Nicolas A Bamat1,2,3, Elizabeth J Thompson4, Rachel G Greenberg4,5, Scott A Lorch6, Athena F Zuppa7,8, Eric C Eichenwald6, Veeral N Tolia9,10, Reese H Clark10, P Brian Smith4,5, Christoph P Hornik4,5, Jason E Lang4, Matthew M Laughon11. 1. Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. bamatn@chop.edu. 2. Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, USA. bamatn@chop.edu. 3. Center for Clinical Pharmacology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. bamatn@chop.edu. 4. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA. 5. Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. 6. Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 7. Center for Clinical Pharmacology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 8. Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 9. Department of Neonatology, Baylor University Medical Center, Dallas, TX, USA. 10. The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, FL, USA. 11. Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract
OBJECTIVE: Furosemide renal clearance is slow after very preterm (VP) birth and increases with postnatal maturation. We compared furosemide dose frequency and total daily dose between postmenstrual age (PMA) groups in VP infants. STUDY DESIGN: Observational cohort study of VP infants exposed to a repeated-dose course of furosemide in Pediatrix neonatal intensive care units (NICU) from 1997 to 2016. RESULTS: We identified 6565 furosemide courses among 4638 infants. There were no statistically significant differences between PMA groups on the odds of receiving more frequent furosemide dosing. Furosemide courses initiated at <28 weeks PMA were associated with a higher total daily dose than those initiated at a later PMA. CONCLUSIONS: Furosemide dosing practices in the NICU are similar across PMA groups, despite maturational changes in drug disposition. Research is needed to identify and test rational dosing strategies across the PMA spectrum for this commonly used but unproven pharmacotherapy.
OBJECTIVE: Furosemide renal clearance is slow after very preterm (VP) birth and increases with postnatal maturation. We compared furosemide dose frequency and total daily dose between postmenstrual age (PMA) groups in VP infants. STUDY DESIGN: Observational cohort study of VP infants exposed to a repeated-dose course of furosemide in Pediatrix neonatal intensive care units (NICU) from 1997 to 2016. RESULTS: We identified 6565 furosemide courses among 4638 infants. There were no statistically significant differences between PMA groups on the odds of receiving more frequent furosemide dosing. Furosemide courses initiated at <28 weeks PMA were associated with a higher total daily dose than those initiated at a later PMA. CONCLUSIONS: Furosemide dosing practices in the NICU are similar across PMA groups, despite maturational changes in drug disposition. Research is needed to identify and test rational dosing strategies across the PMA spectrum for this commonly used but unproven pharmacotherapy.
Authors: L S Miall; M J Henderson; A J Turner; K G Brownlee; J T Brocklebank; S J Newell; V L Allgar Journal: Pediatrics Date: 1999-12 Impact factor: 7.124
Authors: Elizabeth J Thompson; Daniel K Benjamin; Rachel G Greenberg; Karan R Kumar; Kanecia O Zimmerman; Matthew Laughon; Reese H Clark; P Brian Smith; Christoph P Hornik Journal: Neonatology Date: 2020-10-07 Impact factor: 4.035
Authors: Rachel G Greenberg; Sreepriya Gayam; Destiny Savage; Andrew Tong; Daniel Gorham; Ari Sholomon; Reese H Clark; Daniel K Benjamin; Matthew Laughon; P Brian Smith Journal: J Pediatr Date: 2018-12-20 Impact factor: 6.314
Authors: Erik A Jensen; Kevin Dysart; Marie G Gantz; Scott McDonald; Nicolas A Bamat; Martin Keszler; Haresh Kirpalani; Matthew M Laughon; Brenda B Poindexter; Andrea F Duncan; Bradley A Yoder; Eric C Eichenwald; Sara B DeMauro Journal: Am J Respir Crit Care Med Date: 2019-09-15 Impact factor: 21.405
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Authors: Nicolas A Bamat; Timothy D Nelin; Eric C Eichenwald; Haresh Kirpalani; Matthew M Laughon; Wesley M Jackson; Erik A Jensen; Kathleen A Gibbs; Scott A Lorch Journal: J Pediatr Date: 2020-11-03 Impact factor: 4.406
Authors: Emily M Hsieh; Christoph P Hornik; Reese H Clark; Matthew M Laughon; Daniel K Benjamin; P Brian Smith Journal: Am J Perinatol Date: 2013-12-17 Impact factor: 3.079