ArticleCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine2024
Continuous frusemide infusion versus intermittent bolus therapy in paediatric intensive care: A single centre retrospective study.
Article in Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Frusemide is a common diuretic administered to critically ill children intravenously, by either continuous infusion (CI) or intermittent bolus (IB). We aim to describe the characteristics of children who receive intravenous frusemide, patterns of use, and incidence of acute kidney injury (AKI), and to investigate factors associated with commencing CI. Design: Retrospective observational study. Setting: Paediatric intensive care unit (PICU), the Royal Children's Hospital Melbourne. Participants: Children who received intravenous frusemide during PICU admission lasting ≥24 h between 2017 and 2022. Main outcome measures: The primary outcome was the daily dose of frusemide. Secondary outcomes included timing of therapy from PICU admission, fluid balance at frusemide initiation, additional diuretic therapy, and the incidence of AKI at admission and frusemide initiation. Children who received CI were compared with those who received IB only using multivariable logistic regression analyses. Results: Nine thousand three ninety-four children were admitted during the study period. A total of 1387 children (15 %) received intravenous frusemide, including 220 children (16 %) by CI. The CI group were younger (132 vs 202 days, Conclusion: Frusemide infusions are administered more commonly to children with CHD, later in PICU admission, and at higher daily doses compared to IB. Children who receive CI have a higher incidence and severity of AKI at initiation.
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