Objective:

To compare the efficacy of continuous infusion versus intermittent bolus furosemide in adult patients with acute heart failure or NYHA class III–IV symptoms, focusing on all-cause mortality and freedom from congestion.

Approach:

Key Findings:

• The intermittent intravenous (iIV) arm showed a numerical trend toward higher all-cause mortality compared to the continuous intravenous (cIV) arm, but this was not statistically significant (RR: 1.36, 95% CI: 0.96–1.94, p = 0.08).
• The cIV arm demonstrated significant improvements in freedom from congestion compared to the iIV arm (RR: 1.42, 95% CI: 1.06–1.91, p = 0.02).
• The cIV arm showed significant improvements in weight loss, 24-h urine volume, length of hospital stay, edema resolution time, time to dyspnea improvement, post-treatment LVEF, post-treatment LVEDD, and post-treatment BNP levels.

Interpretation:

Continuous infusion of furosemide is associated with faster relief of congestion and greater weight loss compared to intermittent bolus administration, although no significant advantage was found for long-term survival.

Limitations:

• Sample size limitations in previous studies may lack the statistical power to detect clinically relevant endpoints.
• Geographical imbalance in participant demographics may limit the generalizability of findings.

Conclusion:

Continuous infusion of furosemide may provide better short-term outcomes in acute heart failure management, but further research is needed to assess long-term effects.

Sources:

• Systematic Review Registration
Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.