What is it about?

Examine the method of intravenous furosemide (bolus vs intermittent) in critically ill patients

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Why is it important?

Nine studies (n=464) were eligible in the data synthesis. Both continuous and bolus furosemide resulted in no difference in all-cause mortality (seven studies; n=396; I2=0%; Fixed-effect Model (FEM): Odd Ratio (OR) 1.15 [95%CI 0.67,1.96]; ρ=0.64). Continuous furosemide was associated with significant greater total urine output (n=132; I2=70%; Random-effect Model:OR 811.19 [95%CI 99.84,1522.53]; ρ=0.03), but longer length of hospital stay (n=290; I2=40%; FEM:OR 2.84 [95%CI 1.74,3.94]; ρ<0.01) in comparison to bolus group. No statistical significance was found in the changes of creatinine and eGFR between both groups.

Perspectives

In this meta-analysis, continuous furosemide was associated with greater diuretic effect in total urine output as compared to the bolus one, neither of them had any differences in mortality and changes of renal function test. However, a large adequately powered randomised clinical trial is required to fill this knowledge gap.

Dr Ka Ting Ng
University of Malaya

Based on this meta-analysis, it is found that continuous infusion of furosemide is associated with greater diuretic effect in the total urine output as compared to the intermittent bolus injection of furosemide. In terms of mortality and effect on renal function test, neither showed any significant differences. Further studies and researches are needed to verify the results of the meta-analysis.

Aslinah Velayit
International Medical University

Read the Original

This page is a summary of: Continuous Infusion Versus Intermittent Bolus Injection of Furosemide in Critically Ill Patients: A Systematic Review and Meta-Analysis, Journal of Cardiothoracic and Vascular Anesthesia, January 2018, Elsevier,
DOI: 10.1053/j.jvca.2018.01.004.
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