Very High-Dose Furosemide Continuous Infusions: A Case Series.

Area of Science:

• Nephrology
• Pharmacology

Background:

• Limited data exists on the efficacy and safety of very high-dose furosemide continuous infusions (≥40 mg/h) for fluid management.
• This novel administration strategy may provide valuable insights into loop diuretic use.

Purpose of the Study:

• To evaluate the efficacy and safety of very high-dose furosemide continuous infusions in patients requiring significant volume removal.

Main Methods:

• Retrospective chart review of 22 patients receiving very high-dose furosemide infusions (≥40 mg/h) between April 2017 and January 2019.
• Data collected included urine output, acute kidney injury, hypotension, electrolyte abnormalities, and ototoxicity.

Main Results:

• A significant increase in median 24-hour urine output was observed, from 1193 mL before infusion to 3518 mL after (P < .01).
• Serum creatinine transiently increased but normalized within 48 hours.
• No electrolyte abnormalities or ototoxicity were reported; only two patients experienced hypotension.

Conclusions:

• Very high-dose furosemide continuous infusions effectively increase diuresis without compromising renal function or causing electrolyte disturbances.
• This strategy appears safe regarding ototoxicity and hypotension, warranting further investigation.