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Administration of Subcutaneous Furosemide in Elastomeric Pump vs. Oral Solution for the Treatment of Diuretic Refractory Congestion

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Abstract

Introduction

The most common symptom in heart failure (HF) is congestion, which can be refractory to diuretic treatment.

Aim

To verify whether, in patients with advanced HF and diuretic resistance, subcutaneous furosemide or furosemide in an oral solution can improve the clinical-analytical status.

Methods

From 2018 to 2020, 27 consecutive outpatients with diuretic resistance, not candidates for other alternatives, were recruited. Patients were treated either with subcutaneous furosemide in elastomeric pump (n: 10) or with oral solution (n: 17) for 5 days.

Results

The functional status (NYHA) improved with subcutaneous administration (predose: 3.8 ± 0.5 vs. postdose: 3.1 ± 0.7; p: 0.02) and oral solution (predose: 3.7 ± 0.3 vs. postdose: 2.5 ± 0.7; p: 0.0001). Weight loss was greater with the oral solution (predose: 85.5 ± 19.5 vs. postdose: 81.3 ± 18.8Kg; p: 0.0001) than subcutaneous (predose: 81.6 ± 15.9 vs. postdose: 80.4 ± 15.1kg; p: 0.16). Creatinine showed a non-significant increase in both groups. The number of hospital visits showed no difference between both options.

Conclusions

The administration of furosemide, both subcutaneously by elastomeric pump or drinking the oral solution, is effective for the treatment of congestion in advanced HF refractory to diuretic treatment.

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Funding

This research received no Grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Heart Failure and Transplant Unit, La Fe University and Polytechnic Hospital, Number 106, Fernando Abril Martorell Av, 46026, Valencia, Spain

    Raquel López-Vilella, Ignacio Sánchez-Lázaro, Inmaculada Husillos Tamarit, Víctor Donoso Trenado & Luis Almenar Bonet

  2. Cardiology Department, La Fe University and Polytechnic Hospital, Valencia, Spain

    Raquel López-Vilella, Ignacio Sánchez-Lázaro, Inmaculada Husillos Tamarit, Víctor Donoso Trenado, Luis Martínez Dolz & Luis Almenar Bonet

  3. Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Valencia, Spain

    Ignacio Sánchez-Lázaro, Julio Núñez Villota, Luis Martínez Dolz & Luis Almenar Bonet

  4. Hospital Pharmacy Department, La Fe University and Polytechnic Hospital, Valencia, Spain

    Emilio Monte Boquet

  5. Cardiology Department, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, Spain

    Julio Núñez Villota

  6. Department of Medicine, University of Valencia, Valencia, Spain

    Julio Núñez Villota & Luis Almenar Bonet

Authors
  1. Raquel López-Vilella
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  2. Ignacio Sánchez-Lázaro
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  3. Inmaculada Husillos Tamarit
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  4. Emilio Monte Boquet
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  5. Julio Núñez Villota
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  6. Víctor Donoso Trenado
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  7. Luis Martínez Dolz
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  8. Luis Almenar Bonet
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Contributions

All persons listed as authors must have contributed substantially to the design, performance, analysis, or reporting of the work. RL-V: Designed research, Performed research, Collected datam Analyzed datam Wrote paper, Review of the manuscript. IS-L: Designed research, Performed research, Analyzed data, Review of the manuscript. IHT: Collected data, Analyzed data Review of the manuscript. EMB: Designed research, Wrote paper, Review of the manuscript. JNV: Designed research, Wrote paper, Review of the manuscript. VDT: Designed research, Collected data, Wrote paper, Review of the manuscript. LMD: Analyzed data, Wrote paper, Review of the manuscript. LAB: Designed research, Performed research, Collected datam Analyzed datam Wrote paper, Review of the manuscript.

Corresponding author

Correspondence to Raquel López-Vilella.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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López-Vilella, R., Sánchez-Lázaro, I., Husillos Tamarit, I. et al. Administration of Subcutaneous Furosemide in Elastomeric Pump vs. Oral Solution for the Treatment of Diuretic Refractory Congestion. High Blood Press Cardiovasc Prev 28, 589–596 (2021). https://doi.org/10.1007/s40292-021-00476-4

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  • DOI: https://doi.org/10.1007/s40292-021-00476-4

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