PULMONARY-FUNCTION CHANGES AFTER NEBULIZED AND INTRAVENOUS FRUSEMIDE IN VENTILATED PREMATURE-INFANTS

Aims-To compare the effects of a single dose of frusemide administered either intravenously or by nebulisation on pulmonary mechanics in pre mature infants with evolving chronic lung disease. Methods-The effect of frusemide on pulmonary mechanics was studied at a median postnatal age of 23 (range 14-52) days in 19 premature infants at 24 to 30 weeks gestational age, who had been dependent on mechanical ventilation sin ce birth. Frusemide (1 mg/kg/body weight) was administered, in random order, intravenously and by nebulisation, on two separate occasions 24 hours apart. Pulmonary function studies were performed before and at 30, 60, and 120 minutes after administration of frusemide. Urine was c ollected for six hours immediately before and for six hours after admi nistration of frusemide. Results-Nebulised frusemide increased the tid al volume 31 (SE 11.5)% and compliance 34 (SE 12)% after two hours, wh ereas no change in either was noted for up to two hours after intraven ous frusemide administration. Neither intravenous nor nebulised frusem ide had any effect on airway resistance. Six hour urine output increas ed from a mean (SE) of 3.3 (0.4) ml/kg/hour to 5.9 (0.8) ml/kg/hour fo llowing intravenous frusemide administration while nebulised frusemide had no effect on urine output. Urinary sodium, potassium, and chlorid e losses were also significantly higher after intravenous frusemide, w hereas nebulised frusemide did not increase urinary electrolyte losses . Conclusion-Single dose nebulised frusemide improves pulmonary functi on in premature infants with evolving chronic lung disease without adv erse effects on fluid and electrolyte balance.