Intravenous bumetanide and furosemide achieved similar 24-hour urine output, but bumetanide yielded a greater furosemide-equivalent response (52 vs 33 mL/mg; P=0.007) in acute heart failure.
Cohort (n=120)
Does intravenous bumetanide improve total urine output compared to intravenous furosemide in patients with acute decompensated heart failure?
Intravenous bumetanide and furosemide achieve similar total 24-hour urine output in acute decompensated heart failure, though bumetanide may have a greater per-milligram equivalent diuretic effect.
ABSTRACT: Loop diuretics are a fundamental cornerstone in management of hypervolemia encountered in acute decompensated heart failure. There is variation in the literature describing relative potency of loop diuretic agents, and there are very limited available data specific to the heart failure population. In this retrospective cohort study, we aimed to compare the urine output response between intravenous furosemide and bumetanide in patients with acute decompensated heart failure. Patients were eligible for inclusion if they were admitted between July 1, 2021, and June 30, 2022, with acute decompensated heart failure and received intravenous bumetanide or furosemide within 48 hours of admission. Propensity matching was used to determine comparison groups. The primary outcome was total urine output for 24 hours after initiation of the diuretic regimen. A total of 120 patients (60 in each group) were matched after exclusion criteria were applied. The total urine output was similar between groups. The bumetanide group did demonstrate a greater urine output: furosemide-equivalent response (52 ± 46 mL/mg vs. 33 ± 25 mL/mg; P = 0.007). Based on our analysis, similar urine output may be achieved with either intravenous bumetanide or furosemide in acute decompensated heart failure; however, a higher dose of furosemide may be required than what has been previously established as an equivalent dose to bumetanide to achieve a similar diuretic effect. These results should warrant further investigation to better establish dose-response relationships with loop diuretics in acute decompensated heart failure.
Kefer et al. (Thu,) conducted a cohort in acute decompensated heart failure (n=120). intravenous bumetanide vs. intravenous furosemide was evaluated on total urine output for 24 hours after initiation of the diuretic regimen. Intravenous bumetanide and furosemide achieved similar 24-hour urine output, but bumetanide yielded a greater furosemide-equivalent response (52 vs 33 mL/mg; P=0.007) in acute heart failure.
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