Intermittent administration of furosemide versus continuous infusion in the postoperative management of children following open heart surgery.
OBJECTIVE
To compare the amount of furosemide needed to fulfil defined criteria for renal output if given intermittently or as a continuous infusion and to compare the effect of these two regimens on hemodynamic variables and urine electrolyte concentrations.


METHODS
Prospective randomized study of postoperative hemodynamically stable pediatric cardiac patients. The patients were given furosemide according to the urine output, either as an intermittent bolus injection or as a continuous infusion.


METHODS
Pediatric intensive care unit in a university hospital.


METHODS
The patients were randomly assigned before admission to either the intermittent i.v. or the continuous furosemide i.v. infusion group.


RESULTS
Demographic and hemodynamic data were recorded for a maximum of 72 h, as were furosemide dose, urine output, and fluid and inotropic drug requirements. Forty-six patients completed the study. Maximal hourly urine output was significantly higher in the intermittent group. A significantly lower dose of furosemide in the intermittent group produced the same 24-h urine volume as in the continuous infusion group.


CONCLUSIONS
Intermittent furosemide administration may be recommended in hemodynamically stable postoperative pediatric cardiac patients because of less drug requirement. However, the high maximal urine output may cause hemodynamic problems in patients who depend on high inotropic support.
Klinge
J M
JM
University of Erlangen-Nuremberg, Hospital for Children and Adolescents, Erlangen, Germany.
Scharf
J
J
Hofbeck
M
M
Gerling
S
S
Bonakdar
S
S
Singer
H
H
D002675:Child, Preschool; D004232:Diuretics / Q000008:administration & dosage*; D005260:Female; D005665:Furosemide / Q000008:administration & dosage*; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D011182:Postoperative Care; D011446:Prospective Studies; D011897:Random Allocation; D018709:Statistics, Nonparametric; D014556:Urine
D004232:Diuretics; D005665:Furosemide