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

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.