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Tytuł pozycji:

Furosemide use in Italian neonatal intensive care units: a national survey

Tytuł:
Furosemide use in Italian neonatal intensive care units: a national survey
Autorzy:
Valeria Anna Manfredini
Chiara Cerini
Antonio Clavenna
Andrea Dotta
Maria Letizia Caccamo
Alex Staffler
Luca Massenzi
Rossano Massimo Rezzonico
on the behalf of study Group of Neonatal Pharmacoterapy of the Italian Society of Neonatology
Temat:
Furosemide
Newborn
Posology
Off-label
Pediatrics
RJ1-570
Źródło:
Italian Journal of Pediatrics, Vol 46, Iss 1, Pp 1-8 (2020)
Wydawca:
BMC, 2020.
Rok publikacji:
2020
Kolekcja:
LCC:Pediatrics
Typ dokumentu:
article
Opis pliku:
electronic resource
Język:
English
ISSN:
1824-7288
Relacje:
http://link.springer.com/article/10.1186/s13052-020-00851-2; https://doaj.org/toc/1824-7288
DOI:
10.1186/s13052-020-00851-2
Dostęp URL:
https://doaj.org/article/566227a302904ab7b66214b2042e2d5c  Link otwiera się w nowym oknie
Numer akcesji:
edsdoj.566227a302904ab7b66214b2042e2d5c
Czasopismo naukowe
Abstract Background Furosemide is approved in full term neonates to treat edema associated with congestive heart failure, cirrhosis and renal diseases. It is often administered off-label in premature neonates, to treat respiratory conditions and at doses greater-than-recommended. We conducted a national survey on behalf of the Neonatal Pharmacotherapy Study Group of the Italian Society of Neonatology (SIN), to investigate its use in Italian neonatal intensive care units (NICUs), in conformity with current guidelines. Methods Between December 2016 and June 2017, a 14-item multiple-choice online questionnaire was sent to all NICU directors from the SIN directory. Gestational age, route of administration, posology, indications, referenced guidelines, adverse effects monitoring and the presence of Paediatric Cardiology or Cardiosurgery service on site were assessed. A chi-square test was performed 1) to evaluate differences in the distribution of responses between NICUs administering furosemide at doses higher-than-recommended; 2) to compare the proportion of NICUs administering furosemide at high doses in institutions with versus without a Paediatric Cardiology or Cardiosurgery service. Results The response rate was 50% (57/114). The intravenous and oral routes were chosen primarily; the intravenous administration in single doses predominated over continuous infusion. Its main therapeutic indications were congestive heart failure/overload (94.7%) and oligo-anuria (87.7%) however furosemide was also frequently used for broncopulmonary dysplasia (50.9%) and respiratory distress syndrome and/or transient tachypnea of the newborn (24.6%). In 28/57 NICUs furosemide was administered at doses higher-than-recommended. In most NICUs the same posology was used in term and preterm neonates. Compared to the total sample, a larger proportion of NICUs administering doses greater-than-recommended referenced current literature for reasons to do so (19.3 and 32.1% respectively). The presence of a Paediatric Cardiology or Cardiosurgery service on site did not correlate with the chosen posology. The majority of NICUs performed acoustic test and renal ultrasound for furosemide exposure greater than 2 weeks. Conclusions In Italian NICUs, furosemide is commonly prescribed to term and preterm newborns for label and unlabeled indications. Doses greater-than-recommended are frequently administered. Such use is not necessarily inappropriate. More research is required to assess the efficacy and safety of unlabeled use.
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