Elizabeth J Thompson1, Rachel G Greenberg2, Karan Kumar2, Matthew Laughon3, P Brian Smith2, Reese H Clark4, Andromeda Crowell5, Layla Shaw5, Louis Harrison5, Gabrielle Scales5, Nicole Bell5, Christoph P Hornik6. 1. Department of Pediatrics, Duke University School of Medicine, Durham, NC. 2. Duke Clinical Research Institute & Department of Pediatrics, Duke University School of Medicine, Durham, NC. 3. Department of Pediatrics & Division of Neonatology, University of North Carolina, Chapel Hill, NC. 4. The Pediatrix-Obstetrix Center for Research, Education, and Quality, Sunrise, FL. 5. Duke Star Program, Duke Clinical Research Institute, Durham, NC. 6. Duke Clinical Research Institute & Department of Pediatrics, Duke University School of Medicine, Durham, NC. Electronic address: christoph.hornik@duke.edu.
Abstract
OBJECTIVE: To evaluate the association between furosemide exposure and patent ductus arteriosus (PDA) in a large, contemporary cohort of hospitalized infants with very low birth weight (VLBW). STUDY DESIGN: Using the Pediatrix Medical Group Clinical Data Warehouse, we identified all inborn infants of VLBW <37 weeks of gestation discharged from the neonatal intensive care unit after the first postnatal week from 2011 to 2015. We defined PDA as any medical (ibuprofen or indomethacin) or surgical PDA therapy. We collected data up to the day of PDA treatment or postnatal day 18 for infants not diagnosed with PDA. We performed multivariable logistic regression to evaluate the association between PDA and exposure to furosemide. RESULTS: We included 43 576 infants from 337 neonatal intensive care units, of whom 6675 (15%) underwent PDA treatment. Infants with PDA were more premature and more often exposed to mechanical ventilation and inotropes. Furosemide was prescribed to 4055 (9%) infants. On multivariable regression, exposure to furosemide was associated with decreased odds of PDA treatment (OR 0.72; 95% CI 0.65-0.79). Increasing percentage of days with furosemide exposure was not associated with PDA treatment (OR 1.01; 95% CI 0.97-1.06). CONCLUSIONS: Furosemide exposure was not associated with increased odds of PDA treatment in hospitalized infants of VLBW. Further studies are needed to characterize the efficacy and safety of furosemide in premature infants.
OBJECTIVE: To evaluate the association between furosemide exposure and patent ductus arteriosus (PDA) in a large, contemporary cohort of hospitalized infants with very low birth weight (VLBW). STUDY DESIGN: Using the Pediatrix Medical Group Clinical Data Warehouse, we identified all inborn infants of VLBW <37 weeks of gestation discharged from the neonatal intensive care unit after the first postnatal week from 2011 to 2015. We defined PDA as any medical (ibuprofen or indomethacin) or surgical PDA therapy. We collected data up to the day of PDA treatment or postnatal day 18 for infants not diagnosed with PDA. We performed multivariable logistic regression to evaluate the association between PDA and exposure to furosemide. RESULTS: We included 43 576 infants from 337 neonatal intensive care units, of whom 6675 (15%) underwent PDA treatment. Infants with PDA were more premature and more often exposed to mechanical ventilation and inotropes. Furosemide was prescribed to 4055 (9%) infants. On multivariable regression, exposure to furosemide was associated with decreased odds of PDA treatment (OR 0.72; 95% CI 0.65-0.79). Increasing percentage of days with furosemide exposure was not associated with PDA treatment (OR 1.01; 95% CI 0.97-1.06). CONCLUSIONS: Furosemide exposure was not associated with increased odds of PDA treatment in hospitalized infants of VLBW. Further studies are needed to characterize the efficacy and safety of furosemide in premature infants.
Authors: Barbara J Stoll; Nellie I Hansen; Edward F Bell; Michele C Walsh; Waldemar A Carlo; Seetha Shankaran; Abbot R Laptook; Pablo J Sánchez; Krisa P Van Meurs; Myra Wyckoff; Abhik Das; Ellen C Hale; M Bethany Ball; Nancy S Newman; Kurt Schibler; Brenda B Poindexter; Kathleen A Kennedy; C Michael Cotten; Kristi L Watterberg; Carl T D'Angio; Sara B DeMauro; William E Truog; Uday Devaskar; Rosemary D Higgins Journal: JAMA Date: 2015-09-08 Impact factor: 56.272
Authors: Matthew M Laughon; Kim Chantala; Sofia Aliaga; Amy H Herring; Christoph P Hornik; Rachel Hughes; Reese H Clark; P Brian Smith Journal: Am J Perinatol Date: 2014-05-06 Impact factor: 3.079
Authors: Ömer Erdeve; Emel Okulu; Yogen Singh; Richard Sindelar; Mehmet Yekta Oncel; Gianluca Terrin; Giovanni Boscarino; Ali Bülbül; Hannes Sallmon; Begüm Atasay; Fahri Ovalı; Ronald I Clyman Journal: Turk Arch Pediatr Date: 2022-03