Furosemide clearance Mandatory in very Preterm Neonates earl
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Furosemide is a diuretic that is commonly used off-label in neonates with oliguria and/or edema. Preterm neonates have a lower clearance rate than term neonates or infants. The aim of this study was to determine the factors that predict PK parameters like furosemide clearance (CL) in very preterm (VP) neonates (less than 28 weeks gestation) during the first two weeks of life.

Furosemide was administered at 0.5 or 1 mg/kg in a 0.5?h infusion via a syringe pump, and blood samples were drawn from an artery or vein after the intravenous injection. The serum furosemide concentration was measured using high performance liquid chromatography. The PK parameters were then analyzed using Bayesian estimation.

Results:
--13 blood samples were obtained from 10 VP neonates after intravenous injection.

--The mean postconceptional age and mean postnatal days at exposure to furosemide was 26.9 weeks and 7.1 days, respectively.

--The estimated mean CL was 16.5 mL/kg/h. The mean distribution volume (Vd) and elimination half life (t1/2) was 0.37 L/kg and 15.3 h, respectively.

--Furosemide CL was negatively associated with serum creatinine (SCr) [CL = 84.2 – 67.1 × SCr (mg/dL)].

Finally, VP neonates had a higher CL than subjects in other preterm neonatal studies during the first two weeks of life. The SCr level was the only factor that influenced furosemide CL, suggesting that it could be used as a guide for furosemide dosing in VP neonates.

Source: https://onlinelibrary.wiley.com/doi/10.1111/ped.14735?af=R
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