Assessing Response To Furosemide Administered By IV Infusion Versus IV Intermittent Boluses To Patients With Acute Decompensated Heart Failure Using Thoracic Fluid Content Measurement

Abstract

Background: The use of continuous infusion or IV boluses to treat acute
decompensated heart failure (ADHF) with loop diuretics is still debatable. Aim and
Objective: To evaluate differences between the two administration routes on the
thoracic fluid content (TFC) and the renal functions. Methods: Sixty patients with
ADHF admitted to the critical care medicine department, Saifee Hospital, Mumbai,
were initially enrolled in the study. Twenty patients were excluded due to EF > 40%,
myocardial infarction within 30 days, and baseline serum creatinine level > 4.0 mg/dL.
Furosemide (120 mg/day) was given to the remaining 50 pts who continued the study
after 1:1 randomization to either continuous infusion (group-I, 25 pts) or three equal
intermittent daily doses (group-II, 25 pts). Subsequent dose titration was allowed after
24 h, but not earlier, according to patient’s response. No other diuretic medications
were allowed. All patients were daily evaluated for NYHA class, urine output, TFC,
body weight, serum K+ , and renal chemistry. R