Prolonged furosemide exposure and risk of abnormal newborn hearing screen in premature infants

Wang, Laura A; Smith, P. Brian; Laughon, Matthew M.; Goldberg, Ronald N.; Ku, Lawrence; Zimmerman, Kanecia O.; Balevic, Stephen J.; Clark, Reese H.; Benjamin, Daniel K.; Greenberg, Rachel G.

doi:10.1016/j.earlhumdev.2018.08.009

Cited by 21 publications

(20 citation statements)

References 32 publications

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“…Infants less than 32 weeks gestational age are the most vulnerable given their kidney immaturity [33]. Previous research showed that preterm infants are commonly exposed to prolonged treatment with average exposure duration of at least 12 days [1,36]. Furthermore, recent data show that preterm newborns exposed to furosemide suffer from more severe comorbidities than unexposed patients [6,19,36].…”

Section: Discussionmentioning

confidence: 99%

“…Previous research showed that preterm infants are commonly exposed to prolonged treatment with average exposure duration of at least 12 days [1,36]. Furthermore, recent data show that preterm newborns exposed to furosemide suffer from more severe comorbidities than unexposed patients [6,19,36]. Indeed, long-term exposure to furosemide (greater than 14 days) in extremely preterm infants warrants even closer monitoring of side effects.…”

Section: Discussionmentioning

confidence: 99%

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Furosemide use in Italian neonatal intensive care units: a national survey

Manfredini¹,

Cerini

Clavenna

et al. 2020

Ital J Pediatr

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Background: Furosemide is approved in full term neonates to treat edema associated with congestive heart failure, cirrhosis and renal diseases. It is often administered off-label in premature neonates, to treat respiratory conditions and at doses greater-than-recommended. We conducted a national survey on behalf of the Neonatal Pharmacotherapy Study Group of the Italian Society of Neonatology (SIN), to investigate its use in Italian neonatal intensive care units (NICUs), in conformity with current guidelines. Methods: Between December 2016 and June 2017, a 14-item multiple-choice online questionnaire was sent to all NICU directors from the SIN directory. Gestational age, route of administration, posology, indications, referenced guidelines, adverse effects monitoring and the presence of Paediatric Cardiology or Cardiosurgery service on site were assessed. A chi-square test was performed 1) to evaluate differences in the distribution of responses between NICUs administering furosemide at doses higher-than-recommended; 2) to compare the proportion of NICUs administering furosemide at high doses in institutions with versus without a Paediatric Cardiology or Cardiosurgery service. Results: The response rate was 50% (57/114). The intravenous and oral routes were chosen primarily; the intravenous administration in single doses predominated over continuous infusion. Its main therapeutic indications were congestive heart failure/overload (94.7%) and oligo-anuria (87.7%) however furosemide was also frequently used for broncopulmonary dysplasia (50.9%) and respiratory distress syndrome and/or transient tachypnea of the newborn (24.6%). In 28/57 NICUs furosemide was administered at doses higher-than-recommended. In most NICUs the same posology was used in term and preterm neonates. Compared to the total sample, a larger proportion of NICUs administering doses greater-than-recommended referenced current literature for reasons to do so (19.3 and 32.1% respectively). The presence of a Paediatric Cardiology or Cardiosurgery service on site did not correlate with the chosen posology. The majority of NICUs performed acoustic test and renal ultrasound for furosemide exposure greater than 2 weeks.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Furosemide use in Italian neonatal intensive care units: a national survey

Manfredini¹,

Cerini

Clavenna

et al. 2020

Ital J Pediatr

View full text Add to dashboard Cite

show abstract

“…Risk factors affecting hearing impairments ware shown in therefore, it should be of priority in neonatal care 16,17) . 8,10,11,18) . The ototoxicity of aminoglycoside de pends on treatment duration, serum peak and trough concentra tions, concomitant diseases, and the simultaneous administra tion of loop diuretics and/or vancomycin.…”

Section: Resultsmentioning

confidence: 99%

Hearing Impairments in Preterm Infants: Factors Associated with Discrepancies between Screening and Confirmatory Test Results

Han¹,

Shin²,

Lee³

et al. 2020

Neonatal Med

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Purpose: The aim of the study was to investigate risk factors of hearing impairments in preterm infants and analyze factors associated with discrepancies between neonatal hearing screening (NHS) and confirmatory test results. Methods: We analyzed the medical records of 352 preterm infants born at 23 to 32 weeks' gestational age (GA) who underwent both automated auditory brainstem response (aABR) and confirmatory ABR (cABR). Results: Mean GA, mean birth weight, the incidence of small for GA and cesarean section birth were significantly different between the pass and refer groups on aABR and the normal and abnormal groups of cABR. On univariate analysis, bronchopul monary dysplasia (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.00 to 7.48), intraventricular hemorrhage (OR, 7.02; 95% CI, 1.59 to 31.05), and use of furosemide (OR, 3.84; 95% CI, 1.38 to 10.73) were the factors related to refer results on aABR. Peri ventricular leukomalacia (PVL; OR, 4.00; 95% CI, 1.39 to 11.52) and use of vancomycin (OR, 2.86; 95% CI, 1.22 to 6.73) were associated with abnormal cABR. Twentyfive (7.9%) infants had discrepant aABR and cABR results, particularly males and those in whom vancomycin was used. Conclusion: PVL and use of vancomycin were confirmed as independent risk factors for hearing loss in infants born at less than 32 weeks' GA. Also, discrepancies between the screening and confirmatory test may occur, especially among male infants and those in whom vancomycin was used. The hearing of infants must be assessed more carefully in such groups regardless of NHS results.

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“…( 17 ) Similarly, in a retrospective study of more than 7000 infants, Gopel et al found no association between aminoglycosides and hearing loss ( 18 ). Wang et al also found there was no statistically significant difference in abnormal hearing screening in 1020 premature babies who were exposed to prolonged furosemide ( 19 ). Despite historical concerns, a large body of evidence now supports the favorable safety profile of vancomycin, aminoglycosides and furosemide, mainly because of conservative dosing regimens in neonates and dose modification of drugs based on serum levels ( 20 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

Treatment for hypotension in the first 24 postnatal hours and the risk of hearing loss among extremely low birth weight infants

Gogcu

Washburn

2020

J Perinatol

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Objective: To evaluate whether treated hypotension in the first 24 postnatal hours is associated with hearing loss in extremely low birth weight (ELBW) infants. Study Design: In a cohort of 735 ELBW infants, we identified 25 with sensorineural hearing loss at 12–24 months adjusted age. For each case we selected 3 controls with normal hearing. Logistic regression models were used to adjust for confounding variables. Results: 60% of cases and 25% of controls were treated for hypotension. After adjusting for confounding variables (gestational age, antenatal glucocorticoids, 5 minute Apgar < 6, insertion of an umbilical catheter, treatment with high frequency ventilation, and major cranial ultrasound abnormality), treated hypotension was associated with an increased risk of sensorineural hearing loss (adjusted odds ratio: 3.6; 95% confidence interval: 1.3–9.7). Conclusions: Treated hypotension in ELBW infants in the first 24 hours of life is associated with an increased risk of sensorineural hearing loss.

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Prolonged furosemide exposure and risk of abnormal newborn hearing screen in premature infants

Cited by 21 publications

References 32 publications

Furosemide use in Italian neonatal intensive care units: a national survey

Furosemide use in Italian neonatal intensive care units: a national survey

Hearing Impairments in Preterm Infants: Factors Associated with Discrepancies between Screening and Confirmatory Test Results

Treatment for hypotension in the first 24 postnatal hours and the risk of hearing loss among extremely low birth weight infants

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