Pulmonary function changes after nebulised and intravenous frusemide in ventilated premature infants
Presented at the Society for Pediatric
Research Annual Meeting, May 1995, San Diego, USA.
Division of Neonatology, Department of Pediatrics,
Georgetown University Medical Center, M3400, Washington, DC 20007, USA
Correspondence to: Dr Ramasubbareddy Dhanireddy.
Accepted 31 January 1997
AIMS
To compare the effects of a single dose of
frusemide administered either intravenously or by nebulisation on
pulmonary mechanics in premature infants with evolving chronic lung disease.
METHODSThe 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 since 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 collected for six hours
immediately before and for six hours after administration of frusemide.
RESULTSNebulised frusemide increased the
tidal volume 31(SE 11.5)% and compliance 34 (SE 12)% after two hours,
whereas no change in either was noted for up to two hours after
intravenous frusemide administration. Neither intravenous nor nebulised
frusemide had any effect on airway resistance. Six hour urine output
increased from a mean (SE) of 3.3 (0.4) ml/kg/hour to 5.9 (0.8)
ml/kg/hour following intravenous frusemide administration while
nebulised frusemide had no effect on urine output. Urinary sodium,
potassium, and chloride losses were also significantly higher after
intravenous frusemide, whereas nebulised frusemide did not increase
urinary electrolyte losses.
CONCLUSIONSingle dose nebulised frusemide
improves pulmonary function in premature infants with evolving chronic
lung disease without adverse effects on fluid and electrolyte balance.
© 1997 by Archives of Disease in Childhood
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