Spironolactone

1999 ◽  
Vol 18 (3) ◽  
pp. 43-46 ◽  
Author(s):  
Barbara Noerr
Keyword(s):  
Heart Failure ◽  
Intensive Care Unit ◽  
Congestive Heart Failure ◽  
Intensive Care ◽  
Side Effects ◽  
Chronic Lung Disease ◽  
Neonatal Intensive Care ◽  
Age Groups ◽  
Extracellular Fluid ◽  
Appropriate Use

DIURETICS ARE COMMONLY USED IN the neonatal intensive care unit (NICU) to remove excess extracellular fluid secondary to various diseases, such as chronic lung disease (CLD) and congestive heart failure (CHF). Diuretics are among the most used of all medications across age groups. They are also among the most abused medications, with the potential for many untoward side effects.3,4 Thus, NICU nurses must understand their appropriate use, their possible consequences, and the monitoring required when using them. Furosemide and chlorothiazide have been reviewed previously (see Neonatal Network, 1991, 9(7): 65–67, and 1993, 12(7): 69–70, respectively). This column focuses on spironolactone use.

scholarly journals Patent ductus arteriosus in preterm infants; experience of a tertiary referral neonatal intensive care unit: prevalence, complications, and management

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Fatma Alzahraah Mostafa ◽  
Antoine Abdelmassih ◽  
Elham Sultan ◽  
Dalia Mosallam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Side Effects ◽  
Patent Ductus Arteriosus ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Patent Ductus

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.

Nitric Oxide and Bleeding Time

PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 134-135
Author(s):  
Benjamin Gaston ◽  
Julian F. Keith
Keyword(s):  
Nitric Oxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Acute Lung Injury ◽  
Side Effects ◽  
Lung Injury ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Bleeding Time

Abman, Kinsella, and co-workers caution against the widespread use of nitric oxide (NO) gas in the neonatal intensive care unit.1,2 However, like other leading advocates of NO therapy, they limit their remarks concerning toxicology to a discussion of the risks of acute lung injury and methemoglobinemia. It must be remembered that NO may have other important side effects as well. In particular, NO inhalation in concentrations of 30 ppm prolongs bleeding time in rabbits and humans,3 making it a uniquely dangerous agent for use in preterm infants at risk for intraventricular hemorrhage.

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