[Intravenous furosemide for acute heart failure : continuous infusion or intermittent bolus ?]
Joana Dias1, Sebastian Carballo1, Philippe Meyer2
1Service de médecine interne générale, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.
Abstract:
Loop diuretics are strongly recommended by current guidelines for the treatment of acute heart failure. Intravenous furosemide can be administered either as a continuous infusion or as an intermittent bolus. The choice between these two routes is not always obvious in clinical practice. The understanding of their different mechanisms of action, as well as the notion of diuretic resistance, can help identify patients who may benefit from either of these two routes. This article aims at discussing these aspects and their pathophysiology, as well as summarizing the current body of evidence from randomized trials comparing continuous vs. intermittent administration of furosemide in acute heart failure.
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