Furosemide clearance in very preterm neonates early in life: A pilot study using scavenged samples
Background Furosemide is an off‐label drug, frequently used as a diuretic in neonates with oliguria and/or edema. Its clearance in preterm neonates is lower than in term neonates or children. We aimed, herein, to clarify furosemide clearance (CL) in very preterm (VP) neonates (
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| Veröffentlicht in: | Pediatrics international 2022-01, Vol.64 (1), p.e14735-n/a |
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| creator | Okazaki, Kaoru Fukuoka, Noriyasu Kuboi, Toru Unemoto, Jun Kondo, Masatoshi Kusaka, Takashi Itoh, Susumu |
| description | Background
Furosemide is an off‐label drug, frequently used as a diuretic in neonates with oliguria and/or edema. Its clearance in preterm neonates is lower than in term neonates or children. We aimed, herein, to clarify furosemide clearance (CL) in very preterm (VP) neonates ( |
| doi_str_mv | 10.1111/ped.14735 |
| format | Article |
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Furosemide is an off‐label drug, frequently used as a diuretic in neonates with oliguria and/or edema. Its clearance in preterm neonates is lower than in term neonates or children. We aimed, herein, to clarify furosemide clearance (CL) in very preterm (VP) neonates (<28 weeks’ gestation) within the first 2 weeks of life and identify the factors predictive of the pharmacokinetics (PK) parameters, such as CL.
Methods
Furosemide was administered at 0.5 or 1 mg/kg in a 0.5‐h infusion via a syringe pump; 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
Thirteen blood samples were obtained from 10 VP neonates after intravenous injection. The mean postconceptional age and mean postnatal days at exposure to furosemide were 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) were 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)].
Conclusions
Very preterm neonates within the first 2 weeks of life had a higher CL than subjects in other preterm neonatal studies. The SCr level was the sole parameter influencing furosemide CL and might serve as a good index for furosemide dosing in VP neonates.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/ped.14735</identifier><identifier>PMID: 33848384</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Bayes Theorem ; Bayesian analysis ; Child ; Creatinine ; Diuretics ; Edema ; Furosemide ; Humans ; infant ; Infant, Extremely Premature ; Infant, Newborn ; Intravenous administration ; Liquid chromatography ; neonatal intensive care units ; Neonates ; Off-Label Use ; Pediatrics ; Pharmacokinetics ; Pilot Projects</subject><ispartof>Pediatrics international, 2022-01, Vol.64 (1), p.e14735-n/a</ispartof><rights>2021 Japan Pediatric Society</rights><rights>2021 Japan Pediatric Society.</rights><rights>2022 Japan Pediatric Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3775-2d2db58d950f28e90c96e60feb15044e35d540175c0a258777b074f9822a7ca83</citedby><cites>FETCH-LOGICAL-c3775-2d2db58d950f28e90c96e60feb15044e35d540175c0a258777b074f9822a7ca83</cites><orcidid>0000-0001-7002-468X ; 0000-0003-0790-737X ; 0000-0003-2121-1862</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fped.14735$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fped.14735$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33848384$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okazaki, Kaoru</creatorcontrib><creatorcontrib>Fukuoka, Noriyasu</creatorcontrib><creatorcontrib>Kuboi, Toru</creatorcontrib><creatorcontrib>Unemoto, Jun</creatorcontrib><creatorcontrib>Kondo, Masatoshi</creatorcontrib><creatorcontrib>Kusaka, Takashi</creatorcontrib><creatorcontrib>Itoh, Susumu</creatorcontrib><title>Furosemide clearance in very preterm neonates early in life: A pilot study using scavenged samples</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Background
Furosemide is an off‐label drug, frequently used as a diuretic in neonates with oliguria and/or edema. Its clearance in preterm neonates is lower than in term neonates or children. We aimed, herein, to clarify furosemide clearance (CL) in very preterm (VP) neonates (<28 weeks’ gestation) within the first 2 weeks of life and identify the factors predictive of the pharmacokinetics (PK) parameters, such as CL.
Methods
Furosemide was administered at 0.5 or 1 mg/kg in a 0.5‐h infusion via a syringe pump; 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
Thirteen blood samples were obtained from 10 VP neonates after intravenous injection. The mean postconceptional age and mean postnatal days at exposure to furosemide were 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) were 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)].
