Comparison of 6-hour infusion versus bolus furosemide in premature infants.

Author(s): Reiter PD, Makhlouf R, Stiles AD

Affiliation(s): Department of Pharmacy, University Hospital, School of Pharmacy, Denver, CO 80262, USA.

Publication date & source: 1998-01, Pharmacotherapy., 18(1):63-8.

Publication type: Clinical Trial; Randomized Controlled Trial

STUDY OBJECTIVE: To compare the renal, hemodynamic, and pulmonary effects of a 6-hour infusion of furosemide versus conventional bolus administration in premature infants. DESIGN: Prospective, blinded, placebo-controlled, randomized study. SETTING: Two level III, university-based neonatal intensive care units. PATIENTS: Thirty premature infants with significant lung disease, requiring furosemide after a red cell infusion. INTERVENTIONS: Infants received furosemide 1 mg/kg over 2 minutes, followed by a 6-hour placebo infusion, or a small loading dose of 0.1 mg/kg, followed by a slow infusion of 0.9 mg/kg over 6 hours. Serum and urine were collected to determine percentage fractional excretion of sodium (FENa). MEASUREMENTS AND MAIN RESULTS: Urine output and blood pressure were measured every 2 hours after furosemide administration. Percentage FENa was measured immediately before furosemide and compared with pooled urine from an 8-hour collection after furosemide administration. Serum sodium, creatinine, and calcium were measured before and 24 hours after drug administration. Mean airway pressure and percentage inspired oxygen were compared before, 1-4 hours after, and 4-12 hours after drug administration. No significant differences were detected between the two methods of drug administration. CONCLUSION: Our data suggest that a 6-hour infusion of furosemide does not offer substantial clinical advantage over conventional bolus administration in premature infants when focusing on urine output, blood pressure, FENa, or pulmonary effect.