Comparison of hemodynamic and biochemical effects of furosemide by continuous infusion and intermittent bolus in critically ill patients.
Positive fluid balance in critically ill patients is a common problem in the intensive care unit (ICU) often associated with a poor outcome. In addition, clinically important changes in hemodynamic variables have been found to occur after diuretic therapy. This study was conducted to evaluate the safety and relative effectiveness of two diuretic protocols in the ICU. Twenty-two patients in the medical ICU with pulmonary edema or fluid overload and PaO2/FIO2 pressure less than 300, were randomized to diuretic therapy by either continuous infusion or intermittent bolus. Hemodynamic and biochemical measurements were recorded. Protocol-guided diuretic management can be readily and safely implemented in the ICU. Although both continuous and bolus diuretic regimens appear to be equally effective in achieving negative fluid balance, the clinician may consider a continuous infusion of furosemide in the hemodynamically and electrolytically unstable patient to ensure more controlled diuresis with less hemodynamic and electrolyte alteration. From a nursing perspective, a continuous infusion of furosemide is a more efficient means of drug delivery.
Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran. vazeena@pearl.sums.ac.ir
Mojtaba
M
Mojtahedzadeh
Ebrahim
E
Salehifar
Afsaneh
A
Vazin
Hanieh
H
Mahidiani
Atabak
A
Najafi
Maria
M
Tavakoli
Mohsen
M
Nayebpour
Mohammad
M
Abdollahi
D000704:Analysis of Variance; D004232:Diuretics / Q000008:administration & dosage* / Q000494:pharmacology; D005665:Furosemide / Q000008:administration & dosage* / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods*; D011446:Prospective Studies; D014882:Water-Electrolyte Balance / Q000187:drug effects
D004232:Diuretics; D005665:Furosemide