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Published Online, 5 September 2006, www.theannals.com, DOI 10.1345/aph.1G693.
 The Annals of Pharmacotherapy: Vol. 40, No. 10, pp. 1797-1803. DOI 10.1345/aph.1G693
© 2006 Harvey Whitney Books Company.
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SURGERY

Efficacy and Safety of a Furosemide Continuous Infusion Following Cardiac Surgery

Brian E Gulbis, PharmD

at time of writing, Adult Internal Medicine Resident, Medical University of South Carolina, Charleston, SC; now, Cardiovascular Clinical Specialist, Memorial Hermann-Texas Medical Center, Houston, TX

Anne P Spencer, PharmD

Associate Professor of Pharmacy and Clinical Sciences, Medical University of South Carolina

Reprints: Dr. Gulbis, Department of Pharmacy Services, Memorial Hermann-Texas Medical Center, 6411 Fannin St., Houston, TX 77030-1501, fax 713/704-0063, Brian.Gulbis{at}memorialhermann.org

OBJECTIVE: To review the literature regarding the efficacy and safety of continuous intravenous infusion of loop diuretics following cardiac surgery.

DATA SOURCES: Articles were identified through a MEDLINE search (1966-March 2006) using the key words furosemide, bumetanide, torsemide, ethacrynic acid, loop diuretics, continuous infusions, intravenous infusions, surgery, cardiac surgery, cardiovascular surgery, and thoracic surgery. Search results were limited to studies in human subjects published in English. Additional references were identified through review of the bibliographies of the articles cited.

STUDY SELECTION AND DATA EXTRACTION: All clinical trials and observational reports identified that evaluated or described the efficacy and/or safety of a continuous infusion of a loop diuretic in adult or pediatric patients who had undergone cardiac surgery were included in this review.

DATA SYNTHESIS: Loop diuretics are often used to promote diuresis following cardiac surgery. Studies in patients who have undergone cardiac surgery have demonstrated that a more consistent and sustained diuresis is produced by a continuous infusion of furosemide compared with intermittent bolus doses of furosemide. However, there does not appear to be a significant difference in total urine output or change in serum electrolyte levels when furosemide is administered as a continuous infusion compared with intermittent bolus doses.

CONCLUSIONS: A continuous infusion of furosemide is an effective and safe method of diuresis in patients undergoing cardiac surgery.

Key Words: cardiac surgery, continuous infusion, furosemide, loop diuretics

Published Online, September 5, 2006. www.theannals.com, DOI 10.1345/aph.1G693




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