Diuretic Use and Subsequent Electrolyte Supplementation in a Level IV Neonatal Intensive Care Unit
| Autor: | Lauren L. Dartois, Michael E. P. Murphy, Emma L. Ross, Theresa R. Grover, Claire Levek |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Neonatal intensive care unit business.industry medicine.medical_treatment Clinical Investigations Level iv Electrolyte 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Pediatrics Perinatology and Child Health Emergency medicine medicine Pharmacology (medical) Diuretic business |
| Zdroj: | The Journal of Pediatric Pharmacology and Therapeutics. 25:124-130 |
| ISSN: | 1551-6776 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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