• Ramona O Hopkins, George Thomsen, Louise Bezdjian, and Larissa Rodriguez.
• Coronary Intensive Care Unit, Intermountain Medical Center in Murray, Utah 84107, USA.
• Crit Care Nurse. 2012 Dec 1;32(6):25-34.

BackgroundMany critically ill patients have severe volume overload due to vigorous fluid resuscitation. Optimal fluid management strategies to clear tissue edema are unclear.ObjectiveTo assess safety and effectiveness of a clinical application of a furosemide infusion protocol in edematous critically ill patients.MethodsA prospective, cohort study of consecutive adult critically ill patients who received furosemide infusion by protocol from June 2003 to July 2004.ResultsThe mean total dose of furosemide was 2240 mg. The mean cumulative fluid balance therapy was -3376 mL. Electrolyte values in the critical laboratory range were 3.3% for potassium, 0.2% for sodium, and no critical values for magnesium. The mean change in creatinine level was +0.2 mg/dL during furosemide infusion therapy, but the mean creatinine level returned to baseline by 3 days after the furosemide infusion. A minimum mean arterial pressure less than 55 mm Hg occurred 12% of the time during the furosemide infusion.ConclusionsFurosemide infusion therapy was associated with moderately negative cumulative fluid balances, electrolyte shifts, and mild transient worsening of renal function.

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