Furosemide in preterm infants treated with indomethacin for patent ductus arteriosus

• Published in: Acta Paediatrica Vol. 98; no. 5; pp. 797 - 803
• Main Authors: Andriessen, Peter, Struis, Nicole C., Niemarkt, Hendrik, Oetomo, Sidarto Bambang, Tanke, Ronald B., Van Overmeire, Bart
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2009; Blackwell
• Subjects: Biological and medical sciences; Cohort Studies; Creatinine - blood; Cyclooxygenase Inhibitors - adverse effects; Diuretics - therapeutic use; Ductus Arteriosus, Patent - drug therapy; Female; Furosemide; Furosemide - therapeutic use; General aspects; Humans; Indomethacin; Indomethacin - adverse effects; Infant, Newborn; Infant, Premature; Kidney Diseases - chemically induced; Kidney Diseases - prevention & control; Kidney Function Tests; Male; Medical sciences; Multivariate Analysis; Patent ductus arteriosus; Renal function; Retrospective Studies; Sodium - blood; Treatment Outcome; Urine; Human; Premature; Prostaglandin-endoperoxide synthase; Pediatrics; Renal function; Patent ductus arteriosus; Enzyme; Indometacin; Enzyme inhibitor; Persistence of ductus arteriosus; Infant; Furosemide; Tocolytic; Non steroidal antiinflammatory agent; Diuretic; Newborn diseases; Treatment; Prematurity; Sulfonamides; Indoleacetic acid derivatives; Anthranilic acid derivatives; Antihypertensive agent; Oxidoreductases; Indomethacin
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2009.01224.x

Objective: To evaluate the effect of furosemide on renal function and water balance in preterm infants treated with indomethacin (3 × 0.2 mg/kg at 12‐h intervals) for symptomatic patent ductus arteriosus. Patients and Methods: We performed a retrospective multi‐centre double cohort study in preterm infants <32 weeks of gestational age. Thirty‐two infants treated with furosemide (1 mg/kg i.v.) before each indomethacin dose (furosemide group) were matched with 32 infants with indomethacin treatment alone (control‐group). Renal effects (urine output, weight gain, serum creatinine, sodium concentration) were registered. Results: The study groups were comparable for gestational age, birth weight and day of therapy. Pretreatment differences were observed for urine output, weight and serum sodium. However, no differences were noticed in day‐to‐day urine output change or weight gain between the groups. A significant increase in serum creatinine concentration (50% vs. control, 18%; p < 0.05) and a concomitant significant decrease in serum sodium (–9 vs. control, –3 mmoL/L; p < 0.05) in the furosemide group was observed 72–96 h after starting therapy. Conclusion: Furosemide before each indomethacin dose resulted in a significant increase in serum creatinine and hyponatremia, without increasing urine output.