Continuous infusion or bolus injection of loop diuretics for congestive heart failure?

Medwave. 2016 Apr 22:16 Suppl 2:e6426. doi: 10.5867/medwave.2016.6426.
[Article in English, Spanish]

Abstract
in English, Spanish

Loop diuretics are widely used in acute heart failure. However, there is controversy about the superiority of continuous infusion over bolus administration. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified four systematic reviews including 11 pertinent randomized controlled trials overall. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded continuous administration of loop diuretics probably reduces mortality and length of stay compared to intermittent administration in patients with acute heart failure.

Los diuréticos de asa son ampliamente utilizados en insuficiencia cardiaca aguda. Sin embargo, existe controversia respecto a la superioridad de la administración en infusión continua por sobre la administración en bolo. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos cuatro revisiones sistemáticas que en conjunto incluyen 11 estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la administración continua de diuréticos en comparación con la administración intermitente probablemente disminuye la mortalidad y la estadía hospitalaria en pacientes con insuficiencia cardiaca aguda.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Acute Disease
  • Drug Administration Schedule
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Length of Stay
  • Randomized Controlled Trials as Topic
  • Sodium Potassium Chloride Symporter Inhibitors / administration & dosage*
  • Sodium Potassium Chloride Symporter Inhibitors / therapeutic use

Substances

  • Sodium Potassium Chloride Symporter Inhibitors