Diuretic exposure in premature infants from 1997 to 2011.
Diuretic exposure in premature infants from 1997 to 2011.
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DOI：
10.1055/s-0034-1373845
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发表时间：
2015-01
影响因子：
2
通讯作者：
Smith PB
中科院分区：
文献类型：
--
作者：
Laughon MM;Chantala K;Aliaga S;Herring AH;Hornik CP;Hughes R;Clark RH;Smith PB
利尿剂经常被处方标签外早产儿，特别是预防或治疗支气管肺发育不良（BPD）。我们在该组中检查了它们的使用和安全性。1997-2011年在333个新生儿重症监护室对妊娠<32周且出生体重<1500 g的婴儿暴露于利尿剂的回顾性队列研究。我们检查了乙酰唑胺、阿米洛利、布美他尼、氯噻嗪、二氮嗪、依他尼酸、呋塞米、氢氯噻嗪、甘露醇、美托拉宗或螺内酯联合用药的使用情况。确定每个利尿剂使用疗程第一天的呼吸支持和FiO 2。37%（39，357/107，542）的婴儿暴露于至少一种利尿剂;呋塞米是最常用的（93%记录了≥1次剂量），其次是螺内酯、氯噻嗪、氢氯噻嗪、布美他尼和乙酰唑胺。74%的患者同时暴露于1种利尿剂，19%同时暴露于2种利尿剂，6%同时暴露于3种利尿剂。最常见的联合用药是呋塞米/螺内酯，其次是呋塞米/氯噻嗪和氯噻嗪/螺内酯。许多婴儿在呋塞米（47%）、螺内酯（69%）、氯噻嗪（61%）和氢氯噻嗪（68%）新疗程的第一天没有接受机械通气。任何利尿剂的任何不良事件发生率为42/1000婴儿日，呋塞米为35/1000婴儿日。任何严重不良事件的发生率为3.8/1000婴儿-天，任何利尿剂和呋塞米为3.2/1000婴儿-天。与利尿剂暴露相关的最常见实验室检查异常是血小板减少症。尽管没有FDA的适应症，也没有什么安全性数据，但我们人群中超过三分之一的早产儿暴露于利尿剂，许多人的呼吸支持最少。
Diuretics are often prescribed off-label to premature infants, particularly to prevent or treat bronchopulmonary dysplasia (BPD). We examined their use and safety in this group. Retrospective cohort study of infants <32 weeks gestation and <1500 g birth weight exposed to diuretics in 333 neonatal intensive care units from 1997–2011. We examined use of acetazolamide, amiloride, bumetanide, chlorothiazide, diazoxide, ethacrynic acid, furosemide, hydrochlorothiazide, mannitol, metolazone, or spironolactone combination. Respiratory support and FiO2 on the first day of each course of diuretic use were identified. Thirty-seven percent (39,357/107,542) of infants were exposed to at least 1 diuretic; furosemide was the most commonly used (93% with ≥1 recorded dose), followed by spironolactone, chlorothiazide, hydrochlorothiazide, bumetanide, and acetazolamide. Seventy-four percent were exposed to 1 diuretic at a time, 19% to 2 diuretics simultaneously, and 6% to 3 diuretics simultaneously. The most common combination was furosemide/spironolactone, followed by furosemide/chlorothiazide and chlorothiazide/spironolactone. Many infants were not receiving mechanical ventilation on the first day of each new course of furosemide (47%), spironolactone (69%), chlorothiazide (61%), and hydrochlorothiazide (68%). Any adverse event occurred on 42 per 1000 infant-days for any diuretic and 35 per 1000 infant-days for furosemide. Any serious adverse event occurred in 3.8 for any diuretic and 3.2 per 1000 infant-days for furosemide. The most common laboratory abnormality associated with diuretic exposure was thrombocytopenia. Despite no FDA indication and little safety data, over one third of premature infants in our population were exposed to a diuretic, many with minimal respiratory support.
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影响因子：
158.5
作者：
Ballard, Roberta A.;Truog, William E.;Coburn, Christine E.
通讯作者：
Coburn, Christine E.
影响因子：
1.8
作者：
Avenel, S;Bomkratz, A;Danan, C
通讯作者：
Danan, C
影响因子：
158.5
作者：
BURNS, LE;HODGMAN, JE;CASS, AB
通讯作者：
CASS, AB
影响因子：
120.7
作者：
Roberts, R;Rodriguez, W;Crescenzi, T
通讯作者：
Crescenzi, T
影响因子：
2.9
作者：
Mukattash, Tareq;Hawwa, Ahmed F.;McElnay, James C.
通讯作者：
McElnay, James C.