Intravenous furosemide in adults with acute left ventricular failure: a review

Background: Heart failure (HF) is complex and difficult to diagnose in prehospital settings, leading to potential overuse of treatments such as intravenous (IV) furosemide. This prompted a scoping review to assess its effectiveness in managing acute left ventricular failure (ALVF) in emergency contexts. Aim: This study aims to enhance understanding of IV furosemide use in high-acuity prehospital emergencies and its implications for future diuretic therapies. Methods: A scoping review was conducted on literature exploring the use of IV furosemide in high-acuity emergency settings. Results: Three main themes emerged: the accuracy of ALVF diagnosis and its impact on outcomes; the influence of transport times on furosemide administration; and the potential risks of furosemide outweighing its benefits. Conclusion: IV furosemide can alleviate HF symptoms, but prehospital diagnostic challenges may increase the risk or harm to patients, with alternative treatments offering more benefits and fewer adverse effects.