Izvorni znanstveni članak
Continuous infusion versus bolus injection of furosemide in pediatric patients after cardiac surgery: a meta-analysis of randomized studies
Giovanni Landoni
orcid.org/0000-0002-8594-5980
; Department of Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Via Olgettina 60, Milano, 20132 Italy
Alberto Zangrillo
; Department of Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Via Olgettina 60, Milano, 20132 Italy
Luca Cabrini
; Department of Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Via Olgettina 60, Milano, 20132 Italy
Giacomo Monti
; Department of Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Via Olgettina 60, Milano, 20132 Italy
Stefano Turi
; Department of Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Via Olgettina 60, Milano, 20132 Italy
Elena Bignami
; Department of Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Via Olgettina 60, Milano, 20132 Italy
Giuseppe G. L. Biondi-Zoccai
; Interventional Cardiology, Division of Cardiology, Università di Torino, Torino, Italia
Imad Sheiban
; Interventional Cardiology, Division of Cardiology, Università di Torino, Torino, Italia
Sažetak
Introduction. Acute renal failure and fluid retention are common problems in pediatric patients after cardiac surgery. Furosemide, a loop diuretic drug, is frequently administered to increase urinary output. The aim of the present study was to compare efficacy and complications of continuous infusion of furosemide vs bolus injection among pediatric patients after cardiac surgery. Methods. A systematic review and meta-analysis was performed in compliance with The Cochrane Collaboration and the Quality of Reporting of Meta-Analysis (QUORUM) guidelines. The following inclusion criteria were employed for potentially relevant studies: a) random treatment allocation, b) comparison of furosemide bolus vs continuous infusion, c) surgical or intensive care pediatric patients. Non-parallel design randomized trials (e.g. cross-over), duplicate publications and non-human experimental studies were excluded. Results. Up to August 2008, only three studies were found, with 92 patients randomized (50 to continuous infusion and 42 to bolus treatment). Overall analysis showed that continuous infusion and bolus administration were equally effective in achieving the predefined urinary output, and were associated with a similar amount of administered furosemide (WMD=-1.71 mg/kg/day [-5.20; +1.78], p for effect=0.34, p for heterogeneity<0.001, I2=99.0). However, in the continuous infusion group, patients had a significantly reduced urinary output (WMD=-0.48 ml/kg/day [-0.88; -0.08], p for effect=0.02, p for heterogeneity <0.70, I2=0%). Conclusions. Existing data comparing furosemide bolus injection with a continuous infusion are insufficient to confidently assess the best way to administer furosemide to pediatric patients after cardiac surgery. Larger studies are needed before any recommendations can be made.
Ključne riječi
furosemide; cardiac surgery; meta-analysis; intensive care unit; paediatric; acute kidney failure
Hrčak ID:
81728
URI
Datum izdavanja:
1.4.2012.
Posjeta: 2.636 *