Continuous versus intermittent IV furosemide for acute heart failure
Continuous Versus Bolus Intermittent Loop Diuretic Infusion in Acutely Decompensated Heart Failure: Evaluation of Renal Function, Congestion Signs, BNP and Outcome
This trial tests whether giving furosemide as a continuous IV infusion or as intermittent IV boluses works better for adults hospitalized with acute decompensated heart failure.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 370 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Siena Academic / other |
| Locations | 4 sites (Chioggia, Venezia and 3 other locations) |
| Trial ID | NCT02638142 on ClinicalTrials.gov |
What this trial studies
DiurHF is a prospective, multicenter observational comparison of two common intravenous loop diuretic regimens—continuous infusion versus intermittent boluses of furosemide—in patients admitted with acute decompensated heart failure. Participating Italian hospitals enroll adults with clinical signs of congestion and BNP >100 pg/mL and follow them through hospitalization. The study tracks changes in renal function, clinical congestion signs, BNP levels, and short-term clinical outcomes. Exclusions include end-stage renal disease, very high creatinine, recent myocardial infarction, severe hypotension, and major systemic illnesses.
Who should consider this trial
Good fit: Adults (over 18) hospitalized with signs and symptoms of acute decompensated heart failure and BNP >100 pg/mL who do not meet the exclusion criteria are the intended participants.
Not a fit: Patients on dialysis, with creatinine >4 mg/dL, recent myocardial infarction, severe hypotension, or other excluded systemic illnesses would not be expected to benefit from participation.
Why it matters
Potential benefit: If successful, the results could point to a safer and more effective IV diuretic approach that relieves congestion while better preserving kidney function.
How similar studies have performed: Previous pilot and small trials have yielded mixed results about continuous versus bolus loop diuretics, so the approach has some supporting but inconclusive evidence.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients over 18 years; * Patients with diagnosis of ADHF(dyspnea, orthopnea, peripheral edema or major fatigue and at least two clinical signs including rales, hepatomegaly, pulmonary congestion on chest radiography, jugular vein dilatation, or a third heart sound); * Blood BNP \> 100 pg/mL; ADHF: Acute Decompensated Heart Failure; BNP: B-type Natriuretic Peptide; IV: IntraVenous; LVEF: Left Ventricular Ejection Fraction. Exclusion Criteria: * Patients who receive more than 40 mg of IV furosemide; * End-Stage renal disease or renal replacement therapy; * Recent myocardial infarction (within thirty days of screening); * Systolic blood pressure \< 80 mmHg; * Creatinine levels \> 4 mg/dL; * Patients affected by sepsis, liver diseases, inflammatory diseases or neoplastic diseases.
Where this trial is running
Chioggia, Venezia and 3 other locations
- Ospedale Madonna della Navicella — Chioggia, Venezia, Italy (Recruiting)
- Azienda Ospedaliera di Padova — Padova, Italy (Recruiting)
- University of Rome La Sapienza — Roma, Italy (Recruiting)
- Department of Internal Medicine, Cardiovascular Diseases Unit — Siena, Italy (Recruiting)
Study contacts
- Principal investigator: Alberto Palazzuoli, MD — University of Siena
- Study coordinator: Alberto Palazzuoli, MD
- Email: palazzuoli2@unisi.it
- Phone: +390577585363
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.