Trial reportESC heart failure2017
Rationale and study design of intravenous loop diuretic administration in acute heart failure: DIUR-AHF.
Trial report in ESC heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Continuous infusion versus bolus injection of loop diuretics for acute heart failure.The Cochrane database of systematic reviews · 2024Pooled it
- Ultrafiltration for acute heart failure.The Cochrane database of systematic reviews · 2022Pooled it
- Intermittent furosemide administration in patients with or at risk for acute kidney injury: Meta-analysis of randomized trials.PloS one · 2018Pooled it
- Rationale and study design of intravenous loop diuretic administration in acute heart failure: DIUR-AHF.ESC heart failure · 2017Trial
- Continuous Versus Intermittent Loop Diuretics Step-by-Step Protocol in Acute Heart Failure (DIUR-AHF): A Propensity-Matched Analysis.Journal of the American Heart Association · 2026Article
- Right Ventricular-Pulmonary Artery Uncoupling and Strain in Acute Heart Failure.Journal of the American Heart Association · 2025Observational
- The Changing Role of Loop Diuretics in Heart Failure Management across the Last Century.Journal of clinical medicine · 2024Review
- Additive harmful effects of acute kidney injury and acute heart failure on mortality in hospitalized patients.Kidney research and clinical practice · 2022Article
- Different Renal Function Patterns in Patients With Acute Heart Failure: Relationship With Outcome and Congestion.Frontiers in cardiovascular medicine · 2022Article
- Effects of Metolazone Administration on Congestion, Diuretic Response and Renal Function in Patients with Advanced Heart Failure.Journal of clinical medicine · 2021Article
- Loop Diuretic Administration in Patients with Acute Heart Failure and Reduced Systolic Function: Effects of Different Intravenous Diuretic Doses and Diuretic Response Measurements.Journal of clinical medicine · 2019Article
- Evaluation of diuretic efficiency of intravenous furosemide in patients with advanced heart failure in a heart failure clinic.Therapeutic advances in cardiovascular diseaseArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsAlthough loop diuretics are the most commonly used drugs in acute heart failure (AHF) treatment, their short-term and long-term effects are relatively unknown. The significance of worsening renal function occurrence during intravenous treatment is not clear enough. This trial aims to clarify all these features and contemplate whether continuous infusion is better than an intermittent strategy in terms of decongestion efficacy, diuretic efficiency, renal function, and long-term prognosis. METHODS AND
resultsThis is a prospective, multicentre, randomized study that compares continuous infusion to intermittent infusion and a low vs. high diuretic dose of furosemide in patients with a diagnosis of acute heart failure, BNP ≥ 100 pg/mL, and specific chest X-ray signs. Randomization criteria have been established at a 1:1 ratio using a computer-generated scheme of either twice-daily bolus injection or continuous infusion for a time period ranging from 72 to 120 h. The initial dose will be 80 mg/day of intravenous furosemide and, in the case of poor response, will be doubled using an escalation algorithm. A high diuretic dose is defined as a furosemide daily amount >120 mg/day respectively.
conclusionsContinuous and high dose groups could reveal a more intensive diuresis and a greater decongestion with respect to intermittent and low dose groups; high dose and poor loop diuretic efficiency should be related to increased diuretic resistance, renal dysfunction occurrence, and greater congestion status. Poor diuretic response will be associated with less decongestion and an adverse prognosis.
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Registered trials
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