The Impact of IV Furosemide Use on the Total Serum Bilirubin Levels of Very Low Birth Weight Neonates

靜脈給予Furosemide對非常低出生體重新生兒血清總膽紅素影響之相關性研究

10.6168/FJCP.2013.2104.01

李榮明(Zon-Min Lee)；張學文(Hsueh-Wen Chang)；李炳鈺(Ping-Yu Lee)；戴志江(Chih-Chiang Tai)；雷建邦(Chien-Bang Lei)

VLBW新生兒 ； 藥物引起高膽紅素血症 ； Furosemide ； VLBW Neonate ； Drug-Induced Hyperbilirubinemia

臺灣臨床藥學雜誌

21卷4期（2013 / 12 / 31）

283 - 290

英文

Background: Neonatal hyperbilirubinemia is common. Sulfisoxazole and ceftriaxone are known to be contraindicated in neonates with potential kernicterus because of the high protein-binding ability of these drugs. However, drugs with high protein-binding abilities, such as furosemide (＞90%), are commonly used in very low birth weight (VLBW) neonates.Objectives: he aim of this study was to determine whether IV furosemide could deteriorate hyperbilirubinemia in VLBW neonates.Methods: To determine the extent of blood loss and the hemoglobin levels of the VLBW neonates who exhibited no signs of infection ＞ 10 days and ≤ 30 days following birth were recorded and calculated. The effects of blood loss and phototherapy use or not on the total serum bilirubin (TSB) levels were calculated and used to correct the influence of each intravenous (IV) dose of furosemide on the TSB levels.Results: Ninety-six VLBW neonates were included in the study. Following corrections based on hemoglobin level changes and phototherapy use or not, the average difference between the TSB levels before and after IV furosemide use was 0.292 ± 1.478 mg/dL, which suggested that IV furosemide slightly elevated the TSB levels in VLBW neonates.Conclusions: Despite the high protein-binding ability, short-term use (one or two days) of IV furosemide might not have significant impact on the TSB levels in VLBW neonates. (n = 58, P = 0.138) Further studies are required to evaluate the influence of long-term IV furosemide use in neonates.

Background: Neonatal hyperbilirubinemia is common. Sulfisoxazole and ceftriaxone are known to be contraindicated in neonates with potential kernicterus because of the high protein-binding ability of these drugs. However, drugs with high protein-binding abilities, such as furosemide (＞90%), are commonly used in very low birth weight (VLBW) neonates.Objectives: he aim of this study was to determine whether IV furosemide could deteriorate hyperbilirubinemia in VLBW neonates.Methods: To determine the extent of blood loss and the hemoglobin levels of the VLBW neonates who exhibited no signs of infection ＞ 10 days and ≤ 30 days following birth were recorded and calculated. The effects of blood loss and phototherapy use or not on the total serum bilirubin (TSB) levels were calculated and used to correct the influence of each intravenous (IV) dose of furosemide on the TSB levels.Results: Ninety-six VLBW neonates were included in the study. Following corrections based on hemoglobin level changes and phototherapy use or not, the average difference between the TSB levels before and after IV furosemide use was 0.292 ± 1.478 mg/dL, which suggested that IV furosemide slightly elevated the TSB levels in VLBW neonates.Conclusions: Despite the high protein-binding ability, short-term use (one or two days) of IV furosemide might not have significant impact on the TSB levels in VLBW neonates. (n = 58, P = 0.138) Further studies are required to evaluate the influence of long-term IV furosemide use in neonates.