Furosemide for Patent Ductus Arteriosus During Cyclooxygenase Inhibitor Therapy: A Systematic Review

Overview

Journal Pediatr Int

Specialty Pediatrics

Date 2024 Sep 30

PMID 39349400

Authors

Hiroki Kitaoka

Yusuke Terada

Kosuke Tanaka

Masatoshi Nozaki

Satoshi Masutani

Tetsuya Isayama

Katsuaki Toyoshima

Affiliations

Soon will be listed here.

Abstract

Background: Although furosemide is used during cyclooxygenase (COX) inhibitor therapy for patent ductus arteriosus (PDA), there are concerns regarding increased ductal closure failure and acute renal failure (ARF). This systematic review explores the effects of furosemide during COX inhibitor therapy.

Methods: We searched MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi databases for randomized clinical trials that assessed furosemide during COX inhibitor therapy for PDA in preterm infants. The primary outcome measure was PDA closure failure. Mortality and other complications were also assessed. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized control trials, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation criteria.

Results: Overall, three trials involving 121 patients were included in the analysis. The overall incidence of PDA closure failure was 28%. Although the result of PDA closure failure, mortality, and ARF were obtained, other outcomes were not described in any of the studies. The risk of bias was high. The risk of PDA closure failure did not increase with furosemide administration. Furosemide was not associated with decreased mortality but was associated with an increased risk of ARF (risk ratio, 4.96 [95% confidence interval: 1.80-13.6]). The certainty of evidence for all outcomes was very low.

Conclusion: Although furosemide is not associated with an increased risk of PDA closure failure or mortality, the risk of ARF increases after furosemide administration during COX inhibitor therapy.

Citing Articles

Furosemide for patent ductus arteriosus during cyclooxygenase inhibitor therapy: A systematic review.

Kitaoka H, Terada Y, Tanaka K, Nozaki M, Masutani S, Isayama T Pediatr Int. 2024; 66(1):e15822.

PMID: 39349400 PMC: 11580366. DOI: 10.1111/ped.15822.

References

Dudley S, Sen S, Hanson A, Khuffash A, Levy P . The role of furosemide and fluid management for a hemodynamically significant patent ductus arteriosus in premature infants. J Perinatol. 2022; 42(12):1703-1707. DOI: 10.1038/s41372-022-01450-1. View

Lee B, Byun S, Chung M, Chang J, Kim H, Kim E . Effect of furosemide on ductal closure and renal function in indomethacin-treated preterm infants during the early neonatal period. Neonatology. 2010; 98(2):191-9. DOI: 10.1159/000289206. View

Noori S, McCoy M, Friedlich P, Bright B, Gottipati V, Seri I . Failure of ductus arteriosus closure is associated with increased mortality in preterm infants. Pediatrics. 2009; 123(1):e138-44. DOI: 10.1542/peds.2008-2418. View

Friedman Z, Demers L, Marks K, Uhrmann S, Maisels M . Urinary excretion of prostaglandin E following the administration of furosemide and indomethacin to sick low-birth-weight infants. J Pediatr. 1978; 93(3):512-5. DOI: 10.1016/s0022-3476(78)81182-2. View

Clyman R . Ibuprofen and patent ductus arteriosus. N Engl J Med. 2000; 343(10):728-30. DOI: 10.1056/NEJM200009073431009. View

Jain A, Shah P . Diagnosis, Evaluation, and Management of Patent Ductus Arteriosus in Preterm Neonates. JAMA Pediatr. 2015; 169(9):863-72. DOI: 10.1001/jamapediatrics.2015.0987. View

Itabashi K, Ohno T, Nishida H . Indomethacin responsiveness of patent ductus arteriosus and renal abnormalities in preterm infants treated with indomethacin. J Pediatr. 2003; 143(2):203-7. DOI: 10.1067/S0022-3476(03)00303-2. View

Brion L, Campbell D . Furosemide for symptomatic patent ductus arteriosus in indomethacin-treated infants. Cochrane Database Syst Rev. 2001; (3):CD001148. DOI: 10.1002/14651858.CD001148. View

Stark A, Smith P, Hornik C, Zimmerman K, Hornik C, Pradeep S . Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018. J Pediatr. 2021; 240:66-71.e4. PMC: 9394450. DOI: 10.1016/j.jpeds.2021.08.075. View

10.

Aziz K, Schles E, Makker K, Wynn J . Frequency of Acute Kidney Injury and Association With Mortality Among Extremely Preterm Infants. JAMA Netw Open. 2022; 5(12):e2246327. PMC: 9856227. DOI: 10.1001/jamanetworkopen.2022.46327. View

11.

Kitaoka H, Terada Y, Tanaka K, Nozaki M, Masutani S, Isayama T . Furosemide for patent ductus arteriosus during cyclooxygenase inhibitor therapy: A systematic review. Pediatr Int. 2024; 66(1):e15822. PMC: 11580366. DOI: 10.1111/ped.15822. View

12.

Guyatt G, Oxman A, Kunz R, Atkins D, Brozek J, Vist G . GRADE guidelines: 2. Framing the question and deciding on important outcomes. J Clin Epidemiol. 2011; 64(4):395-400. DOI: 10.1016/j.jclinepi.2010.09.012. View

13.

Bixler G, Powers G, Clark R, Walker M, Tolia V . Changes in the Diagnosis and Management of Patent Ductus Arteriosus from 2006 to 2015 in United States Neonatal Intensive Care Units. J Pediatr. 2017; 189:105-112. DOI: 10.1016/j.jpeds.2017.05.024. View

14.

Toyoshima K, Momma K, Nakanishi T . In vivo dilatation of the ductus arteriosus induced by furosemide in the rat. Pediatr Res. 2009; 67(2):173-6. DOI: 10.1203/PDR.0b013e3181c2df30. View

15.

Ohlsson A, Walia R, Shah S . Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants. Cochrane Database Syst Rev. 2020; 2:CD003481. PMC: 7012639. DOI: 10.1002/14651858.CD003481.pub8. View

16.

Schena F, Francescato G, Cappelleri A, Picciolli I, Mayer A, Mosca F . Association between Hemodynamically Significant Patent Ductus Arteriosus and Bronchopulmonary Dysplasia. J Pediatr. 2015; 166(6):1488-92. DOI: 10.1016/j.jpeds.2015.03.012. View

17.

Green T, Thompson T, Johnson D, Lock J . Furosemide promotes patent ductus arteriosus in premature infants with the respiratory-distress syndrome. N Engl J Med. 1983; 308(13):743-8. DOI: 10.1056/NEJM198303313081303. View

18.

. [Indomethacin and furosemide in closure of ductus arteriosus]. Bol Med Hosp Infant Mex. 1986; 43(8):482-8. View

19.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

20.

Yeh T, Wilks A, Singh J, Betkerur M, Lilien L, Pildes R . Furosemide prevents the renal side effects of indomethacin therapy in premature infants with patent ductus arteriosus. J Pediatr. 1982; 101(3):433-7. DOI: 10.1016/s0022-3476(82)80079-6. View