When could the administration of furosemide be avoided?
When could the administration of furosemide be avoided?
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DOI：
10.1097/01.rlu.0000082659.54696.f8
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发表时间：
2003-09-01
影响因子：
10.6
通讯作者：
Ham, H
中科院分区：
文献类型：
--
作者：
Kuyvenhoven, J;Piepsz, A;Ham, H
目的：本研究的目的是评估是否一些参数的基本肾图允许一个省略速尿管理的情况下hydronephrosis.Materials和方法：一百三十七名儿童（274肾）提到单或双侧肾积水进行了回顾性评价。在所有儿童中，由于肾排空不满意，获得了额外的呋塞米挑战，随后是排尿后的意见。根据排尿后视图上的残余肾活动将患者分为2组：两个肾脏排空良好（R-）的患者，认为给予呋塞米对其无影响，以及至少I个肾脏部分排空或无排空的患者（R+）。选择用于预测R+和R-的肾图参数为达到最大值的时间（Tmax）、20分钟时的输出效率（01320）和20分钟时的标准化残余活性（诺拉（20））。对于每个参数，然后计算儿童的数量，为他们的呋塞米的管理可能已经omitted.Results：共112名儿童被归类为R-和25个R+。Tmax、OE 20和诺拉（20）的100%阴性预测值的截止值分别为4.5分钟、66%和1.45。应用这些参数的临界值，回顾起来，分别有6（4%）、29（21%）和22（16%）例儿童可以省略呋塞米的给药。根据OE 20和诺拉（20），大量患者可省略呋塞米给药，尽管基础肾图上的肾排空不令人满意。
Purpose: The purpose of this study was to evaluate whether some parameters of the basic renogram allow one to omit the administration of furosemide in cases of hydronephrosis.Materials and Methods: One hundred thirty-seven children (274 kidneys) referred for uni- or bilateral hydronephrosis were evaluated retrospectively. In all children additional furosemide challenges followed by postmicturition views were acquired because of unsatisfactory renal emptying. The patients were categorized into 2 groups according to the residual renal activity on the postmicturition view: those with good emptying (R-) of both kidneys, for which the administration of furosemide was considered of no influence, and those with partial or no emptying of at least I kidney (R+). The renogram parameters chosen for predicting R+ and R- were time to maximum (T-max), output efficiency at 20 minutes (01320), and normalized residual activity at 20 minutes (NORA(20)). For each parameter, the number of children was then calculated, for whom the administration of furosemide could have been omitted.Results: A total of 112 children were categorized as R- and 25 as R+. The cutoff values for 100% negative predictive value of T-max, OE20, and NORA(20) were 4.5 minutes, 66%, and 1.45 respectively. Application of these cutoff values for the parameters yields, in retrospect, 6 (4%), 29 (21%), and 22 (16%) children respectively for whom administration of furosemide could have been omitted.Conclusion: On the basis of OE20 and NORA(20), the administration of furosemide could have been omitted in a substantial number of patients, despite unsatisfactory renal emptying on the basic renogram.