Table 1.
Characteristics of 16 studies by congestion subgroup
| Study | Year | n | Diuretic dose and route | Measurement(s) (h after dose) | Rationale for subgrouping or exclusion |
|---|---|---|---|---|---|
| Baseline congestion—included in analysis | |||||
| Ramìrez and Abelmann23 (acute heart failure) | 1968 | 5∗ | Ethacrynic acid 1 to 2 mg per kg IV | Plasma volume and hematocrit† (1.4) | Class IV heart failure, “considerable fluid retention” |
| Sigurd et al.24 | 1974 | 10 | Bumetanide 3 mg IV | Percent change in plasma volume (2) | Signs of congestive heart failure, diuretics held for 24 h |
| Austin et al.25 | 1976 | 27 | Furosemide 40 to 60 mg IV (n = 9) or ethacrynic acid 25 to 50 mg IV (n = 18) | Plasma volume‡ (1) | Class III heart failure with elevated pulmonary artery pressure (mean of 36 mm Hg) |
| Figueras and Weil26 | 1978 | 21 | Furosemide 40 to 160 mg IV | Plasma volume and hematocrit† (7.4) | Acute pulmonary cardiogenic edema |
| Schuster et al.27 | 1984 | 21∗ | Furosemide 40 to 80 mg IV | Blood volume (4.4) | Persistent clinical signs of mild to moderate pulmonary edema |
| No baseline congestion—included in analysis | |||||
| Davidov et al.28 (plasma volume) | 1967 | 5∗ | Furosemide 80 to 160 mg IV | Blood volume (2) | Edema cleared after treatment with diuretics, previous heart failure |
| Davidov et al.28 (hematocrit) | 1967 | 25∗ | Furosemide 80 to 160 mg IV | Hematocrit (2) | Edema cleared after treatment with diuretics, previous heart failure |
| Davidov et al.29,§ (short term) | 1967 | 32∗ | Furosemide 40 to 300 mg IV | Plasma volume and red cell volume (2) | Hypertensive patients with no signs of heart failure |
| Samet and Bernstein22 (2-h) | 1968 | 25∗ | Ethacrynic acid 200 mg PO | Blood volume (2) | No current signs of heart failure, previous history of heart failure |
| Samet and Bernstein22 (3-h) | 1968 | 5∗ | Ethacrynic acid 200 mg PO | Blood volume (3) | No current signs of heart failure, previous history of heart failure |
| Ramìrez and Abelmann23 (healthy controls) | 1968 | 6∗ | Ethacrynic acid 1 to 2 mg per kg IV | Plasma volume and hematocrit† (1.5) | No known heart or kidney disease |
| Rosenthal30 | 1968 | 10 | Furosemide 0.5 to 0.6 mg per kg IV | Blood volume (1,2) | No known heart or kidney disease |
| Olesen31 | 1970 | 10 | Furosemide 120 mg PO | Hemoglobin concentration (2,4) | Recumbent for 4 h despite no diuretic treatment, history of heart disease |
| Scholz et al.32 | 1970 | 6 | Furosemide 30 mg IV | Plasma volume‡ (3) | 2 with hyperthyroidism but no reported heart or kidney disease |
| Baylis and De Beer33,|| | 1981 | 5 | Furosemide 40 mg IV | Hematocrit¶ (2,3) | No heart or kidney disease |
| Not included in subgroup analysis | |||||
| Haug34 | 1976 | 7 | Furosemide 80 mg PO | Hematocrit¶ (1,3) | Inseparable mix of undertreated heart failure and healthy subjects |
IV, intravenous; PO, per os (oral).
Individual patient data were aggregated to perform the meta-analysis.
Total blood volume was estimated from plasma volumes and hematocrits using the formula in the Supplemental Methods.
Total blood volume was estimated from plasma volume and 45% as the hematocrit value, using the formula in the Supplemental Methods.
Davidov et al.29 reported a study of blood volume measurements obtained at 2, 24, and 48 hours after furosemide 100 mg IV was administered in 6 subjects; however, this study was not included because the authors provided no measure of dispersion (standard deviation or standard error) to generate an inverse variance weight.
Baylis and De Beer33 reported studying piretanide 12 mg IV in the same 5 subjects; however, this study was not included because piretanide is not approved by the US Food and Drug Administration.
Extracted manually from graphic images with digitization software.