الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Summary Congestive heart failure (CHF) refers to a clinical state of systemic and pulmonary congestion resulting from inability of the heart to pump as much blood as required for the adequate metabolism of the body. In cases with significant left to right shunt that cause congestive heart failure; left ventricle contract more forcefully to maintain systemic cardiac output compensating for increased shunting from left to right ventricle during systole that occurs as pulmonary vascular resistance fall in first 3 months of life. In Congestive heart failure (CHF), the body tries to compensate by retaining water to increase blood volume, but this further weakens the heart. Diuretic drugs reduce water in the body. Loop diuretics work on the deep part of the small kidney tubes. They are commonly used in repeated doses intravenously for CHF, but this can cause rapid fluid shifts and lead to marked fluctuations in intravascular volume and to high peak serum levels, thereby increasing their toxicity. It was proposed that loop diuretics (furosemide being the most widely used), when given by continuous infusion may decrease the fluctuations in intravascular volume resulting in a relatively constant urine output. In patients refractory to conventional doses of diuretics, continuous intravenous administration may allow a gradual increase in infusion rate until the desirable hourly diuretic effect is reached. This was a prospective pilot randomized study comparing the efficacy of continuous intravenous infusion versus bolus intravenous administration of Furosemide in 52 infants with congestive heart failure secondary to congenital heart diseases with left to right shunt 27 infants received intravenous boluses of furosemide and 25 infants received intravenous continuous infusion of furosemide. All patients in the study received Furosemide in the following doses: For intravenous injection: 1-2mg/kg/dose every 8 hours. For continuous infusion: 3-6 mg/kg/24 hours continuous intravenous infusion. We found that Intravenous continuous infusion of Furosemide is better than intravenous boluses because of more predictable urine output, less fluctuation of blood pressure and rapid resolution of heart failure symptoms.