Reiter P D, Makhlouf R, Stiles A D
Department of Pharmacy, University Hospital, School of Pharmacy, Denver, CO 80262, USA.
Pharmacotherapy. 1998 Jan-Feb;18(1):63-8.
To compare the renal, hemodynamic, and pulmonary effects of a 6-hour infusion of furosemide versus conventional bolus administration in premature infants.
Prospective, blinded, placebo-controlled, randomized study.
Two level III, university-based neonatal intensive care units.
Thirty premature infants with significant lung disease, requiring furosemide after a red cell infusion.
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).
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.
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.
比较在早产儿中，静脉输注速尿6小时与传统推注给药对肾脏、血流动力学和肺部的影响。
前瞻性、盲法、安慰剂对照、随机研究。
两所大学附属三级新生儿重症监护病房。
30名患有严重肺部疾病的早产儿，在输注红细胞后需要使用速尿。
婴儿先在2分钟内接受1mg/kg的速尿，随后接受6小时的安慰剂输注；或先接受0.1mg/kg的小剂量负荷，随后在6小时内缓慢输注0.9mg/kg。收集血清和尿液以测定钠分数排泄率（FENa）。
速尿给药后每2小时测量尿量和血压。在速尿给药前即刻测量FENa，并与给药后8小时收集的混合尿液进行比较。在给药前及给药后24小时测量血清钠、肌酐和钙。比较给药前、给药后1 - 4小时及给药后4 - 12小时的平均气道压和吸氧百分比。两种给药方法之间未检测到显著差异。
我们的数据表明，在关注尿量、血压、FENa或肺部效应时，对于早产儿，静脉输注速尿6小时相较于传统推注给药并无显著临床优势。
