Pharmacoepidemiology of Furosemide in the Neonatal Intensive Care Unit.
Diuretics
Furosemide
Neonatal
Journal
Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577
Informations de publication
Date de publication:
2020
2020
Historique:
received:
03
04
2020
accepted:
23
07
2020
pubmed:
8
10
2020
medline:
1
9
2021
entrez:
7
10
2020
Statut:
ppublish
Résumé
Furosemide is commonly used off-label in the neonatal intensive care unit (NICU), but current dosing practices vary widely. To describe dosing practices including route, dose, and duration of exposure to furosemide in a large number of community and tertiary NICUs across North America. Using the Pediatrix Medical Group Clinical Data Warehouse, we identified infants who received ≥1 dose of furosemide between 1997 and 2016. We excluded infants with incomplete dosing data. We calculated average daily furosemide dose, cumulative dose, total days of exposure, and maximum daily dose. We compared dosing between infants born at <32 weeks gestational age (GA) and ≥32 weeks GA. A total of 18,572 infants had complete dosing data. The median (interquartile value) postnatal age at first exposure was 11 days (4, 26), the median maximum daily dose was 1.0 mg/kg (0.97, 1.6), the median average daily dose was 1.0 mg/kg (0.88, 1.1), and the median cumulative dose was 2.0 mg/kg (1.0, 4.5). The median total duration of exposure was 2 days (1, 4). A total of 177 (1%) infants received ≥4 mg/kg/day of furosemide. Infants born <32 weeks GA were an older age at initial furosemide exposure compared to those born ≥32 weeks GA: 19 versus 4 days, p < 0.001. Most infants received short courses of furosemide within the labeled dosing parameters. Further studies are needed to assess the safety and efficacy of furosemide in the NICU.
Sections du résumé
BACKGROUND
Furosemide is commonly used off-label in the neonatal intensive care unit (NICU), but current dosing practices vary widely.
OBJECTIVES
To describe dosing practices including route, dose, and duration of exposure to furosemide in a large number of community and tertiary NICUs across North America.
METHOD
Using the Pediatrix Medical Group Clinical Data Warehouse, we identified infants who received ≥1 dose of furosemide between 1997 and 2016. We excluded infants with incomplete dosing data. We calculated average daily furosemide dose, cumulative dose, total days of exposure, and maximum daily dose. We compared dosing between infants born at <32 weeks gestational age (GA) and ≥32 weeks GA.
RESULTS
A total of 18,572 infants had complete dosing data. The median (interquartile value) postnatal age at first exposure was 11 days (4, 26), the median maximum daily dose was 1.0 mg/kg (0.97, 1.6), the median average daily dose was 1.0 mg/kg (0.88, 1.1), and the median cumulative dose was 2.0 mg/kg (1.0, 4.5). The median total duration of exposure was 2 days (1, 4). A total of 177 (1%) infants received ≥4 mg/kg/day of furosemide. Infants born <32 weeks GA were an older age at initial furosemide exposure compared to those born ≥32 weeks GA: 19 versus 4 days, p < 0.001.
CONCLUSIONS
Most infants received short courses of furosemide within the labeled dosing parameters. Further studies are needed to assess the safety and efficacy of furosemide in the NICU.
Identifiants
pubmed: 33027793
pii: 000510657
doi: 10.1159/000510657
pmc: PMC7878291
mid: NIHMS1632408
doi:
Substances chimiques
Furosemide
7LXU5N7ZO5
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
780-784Subventions
Organisme : NICHD NIH HHS
ID : HHSN267200700051C
Pays : United States
Organisme : NIH HHS
ID : U2C OD023375
Pays : United States
Organisme : FDA HHS
ID : R01 FD006099
Pays : United States
Organisme : FDA HHS
ID : R01 FD005101
Pays : United States
Organisme : NHLBI NIH HHS
ID : R33 HL147833
Pays : United States
Organisme : NICHD NIH HHS
ID : K23 HD090239
Pays : United States
Organisme : FDA HHS
ID : U18 FD006298
Pays : United States
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NHLBI NIH HHS
ID : K24 HL143283
Pays : United States
Informations de copyright
© 2020 S. Karger AG, Basel.
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