Comparison of continuous versus intermittent furosemide administration in postoperative pediatric cardiac patients

Crit Care Med. 1992 Jan;20(1):17-21. doi: 10.1097/00003246-199201000-00010.


Objective: To compare the effects of furosemide administered by intermittent iv infusion vs. continuous iv infusion on urine output, hemodynamic variables, and serum electrolyte concentrations.

Design: Prospective, randomized trial.

Setting: Pediatric ICU.

Patients: Postoperative pediatric cardiac patients.

Interventions: Patients were assigned to either the continuous iv infusion or the intermittent infusion groups. The intermittent group received 1 mg/kg iv of furosemide every 4 hrs to be increased by 0.25 mg/kg iv every 4 hrs to a maximum of 1.5 mg/kg iv if the urine output was less than 1 mL/ The continuous infusion group received an initial furosemide dose of 0.1 mg/kg iv (minimum 1 mg) followed by an iv infusion rate of 0.1 mg/ of furosemide to be doubled every 2 hrs to a maximum of 0.4 mg/ if the urine output was less than 1 mL/

Measurements and main results: Demographic variables, fluids, electrolyte and inotropic requirements were the same in both groups. A significantly (p = .045) lower daily dose of furosemide (4.90 +/- 1.78 vs. 6.23 +/- 0.62 mg/ in the continuous iv infusion group produced the same 24-hr urine volume as that of the intermittent group. There was more variability in urine output in the intermittent group as well as more urinary losses of sodium (0.29 +/- 0.15 vs. 0.20 +/- 0.06 mmol/, p = .0007) and chloride (0.40 +/- 0.20 vs. 0.30 +/- 0.12 mmol/, p = .045).

Conclusion: Furosemide administered by continuous iv infusion is advantageous in the post-operative pediatric patient because of a more controlled and predictable urine output with less drug requirement and less urinary loss in sodium and chloride.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Cardiac Surgical Procedures
  • Child, Preschool
  • Electrolytes / blood
  • Electrolytes / chemistry
  • Female
  • Furosemide / administration & dosage*
  • Furosemide / pharmacology
  • Furosemide / therapeutic use
  • Heart Defects, Congenital / drug therapy*
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery
  • Hemodynamics / drug effects
  • Humans
  • Infant
  • Infant, Newborn
  • Infusions, Intravenous / methods*
  • Infusions, Intravenous / standards
  • Intensive Care Units, Pediatric
  • Male
  • Postoperative Period
  • Prospective Studies
  • Urine / chemistry
  • Water-Electrolyte Balance / drug effects


  • Electrolytes
  • Furosemide