Loop diuretics are the main therapy for decongestion of patients with advanced acute heart failure. However, these patients often develop diuretic-resistance or even diuretic-refractoriness. In order to overcome such resistance to diuretic, the clinician can increase the dose of furosemide, or change the way of administration (continuous infusion versus boluses) or associate a different class of diuretics (thiazide diuretics, K+-sparing diuretics) up to the addition of low doses of inotropic agents to improve renal perfusion. At the present time there is no evidence in literature in advanced acute heart failure patients about the superiority of the treatment with furosemide in continuous infusion or in intermittent boluses. The aim of the study was to evaluate the efficacy of furosemide in boluses versus continuous infusion in advanced acute heart failure.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
80
intravenous administration of diuretics
Simone Frea
Torino, To, Italy
Freedom from congestion
Time frame: 72 hours after randomization
Worsening of renal function
Increase in creatinine value \> 0.3 mg/dl or increase \> 1.5 times
Time frame: 72 hours after randomization
Worsening or persistent HF at 72 h
Need to increase the dose of inotropes or diuretics
Time frame: 72 hours after randomization
Change in body weight
Time frame: 72 hours after randomization
Laboratory data variations in NTproBNP
Time frame: 72 hours after randomization
Treatment failure
Composed by the following events: persistence of congestion, need to increase diuretic treatment, need of renal replacement treatment
Time frame: 72 hours after randomization
Weight differences based on diuretic dose unity
Time frame: 72 hours after randomization
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