FUROSEMIDE VS CHLOROTHIAZIDE & FUROSEMIDE IN DIURETIC RESISTANCE IN ILL CHILDREN

利尿是危重儿科患者管理的重要组成部分。 由于多种因素，这些患者发生液体过载。达到适当的液体平衡通常是临床改善所必需的。 目前，儿科重症监护室中利尿的当地标准治疗开始于袢利尿剂呋塞米的给药，剂量为1 mg/kg，每6小时一次。 这种药物治疗方案适用于大多数需要利尿的患者，但随着时间的推移，一些患者对其影响产生耐药性。目前，在这种情况下，有两种可供选择的战略。 一种治疗方法是增加呋塞米的剂量。另一种治疗方法是继续使用相同剂量的呋塞米，并添加一种额外的利尿剂氯噻嗪，它与呋塞米协同作用。 这两种治疗方案在该人群中的相对疗效未知，两种方案均被视为儿科重症监护室的标准治疗。 在我们的研究中，我们建议调查哪一种是更好的治疗，以实现利尿的患者谁经历了反应不足的初始剂量的呋塞米。

Diuresis is an essential part of the management of critically ill pediatric patients. Fluid overload occurs in these patients due to multiple factors. Achievement of appropriate fluid balance is often necessary for clinical improvement. The local standard care for diuresis in the pediatric intensive care unit currently begins with administration of the loop diuretic, furosemide, at a dose of 1 mg/kg every six hours. This medication regimen is adequate for the majority of patients requiring diuresis however some patients develop resistance to its affects over time. At present, there are two alternative stratgies utilized when this situation develops. One treatment is to increase the dosage of furosemide. The other treatment is to continue the same dose of furosemide and add an additional diuretic, chlorothiazide, which acts synergistically with furosemide. The relative efficacy of these two treatment regimens in this population is unkown and both regimens are considered standard care within the pediatric intensive care unit. In our study, we propose to investigate which is the better treatment for achieving diuresis in patients who have experienced inadequate response to initial dosages of furosemide.