Green T P, Johnson D E, Bass J L, Landrum B G, Ferrara T B, Thompson T R
Division of Pediatric Critical Care, University of Minnesota, Minneapolis 55455.
J Pediatr. 1988 Apr;112(4):605-12. doi: 10.1016/s0022-3476(88)80182-3.
To further characterize the place for furosemide in the treatment of newborn infants with respiratory distress syndrome requiring mechanical ventilation, we conducted a blinded, prospective study comparing early prophylactic use (1 mg/kg every 12 hours for four doses beginning at 24 hours of age) with prn use of this drug. Prophylactic administration of furosemide produced no beneficial effect on any measure of pulmonary function compared with use of this drug as needed (prn). However, patients receiving the prophylactic furosemide regimen were found to have more rapid postnatal weight loss, higher pulse rate, and greater sympathomimetic drug requirement during the period of diuretic administration. Patients in the prophylactic group did not demonstrate the moderate expansion in plasma volume between 48 and 96 hours of age seen in the control group. These data suggest that the prophylactic regimen produced an undesirable degree of volume depletion. Further studies should be conducted to develop objective criteria for the selection of the subgroup of patients with respiratory distress syndrome who may benefit from furosemide.
为进一步明确速尿在治疗需要机械通气的新生儿呼吸窘迫综合征中的作用，我们进行了一项双盲前瞻性研究，比较早期预防性使用（从24小时龄开始，每12小时1mg/kg，共四剂）与按需使用该药物的效果。与按需使用速尿相比，预防性使用速尿对任何肺功能指标均无有益影响。然而，接受预防性速尿治疗方案的患者在利尿剂给药期间产后体重减轻更快、脉搏率更高且拟交感神经药物需求量更大。预防性治疗组的患者在48至96小时龄时未表现出对照组所见的血浆容量适度增加。这些数据表明，预防性治疗方案导致了不良程度的容量耗竭。应开展进一步研究，以制定客观标准，用于选择可能从速尿治疗中获益的呼吸窘迫综合征患者亚组。
