Mei-Yi Wu1, Nen-Chung Chang2, Chien-Ling Su3, Yung-Ho Hsu1, Tzen-Wen Chen4, Yuh-Feng Lin5, Chih-Hsiung Wu6, Ka-Wai Tam7. 1. Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan. 2. Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 3. School of Respiratory Therapy, Taipei Medical University, Taipei, Taiwan; Department of Thoracic Internal Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan. 4. Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Taipei Medical Hospital, Taipei, Taiwan. 5. Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 6. Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan. 7. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Center for Evidence-Based Health Care, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan. Electronic address: kelvintam@h.tmu.edu.tw.
Abstract
PURPOSE: The safety and efficacy of continuous infusion vs bolus injection of intravenous loop diuretics to treat acute decompensated heart failure were debated. Our aim is to compare the administration routes of diuretics in hospitalized patients with acute decompensated heart failure. METHODS: A systematic review and meta-analysis of randomized controlled trials was performed to evaluate the effects of continuous infusion vs bolus administration of loop diuretics in patients with acute decompensated heart failure. The primary end points were urine outputs, body weight loss, all causes of mortality, and death from cardiovascular causes. Secondary end points were electrolyte imbalance, change in creatinine levels, tinnitus or hearing loss, and days of hospitalization. RESULTS: Ten randomized controlled trials with 518 patients were identified. Continuous infusion of diuretics was associated with a significantly greater weight loss (weighted mean difference, 0.78; 95% confidence interval, 0.03-1.54) compared with bolus injection. Urine output, the incidence of electrolyte imbalance, change in creatinine level, length of hospitalization, the incidence of ototoxicity, cardiac mortality, and all-cause mortality showed no significant differences between the 2 groups. CONCLUSION: Meta-analysis of the existing limited studies did not confirm any significant differences in the safety and efficacy with continuous administration of loop diuretic, compared with bolus injection in patients with acute decompensated heart failure.
PURPOSE: The safety and efficacy of continuous infusion vs bolus injection of intravenous loop diuretics to treat acute decompensated heart failure were debated. Our aim is to compare the administration routes of diuretics in hospitalized patients with acute decompensated heart failure. METHODS: A systematic review and meta-analysis of randomized controlled trials was performed to evaluate the effects of continuous infusion vs bolus administration of loop diuretics in patients with acute decompensated heart failure. The primary end points were urine outputs, body weight loss, all causes of mortality, and death from cardiovascular causes. Secondary end points were electrolyte imbalance, change in creatinine levels, tinnitus or hearing loss, and days of hospitalization. RESULTS: Ten randomized controlled trials with 518 patients were identified. Continuous infusion of diuretics was associated with a significantly greater weight loss (weighted mean difference, 0.78; 95% confidence interval, 0.03-1.54) compared with bolus injection. Urine output, the incidence of electrolyte imbalance, change in creatinine level, length of hospitalization, the incidence of ototoxicity, cardiac mortality, and all-cause mortality showed no significant differences between the 2 groups. CONCLUSION: Meta-analysis of the existing limited studies did not confirm any significant differences in the safety and efficacy with continuous administration of loop diuretic, compared with bolus injection in patients with acute decompensated heart failure.
Authors: Marijana Sekulic-Jablanovic; Jessica Paproth; Cinzia Sgambato; Giuseppe Albano; Daniel G Fuster; Daniel Bodmer; Vesna Petkovic Journal: Front Cell Neurosci Date: 2022-04-12 Impact factor: 5.505
Authors: Daniel Dante Yeh; Gwendolyn M Van Der Wilden; Catrina Cropano; Yuchiao Chang; David R King; Marc De Moya; Peter Fagenholz; Haytham Kaafarani; Jarone Lee; George Velmahos Journal: J Emerg Trauma Shock Date: 2015 Jan-Mar