Gallusová Jana, Halačová Milada, Cerný Dalibor
Vnitr Lek. 2014 Oct;60(10):885-92.
Furosemide is a loop diuretic used in states of volume overload. The need for high doses is due to its reduced efficacy caused by lower concentration of furosemide achieved at the site of action in the renal tubule lumen and adaptation mechanisms. High doses have been associated with the development of ionic dysbalance, direct toxicity and intravascular volume fluctuations. The way of furosemide administration (intermitent versus continuously) to influence efficacy and safety is contradictory evaluated in EBM.
The aim of this study is to analyze the available data for evaluation of the efficacy and safety of intermittent versus continuous dose regimens.
A systematic search on PubMed from 1990 to 2013 using the keywords - furosemide, loop diuretic, bolus, continuous infusion, efficacy, safety, heart failure, ICU, critical care.
The pharmacokinetic and pharmacodynamic knowledge of furosemide create a theoretical assumption for the preference of continuous infusions before intermittent boluses. Assessement of available studies, however, yet in clinical practice did not proof the advantage of one over the other route of administration.
呋塞米是一种用于容量超负荷状态的袢利尿剂。需要高剂量是因为其在肾小管管腔作用部位达到的呋塞米浓度降低以及适应机制导致其疗效降低。高剂量与离子失衡、直接毒性和血管内容量波动的发生有关。在循证医学中，关于呋塞米给药方式（间歇给药与持续给药）对疗效和安全性影响的评估存在矛盾。
本研究的目的是分析现有数据，以评估间歇给药方案与持续给药方案的疗效和安全性。
1990年至2013年在PubMed上进行系统检索，使用的关键词为——呋塞米、袢利尿剂、大剂量注射、持续输注、疗效、安全性、心力衰竭、重症监护病房、危重症护理。
呋塞米的药代动力学和药效学知识为在间歇大剂量注射前优先选择持续输注创造了理论假设。然而，对现有研究的评估表明，在临床实践中尚未证实一种给药途径优于另一种给药途径。
