Continuous Better Than Bolus Furosemide

Loop diuretics such as furosemide are often used in the management of heart failure, where impairment of renal function is common. In renal insufficiency, both higher dosages and the time course of delivery of furosemide are important to achieve sufficient concentration of diuretic in the renal tubule. This randomized crossover study from the Netherlands compared continuous furosemide infusion with bolus injection in patients with severe heart failure.

Twenty patients with chronic heart failure and long-term oral use of high-dose furosemide were hospitalized and placed on a standard diet and fluid intake. Patients were continued on their usual medications, and received their usual furosemide dose on day three as either an intravenous bolus i…