Table 1 survey questions and frequency of selected answers
From: Furosemide use in Italian neonatal intensive care units: a national survey
N° | Questions | Answers | All centers | Centers prescribing higher doses | p-value* | ||
|---|---|---|---|---|---|---|---|
N = 57 | % | N = 28 | % | ||||
1 | Do you administer furosemide to newborns regardless of their gestation age? | Yes | 55 | 96.5 | 26 | 92.9 | n.s. |
No | 2 | 3.5 | 2 | 7.1 | |||
2 | Which route do you use to administer furosemide? Multiple choices allowed | Intravenous | 57 | 100.0 | 28 | 100.0 | n.s. |
Oral | 43 | 75.4 | 22 | 78.6 | |||
Nebulized | 4 | 7.0 | 2 | 7.1 | |||
Intramuscular | 3 | 5.3 | 1 | 3.6 | |||
3 | For which clinical indications do you use furosemide? Multiple choices allowed | Cardiac overload | 54 | 94.7 | 28 | 100.0 | n.s. |
Oligo/anuria | 50 | 87.7 | 26 | 92.9 | |||
BPD | 29 | 50.9 | 14 | 50.0 | |||
RDS/TTN | 14 | 24.6 | 8 | 28.6 | |||
Other | 2 | 3.5 | 1 | 3.6 | |||
4 | Which intravenous administration do you use? Multiple choices allowed | Single doses, eventually repeated | 49 | 86.0 | 23 | 82.1 | n.s. |
Continuous infusion | 24 | 42.1 | 12 | 42.9 | |||
Single doses plus continuous infusion | 18 | 31.6 | 8 | 28.6 | |||
5 | At which maximum dose do you administer furosemide intravenously (single dose)? | 1–2 mg/kg | 35 | 61.4 | 6 | 21.4 | n.a. |
> 2–4 mg/kg | 17 | 29.8 | 17 | 60.7 | |||
> 4–10 mg/kg | 4 | 7.0 | 4 | 14.3 | |||
> 10 mg/kg | 1 | 1.8 | 1 | 3.6 | |||
6 | In full term newborns, how often do you administer furosemide intravenously? | Every 12 h or more | 24 | 42.1 | 8 | 28.6 | n.s. |
Accordingly to diuresis | 21 | 36.8 | 12 | 42.9 | |||
Every 8 to 12 h | 6 | 10.5 | 5 | 17.9 | |||
Every less than 8 h | 5 | 8.8 | 3 | 10.7 | |||
7 | When repeated intravenous doses are needed, which is the minimum time interval between single doses? | At least 6 h | 29 | 50.8 | 12 | 42.9 | n.s. |
At least 4 h | 17 | 29.8 | 8 | 28.6 | |||
At least 1 h | 9 | 15.7 | 8 | 28.6 | |||
Not applicable | 2 | 3.5 | 1 | 3.6 | |||
8 | In full term newborns, which dose do you use for intravenous continuous infusion? Multiple choices allowed | 0.1–0.2 mg/kg/h | 31 | 54.4 | 10 | 35.7 | n.a. |
0.2–0.4 mg/kg/h | 11 | 19.3 | 9 | 32.1 | |||
0.4–1 mg/kg/h | 6 | 10.5 | 5 | 17.9 | |||
1 mg/kg/h | 2 | 3.5 | 2 | 7.1 | |||
Non applicabile | 15 | 26.3 | 7 | 25.0 | |||
9 | In preterm newborns less then 32 weeks gestational age, do you use different posology? Multiple choices allowed | No | 33 | 57.9 | 12 | 42.9 | 0.045** |
Yes, smaller doses | 15 | 26.3 | 11 | 39.3 | |||
Yes, longer intervals | 11 | 19.3 | 6 | 21.4 | |||
Yes, we greater doses | 2 | 3.5 | 1 | 3.6 | |||
Yes, shorter intervals | 0 | 0.0 | 0 | 0.0 | |||
10 | In general, do you use different posology for different clinical indication? | Yes | 39 | 68.4 | 21 | 75.0 | n.s. |
No | 18 | 31.6 | 7 | 25.0 | |||
11 | For which clinical indications do you use maximum doses higher than 1–2 mg/kg or 0.1–0.2 mg/kg/hour? Multiple choices allowed | Cardiac overload | 20 | 35 | 20 | 71.4 | n.a. |
Oligo/anuria | 11 | 19.3 | 11 | 39.2 | |||
RDS/TTN | 1 | 1.8 | 1 | 3,5 | |||
Not applicable | 29 | 50.9 | 0 | 0.0 | |||
Other | 2 | 3.5 | 2 | 7.1 | |||
12 | Which protocol/guideline/prescribing indication do you refer to for the appropriate dosage and administration in different scenarios? Multiple choices allowed | Manuals of neonatology or neonatal pharmacotherapy | 48 | 84.2 | 24 | 85.7 | 0.006 |
Articles from the literature | 11 | 19.3 | 9 | 32.1 | |||
Center protocols | 9 | 15.8 | 6 | 21.4 | |||
No specific guideline/indication | 7 | 12.3 | 0 | 0.0 | |||
13 | Have you ever had to discontinue the treatment because of drug related adverse events? If yes, which adverse events did occur? | No | 43 | 75.4 | 22 | 78.6 | n.s. |
Yes | 14 | 24.6 | 6 | 21.4 | |||
Metabolic alcalosis | 5 | 8.8 | 2 | 7.1 | |||
Dyselectrolytemia | 5 | 8.8 | 2 | 7.1 | |||
Nephrocalcinosis | 5 | 8.8 | 3 | 10.7 | |||
Hypotension | 4 | 7.0 | 1 | 3.6 | |||
14 | In case of prolonged treatment (> 2 weeks), how do you monitor for side effects? | Renal ultrasound | 4 | 7 | 3 | 10.7 | n.a. |
Acoustic test | 4 | 7 | 3 | 10.7 | |||
Both | 27 | 47.4 | 18 | 64.3 | |||
No follow up | 4 | 7 | 0 | 0 | |||
Not applicable (length of treatment < 2 weeks) | 18 | 31.6 | 4 | 14.3 | |||