Conclusions
Very preterm neonates within the first 2 weeks of life had a higher CL than subjects in other preterm neonatal studies. The SCr level was the sole parameter influencing furosemide CL and might serve as a good index for furosemide dosing in VP neonates.</description><subject>Bayes Theorem</subject><subject>Bayesian analysis</subject><subject>Child</subject><subject>Creatinine</subject><subject>Diuretics</subject><subject>Edema</subject><subject>Furosemide</subject><subject>Humans</subject><subject>infant</subject><subject>Infant, Extremely Premature</subject><subject>Infant, Newborn</subject><subject>Intravenous administration</subject><subject>Liquid chromatography</subject><subject>neonatal intensive care units</subject><subject>Neonates</subject><subject>Off-Label Use</subject><subject>Pediatrics</subject><subject>Pharmacokinetics</subject><subject>Pilot Projects</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LAzEQhoMotlYP_gEJePKwbZJNmqy3UlsVCnpQ8Bayu7Nly36Z7Fb235u67dGBYYaZh3eYF6FbSqbUx6yBdEq5DMUZGlPOWcAI-Tr3fchUoMhcjtCVcztCiJKKX6JRGCqufI5RvO5s7aDMU8BJAcaaKgGcV3gPtseNhRZsiSuoK9OCwx4o-sO6yDN4xAvc5EXdYtd2aY87l1db7BKzh2oLKXambApw1-giM4WDm2OdoM_16mP5Emzenl-Xi02QhFKKgKUsjYVKI0EypiAiSTSHOckgpoJwDqFIBSdUioQYJpSUMiaSZ5FizMjEqHCC7gfdxtbfHbhW7-rOVv6kZioiYUTnjHrqYaAS_7ezkOnG5qWxvaZEH9zU3k3956Zn746KXVz66Yk82eeB2QD85AX0_yvp99XTIPkLu2J9-Q</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Okazaki, Kaoru</creator><creator>Fukuoka, Noriyasu</creator><creator>Kuboi, Toru</creator><creator>Unemoto, Jun</creator><creator>Kondo, Masatoshi</creator><creator>Kusaka, Takashi</creator><creator>Itoh, Susumu</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0001-7002-468X</orcidid><orcidid>https://orcid.org/0000-0003-0790-737X</orcidid><orcidid>https://orcid.org/0000-0003-2121-1862</orcidid></search><sort><creationdate>202201</creationdate><title>Furosemide clearance in very preterm neonates early in life: A pilot study using scavenged samples</title><author>Okazaki, Kaoru ; Fukuoka, Noriyasu ; Kuboi, Toru ; Unemoto, Jun ; Kondo, Masatoshi ; Kusaka, Takashi ; Itoh, Susumu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3775-2d2db58d950f28e90c96e60feb15044e35d540175c0a258777b074f9822a7ca83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Bayes Theorem</topic><topic>Bayesian analysis</topic><topic>Child</topic><topic>Creatinine</topic><topic>Diuretics</topic><topic>Edema</topic><topic>Furosemide</topic><topic>Humans</topic><topic>infant</topic><topic>Infant, Extremely Premature</topic><topic>Infant, Newborn</topic><topic>Intravenous administration</topic><topic>Liquid chromatography</topic><topic>neonatal intensive care units</topic><topic>Neonates</topic><topic>Off-Label Use</topic><topic>Pediatrics</topic><topic>Pharmacokinetics</topic><topic>Pilot Projects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okazaki, Kaoru</creatorcontrib><creatorcontrib>Fukuoka, Noriyasu</creatorcontrib><creatorcontrib>Kuboi, Toru</creatorcontrib><creatorcontrib>Unemoto, Jun</creatorcontrib><creatorcontrib>Kondo, Masatoshi</creatorcontrib><creatorcontrib>Kusaka, Takashi</creatorcontrib><creatorcontrib>Itoh, Susumu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okazaki, Kaoru</au><au>Fukuoka, Noriyasu</au><au>Kuboi, Toru</au><au>Unemoto, Jun</au><au>Kondo, Masatoshi</au><au>Kusaka, Takashi</au><au>Itoh, Susumu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Furosemide clearance in very preterm neonates early in life: A pilot study using scavenged samples</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2022-01</date><risdate>2022</risdate><volume>64</volume><issue>1</issue><spage>e14735</spage><epage>n/a</epage><pages>e14735-n/a</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Background
Furosemide is an off‐label drug, frequently used as a diuretic in neonates with oliguria and/or edema. Its clearance in preterm neonates is lower than in term neonates or children. We aimed, herein, to clarify furosemide clearance (CL) in very preterm (VP) neonates (<28 weeks’ gestation) within the first 2 weeks of life and identify the factors predictive of the pharmacokinetics (PK) parameters, such as CL.
Methods
Furosemide was administered at 0.5 or 1 mg/kg in a 0.5‐h infusion via a syringe pump; 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
Thirteen blood samples were obtained from 10 VP neonates after intravenous injection. The mean postconceptional age and mean postnatal days at exposure to furosemide were 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) were 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)].
Conclusions
Very preterm neonates within the first 2 weeks of life had a higher CL than subjects in other preterm neonatal studies. The SCr level was the sole parameter influencing furosemide CL and might serve as a good index for furosemide dosing in VP neonates.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>33848384</pmid><doi>10.1111/ped.14735</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-7002-468X</orcidid><orcidid>https://orcid.org/0000-0003-0790-737X</orcidid><orcidid>https://orcid.org/0000-0003-2121-1862</orcidid></addata></record> |
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| subjects | Bayes Theorem Bayesian analysis Child Creatinine Diuretics Edema Furosemide Humans infant Infant, Extremely Premature Infant, Newborn Intravenous administration Liquid chromatography neonatal intensive care units Neonates Off-Label Use Pediatrics Pharmacokinetics Pilot Projects |
| title | Furosemide clearance in very preterm neonates early in life: A pilot study using scavenged samples |
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