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Table of Contents
Vol. 98, No. 2, 2010
Issue release date: August 2010
Section title: Original Paper
Neonatology 2010;98:191–199
(DOI:10.1159/000289206)

Effect of Furosemide on Ductal Closure and Renal Function in Indomethacin-Treated Preterm Infants during the Early Neonatal Period

Lee B.S. · Byun S.Y. · Chung M.L. · Chang J.Y. · Kim H.Y. · Kim E.A.-R. · Kim K.-S. · Pi S.-Y.
Division of Neonatology, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 30, 2009
Accepted: September 04, 2009
Published online: March 16, 2010
Issue release date: August 2010

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

Background: Furosemide is known to increase renal prostaglandin synthesis. However, its influence on ductal closure and renal toxicities of indomethacin in preterm infants has not been conclusive, especially during the early neonatal period. Objectives: To identify the effects of furosemide after indomethacin administration on the rate of patent ductus arteriosus (PDA) closure and renal function in preterm infants. Methods: 68 infants (gestational age <34 weeks and birth weight <2,000 g) receiving indomethacin therapy (one course: 0.2–0.1–0.1 mg/kg q 12 h, mostly started <48 h after birth) were randomly assigned to the furosemide (n = 35) or control (n = 33) group. Each indomethacin dose was followed by furosemide (1.0 mg/kg) or placebo. The primary (PDA closure) and secondary (acute renal failure (ARF) and others) outcomes were assessed. Renal parameters before and 0–12 and 24–36 h after the first course of indomethacin were also investigated. Results: In an intention-to-treat analysis, there were no differences in the PDA closure rate between the furosemide (29/34) and the control (27/29) group (p = 0.437). The incidence of ARF (serum creatinine >1.6 mg/dl) was greater in the furosemide group (20/34) than in the control group (3/29) (p < 0.001). Compared with the control group, serum creatinine and cystatin C levels and fractional excretion of sodium were significantly increased in the furosemide group for 24–36 h after indomethacin therapy (p < 0.01). There were no between-group differences in mortality and other neonatal morbidity rates. Conclusions: Use of furosemide in combination with indomethacin increased the incidence of ARF but did not affect the PDA closure rate in preterm infants.

© 2010 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 30, 2009
Accepted: September 04, 2009
Published online: March 16, 2010
Issue release date: August 2010

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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