marlies@ostermann.freeserve.co.uk
Nephron. Clinical Practice
|September 25, 2007
Summary
Continuous frusemide infusion therapy is more effective than intermittent bolus doses for achieving diuresis in critically ill patients. Infusion requires significantly less frusemide (a diuretic) to reach target urine output, improving efficiency.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Nephrology
Background:
- Frusemide is a common diuretic used in intensive care units (ICUs).
- Fluid overload is a significant concern for critically ill patients.
Purpose of the Study:
- To compare the effectiveness of continuous frusemide infusion versus intermittent bolus doses in critically ill patients.
- To determine which frusemide administration method is more efficient for diuresis.
Main Methods:
- A randomized trial involving 59 adult patients with fluid overload in ICUs.
- Patients were assigned to either continuous frusemide infusion or intermittent intravenous boluses.
- Treatment followed pre-defined algorithms targeting a minimum hourly urine output.
Main Results:
- No significant difference in overall 24-hour diuresis between the two groups.
- Continuous infusion required significantly lower doses of frusemide (9.2 mg/h vs. 24.1 mg/h).
- Urine output per milligram of frusemide was higher with continuous infusion (31.6 ml/mg vs. 18 ml/mg).
Conclusions:
- Both frusemide administration methods achieved target diuresis.
- Continuous infusion is more effective due to reduced frusemide dosage requirements.
- No differences observed in mortality, need for ventilation, or renal function changes.
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