Comparison of Different Furosemide Regimens in the Treatment of Acute Heart Failure: A Meta-Analysis

Abstract

Background. To compare the effects of different dosing schemes of furosemide on acute heart failure (AHF). Methods. Literature that compared the efficacy of continuous and intermittent administration of furosemide in AHF patients was retrieved from PubMed, Embase, the Cochrane Library, and ISI Web of Science from inception to May 2022. The primary endpoints included overall weight loss, 24-hour urine volume, length of hospital stay, 24-hour brain natriuretic peptide (BNP) level change, and all-cause mortality. The RevmMan5.4 software was used to analyze the extracted data. Results. A total of 10 studies with 775 patients, including 338 receiving continuous furosemide administration and 387 receiving intermittent furosemide administration, were included. The analysis results showed significant differences in weight loss ( $\text{MD}=1.08$ , 95% CI (0.75~1.40), $P<0.00001$ ) and 24-hour urine volume (MD =335.23, 95% CI (140.98~529.47), $P=0.0007$ ) between the 2 groups. There was no significant difference in terms of length of hospital stay ( $\text{MD}=-0.71$ , 95% CI (-2.74~1.31), $P=0.49$ ) and all-cause mortality ( $\text{RR}=1.59$ , 95% CI (0.92~2.75), $P=0.10$ ). Conclusions. Compared with intermittent administration, continuous infusion of furosemide had a significant effect on the 24-hour urine volume and total weight loss in patients with AHF.