Diuretic Use and Subsequent Electrolyte Supplementation in a Level IV Neonatal Intensive Care Unit.
J Pediatr Pharmacol Ther
; 25(2): 124-130, 2020.
Article
em En
| MEDLINE
| ID: mdl-32071587
ABSTRACT
OBJECTIVES:
To evaluate the relationship between diuretic use, serum electrolyte concentrations, and supplementation requirements in infants admitted to the neonatal intensive care unit.METHODS:
This was a single-center retrospective cohort study conducted in a freestanding children's hospital Level IV NICU. Data were collected for all infants younger than 6 months, admitted to the NICU between January 2015 and May 2017, who received 2 or more consecutive doses of furosemide, chlorothiazide, hydrochlorothiazide, and/or hydrochlorothiazide/spironolactone. The primary outcome was the composite of the incidence of electrolyte abnormalities and/or electrolyte supplementation requirement within 30 days of diuretic exposure.RESULTS:
A total of 72 patients met inclusion criteria, with a median gestational age of 30 weeks. Overall, 92% of patients exposed to diuretics experienced derangement in at least 1 serum electrolyte and/or required electrolyte supplementation during diuretic therapy. Patients born at 36 to 41 weeks' gestational age, receiving thiazide diuretics, experienced a significantly lower rate of the primary outcome (37%, p ≤ 0.001). The most common electrolytes affected by diuretic use were potassium and bicarbonate, with the highest incidence of the primary outcome for potassium occurring in patients receiving furosemide (p = 0.0196). Last, the median total daily dose of chlorothiazide in patients with an adverse event was 15 mg/kg/day, compared with 10 mg/kg/day in patients without an adverse event (p = 0.0041).CONCLUSIONS:
Use of diuretics in young infants is likely to cause electrolyte derangements and/or require electrolyte supplementation. Patients born at earlier gestational ages may be at higher risk for developing such adverse effects.
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Pediatr Pharmacol Ther
Ano de publicação:
2020
Tipo de documento:
Article