Evidence mapPaperPMID 42440860Full record

SynthesisFrontiers in cardiovascular medicine2026

Comparative efficacy of continuous versus intermittent administration of furosemide in acute heart failure: an updated systematic review and meta-analysis of 22 RCTs.

Juan Cai, Danpeng Wang, Ling Yang, Ye Yuan

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Juan CaiDepartment of Cardiology, Nantong Hospital of Traditional Chinese Medicine, Nantong, China.
Danpeng WangThe Second Affliliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ling YangHospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ye YuanSichuan Integrative Medicine Hospital, Chengdu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Acute heart failure is defined as the rapid or gradual onset of signs and/or symptoms of heart failure severe enough to warrant unplanned hospital or emergency department care. As of 2019, an estimated 56.2 million individuals across 204 countries and territories were living with heart failure; data gaps suggest the true burden is likely higher. The global number of HF cases doubled from 27.2 million in 1990 to 56.2 million in 2019, with a parallel doubling observed in both sexes. Intravenous loop diuretics-predominantly furosemide-constitute the cornerstone of decongestive therapy, yet the optimal dosing strategy is still debated. Previous studies have established the framework for this field but yielded conflicting conclusions. In addition, those studies had some limitations. Therefore, we conducted an updated systematic review and meta-analysis that identified and included all RCTs comparing continuous infusion with intermittent bolus furosemide in adult patients with acute heart failure or NYHA class III-IV symptoms. Methods: We conducted a systematic literature search in PubMed, Embase, the Cochrane Library, CNKI, Wan Fang, and VIP databases for relevant studies published up to 1 October 2025. RCTs comparing continuous infusion with intermittent bolus furosemide in adult patients with acute heart failure or NYHA class III-IV symptoms were included. Primary endpoints were all-cause mortality and freedom from congestion. Secondary endpoints were weight loss, 24-h urine volume, length of hospital stay, 72-h urine volume, post-treatment BNP, edema resolution time, time to dyspnea improvement, post-treatment LVEF, and post-treatment LVEDD. Results: A total of 22 RCTs with 2,633 participants were included. The intermittent intravenous (iIV) arm showed a numerical trend toward all-cause mortality without reaching statistical significance (low evidence quality) compared with the continuous intravenous (cIV) arm (RR: 1.36, 95% CI: 0.96-1.94, Discussion: Compared with intravenous bolus furosemide, continuous infusion was associated with faster relief of congestion, greater weight loss, and greater reduction in post-treatment BNP levels (moderate evidence quality). However, no significant advantage was demonstrated for the remaining outcomes or long-term survival, as judged by the quality of evidence and effect estimates. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420260223267, identifier CRD420260223267.

Indexed as

acute heart failurefurosemidemeta-analysisrandomized controlled trialssystematic review

Identifiers

PMID42440860
PMCPMC13333736

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.