Comparison of 6‐Hour Infusion versus Bolus Furosemide in Premature Infants

Abstract

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.