Related Experiment Video
Updated: Mar 11, 2026
07:59
Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
11.8K
Continuous Versus Intermittent Loop Diuretics Step-by-Step Protocol in Acute Heart Failure (DIUR-AHF):
Gaetano Ruocco1,2, Andrea Salzano3,4,5, Sara Franceschi6
1Cardiovascular Research Institute Maastricht Maastrict University Maastricht Netherlands.
Journal of the American Heart Association
|March 10, 2026
Summary
High-dose loop diuretics in acute heart failure increase adverse events and reduce effectiveness. This contrasts with low-dose treatment, suggesting caution with high-dose strategies for better patient outcomes.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Loop diuretics are standard treatment for acute heart failure (AHF) congestion.
- Optimal dosing and administration strategies remain unclear.
Purpose of the Study:
- To compare intermittent versus continuous furosemide infusion.
- To evaluate high-dose (HD) versus low-dose loop diuretics.
- To assess effects on congestion, renal function, and clinical outcomes in AHF.
Main Methods:
- Analysis of the DIUR-AHF study data.
- 370 AHF patients received either continuous or intermittent IV loop diuretics for 72-120 hours.
- HD defined as >120 mg/day; outcomes assessed over 6-month follow-up.
Main Results:
- HD loop diuretics showed similar congestion relief but reduced diuretic efficiency compared to low-dose.
- HD group experienced significantly more adverse events (55% vs 20%).
- Multivariable analysis linked HD treatment to poorer postdischarge outcomes (HR 1.95).
Conclusions:
- High-dose loop diuretics in AHF increase adverse event risk and decrease diuretic response.
- Findings align with previous research on HD diuretics and prognosis in chronic heart failure.
- Further research needed on loop diuretic response with other decongestive therapies.
Related Concept Videos
01:22Heart Failure Drugs: Diuretics
1.1K
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
1.1K
01:20Acute Kidney Injury V: Interprofessional Care
438
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
438
01:22Heart Failure VI: Adjunct Therapies
494
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
494
01:30Heart Failure V: Medical Management
453
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
453
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
323
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
323
01:30Continuous Renal Replacement Therapy
1.5K
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
1.5K