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 define d criteria for renal output if given intermittently or as a continuous infusion and to compare the effect of these two regimens on hemodynam ic variables and urine electrolyte concentrations. Design: Prospective randomized study of postoperative hemodynamically stable pediatric ca rdiac patients. The patients were given furosemide according to the ur ine output, either as an intermittent bolus injection or as a continuo us infusion. Setting: Pediatric intensive care unit in a university ho spital. Patients: The patients were randomly assigned before admission to either the intermittent i. v. or the continuous furosemide i. v. i nfusion group. Measurements and results: Demographic and hemodynamic d ata were recorded for a maximum of 72 h, as were furosemide dose, urin e output, and fluid and inotropic drug requirements. Forty-six patient s completed the study. Maximal hourly urine output was significantly h igher in the intermittent group. A significantly lower dose of furosem ide in the intermittent group produced the same 24-h urine volume as i n the continuous infusion group. Conclusions: Intermittent furosemide administration may be recommended in hemodynamically stable postoperat ive pediatric cardiac patients because of less drug requirement, Howev er, the high maximal urine output may cause hemodynamic problems in pa tients who depend on high inotropic support.