Critical Care and Shock

Comparison of furosemide bolus and furosemide continuous in critical patients with fluid overload in ICU

Abstract

Introduction: Fluid overload in critically ill patients represents an adverse condition that affects the clinical outcome of patients in the intensive care unit (ICU). Furosemide is commonly used in the ICU as a diuretic in conditions associated with fluid overload, and there are several furosemide administration methods. There is no general consensus regarding the superiority of the furosemide administration method between bolus or continuous administration. This study was conducted to see the comparison between bolus and continuous administration on the improvement of fluid overload.

Methods: This study used a single-blind, randomized controlled trial (RCT) design, where researchers provided treatment and primary data sources obtained directly from examinations of patients in the ICU. The selected population was randomly divided into the bolus and continuous furosemide groups. Fluid overload assessment was carried out using cumulative fluid balance (CFB), urine output variable (UOP), and central venous pressure (CVP) indicators.

Results: A total of 42 samples were obtained and met inclusion and exclusion criteria. In the measurement of fluid overload indicators CFB, UOP, and CVP, there were significant changes in each group before and after furosemide administration with a p-value <0.05. However, there was no significant difference in the final results of each CFB, UOP, or CVP indicator in comparing bolus furosemide and continuous furosemide with a p-value >0.05. There was no difference in mortality rates between bolus furosemide and continuous furosemide during 72 hours of monitoring with a p-value of 0.54.

Conclusion: Bolus furosemide and continuous furosemide administration improved fluid overload in the critically ill population in the ICU, but there was no superior method between the two.