The Impact of IV Furosemide Use on the Total Serum Bilirubin Levels of Very Low Birth Weight Neonates

Abstract

Background: Neonatal hyperbilirubinemia is common. Sulfisoxazole and ceftriaxone are known to be contraindicated in neonates with potential kernicterus because of the high protein-binding ability of these drugs. However, drugs with high protein-binding abilities, such as furosemide (＞90%), are commonly used in very low birth weight (VLBW) neonates.Objectives: he aim of this study was to determine whether IV furosemide could deteriorate hyperbilirubinemia in VLBW neonates.Methods: To determine the extent of blood loss and the hemoglobin levels of the VLBW neonates who exhibited no signs of infection ＞ 10 days and ≤ 30 days following birth were recorded and calculated. The effects of blood loss and phototherapy use or not on the total serum bilirubin (TSB) levels were calculated and used to correct the influence of each intravenous (IV) dose of furosemide on the TSB levels.Results: Ninety-six VLBW neonates were included in the study. Following corrections based on hemoglobin level changes and phototherapy use or not, the average difference between the TSB levels before and after IV furosemide use was 0.292 ± 1.478 mg/dL, which suggested that IV furosemide slightly elevated the TSB levels in VLBW neonates.Conclusions: Despite the high protein-binding ability, short-term use (one or two days) of IV furosemide might not have significant impact on the TSB levels in VLBW neonates. (n = 58, P = 0.138) Further studies are required to evaluate the influence of long-term IV furosemide use in neonates.