Absence of tolerance and toxicity to high‐dose continuous intravenous furosemide in haemodynamically unstable infants after cardiac surgery
- 18 April 2007
- journal article
- research article
- Published by Wiley in British Journal of Clinical Pharmacology
- Vol. 64 (6), 796-803
- https://doi.org/10.1111/j.1365-2125.2007.02913.x
Abstract
To evaluate a high-dose continuous furosemide regimen in infants after cardiac surgery. Fifteen haemodynamically unstable infants with volume overload admitted to a paediatric intensive care unit were treated with an aggressive furosemide regimen consisting of a loading bolus (1-2 mg kg(-1)) followed by a continuous infusion at 0.2 mg kg(-1) h(-1) which was adjusted according to a target urine output of 4 ml kg(-1) h(-1). Frequent sampling for furosemide concentrations in blood and urine was done for 3 days with simultaneous assessment of sodium excretion and urine output. The mean furosemide dose was 0.22 (+/- 0.06), 0.25 (+/- 0.10) and 0.22 (+/- 0.11) mg kg(-1) h(-1) on the first, second and third day, respectively. Median urine production was 3.0 (0.6-5.3), 4.2 (1.7-6.6) and 3.9 (2.0-8.5) ml kg(-1) h(-1), respectively, on the first, second and third day of the study. The target urine production was reached at a median time of 24 (6-60) h and this was maintained during the study period. The regimen did not result in toxic serum concentrations and was haemodynamically well tolerated. High-dose continuous furosemide infusion for 72 h in haemodynamically unstable infants after cardiac surgery appears to be a safe and effective treatment for volume overload. Development of tolerance against the effects of furosemide and ototoxic furosemide concentrations were not observed.Keywords
This publication has 19 references indexed in Scilit:
- Development of an optimal furosemide infusion strategy in infants with modeling and simulationClinical Pharmacology & Therapeutics, 2002
- Application of modified sequential organ failure assessment score in children after cardiac surgeryJournal of Cardiothoracic and Vascular Anesthesia, 2001
- Acute Renal Insufficiency and Renal Replacement Therapy After Pediatric Cardiopulmonary Bypass SurgeryPediatric Cardiology, 2001
- Acute Tolerance to Furosemide. Pretreatment with Captopril or Prazosin does not Influence Diuresis and NatriuresisScandinavian Journal of Urology and Nephrology, 1994
- Continuous infusion of loop diuretics in the critically illCritical Care Medicine, 1994
- Addition of metolazone to overcome tolerance to furosemide in infants with bronchopulmonary dysplasiaThe Journal of Pediatrics, 1992
- Comparison of continuous versus intermittent furosemide administration in postoperative pediatric cardiac patientsCritical Care Medicine, 1992
- Alternating Sequential Dosing With Furosemide and Ethacrynic Acid in Drug Tolerance in the NewbornArchives of Pediatrics & Adolescent Medicine, 1989
- Delayed Tolerance to Furosemide DiuresisScandinavian Journal of Urology and Nephrology, 1988
- Furosemide ototoxicity: Clinical and experimental aspectsThe Laryngoscope, 1985