Diuretic Has Similar Effect Regardless of Method or Dose

Acute decompensated heart failure patients respond about the same

THURSDAY, March 3 (HealthDay News) -- The responses of patients with acute decompensated heart failure to loop diuretics don't appear to differ between groups administered the agent by bolus or continuous infusion, or at a high or low dose, according to research published in the March 3 issue of the New England Journal of Medicine.

G. Michael Felker, M.D., M.H.S., of the Duke University School of Medicine in Durham, N.C., and colleagues treated 308 patients with acute decompensated heart failure with furosemide by either a bolus or continuous infusion, and either a low dose (the patient's previous dose) or high dose (2.5 times the previous oral dose).

The researchers found no significant difference in the patients' global assessment of symptoms or in the mean change in serum creatinine levels whether patients received the treatment via bolus or continuous infusion. Patients in the high-dose group experienced a nonsignificant trend toward improved symptoms, but no significant difference in creatinine levels. The high-dose strategy was related to greater diuresis and better outcomes in some secondary measures but also with transient worsening of renal function.

"These findings are not consistent with prior, much smaller studies suggesting that continuous infusion, as compared with boluses, is associated with a lesser degree of renal dysfunction and greater diuresis. One possible explanation for the absence of a significant difference in outcomes between boluses and continuous infusion in our study is the use of a continuous placebo infusion in the patients assigned to boluses; this feature of the study design may have served to increase the time the patients were supine, a position that has been shown to enhance diuresis," the authors write.

Several authors disclosed financial ties to pharmaceutical and/or medical device companies.

Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Copyright © 2011 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95


The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95


Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.


Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.


Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events