{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:34:33Z","timestamp":1782902073180,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,6,5]],"date-time":"2014-06-05T00:00:00Z","timestamp":1401926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:p>Loop diuretics are commonly used in critically ill children to achieve appropriate fluid balance. They are often administered as a continuous intravenous infusion (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) in hemodynamically unstable children because of fewer alterations in central venous pressure, oxygen saturation, and heart rate compared with scheduled intermittent dosing. During the past few years, however, drug shortages have been reported for bumetanide, torsemide, and furosemide. Therefore, to explore the use of alternative agents for <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, we performed a literature search to identify articles evaluating the use of furosemide, bumetanide, ethacrynic acid, and torsemide <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> in critically ill children. The search was limited to English\u2010language articles in the <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> (1946\u2013December 2013), <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> (1980\u2013December 2013), and International Pharmaceutical Abstracts (1970\u2013December 2013) databases and the Cochrane Database of Systematic Reviews (2005\u2013December 2013). Reference citations from relevant articles were also reviewed. A total of 10 reports representing 173 pediatric patients were included in the analysis. Most of the reports provided evidence for furosemide, and no reports with torsemide were identified. Wide variability in <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> dosing was reported in these studies. When selecting the loop diuretic <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> for critically ill patients, clinicians should consider their adverse\u2010event profiles, compatibility with other concomitant intravenous infusions, and pharmacoeconomics. Fluid balance and urine output should be monitored routinely to ensure appropriate response. The lowest initial dose should be used to achieve an appropriate fluid balance and target urine output of 1\u20133\u00a0ml\/kg\/hour while limiting the likelihood of toxicity.<\/jats:p>","DOI":"10.1002\/phar.1443","type":"journal-article","created":{"date-parts":[[2014,6,5]],"date-time":"2014-06-05T01:24:53Z","timestamp":1401931493000},"page":"858-867","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Use of Continuous\u2010Infusion Loop Diuretics in Critically Ill Children"],"prefix":"10.1002","volume":"34","author":[{"given":"Jamie L.","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Pharmacy Clinical and Administrative Sciences University of Oklahoma College of Pharmacy Oklahoma City Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber N.","family":"Thomas","sequence":"additional","affiliation":[{"name":"University of Oklahoma College of Pharmacy Oklahoma City Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter N.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Clinical and Administrative Sciences University of Oklahoma College of Pharmacy Oklahoma City Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,6,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004670050514"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199201000-00010"},{"key":"e_1_2_6_4_1","unstructured":"American Society of Health\u2010System Pharmacists.Current drug shortages: Bumetanide injection [September 30 2013]; Furosemide injection [November 15 2013]; Torsemide injection [October 21 2013]. Available fromhttp:\/\/www.ashp.org\/DrugShortages\/Current\/. Accessed December 12 2013."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(97)00714-5"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050395"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340000819"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2002.127608"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1111\/j.1365-2125.2007.02913.x","article-title":"Absence of tolerance and toxicity to high\u2010dose continuous intravenous furosemide in hemodynamically unstable infants after cardiac surgery","volume":"64","author":"Vorst MJ","year":"2007","journal-title":"Br J Clin Pharmacol"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc5115"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc6146"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp120056"},{"key":"e_1_2_6_13_1","first-page":"50","article-title":"Ethacrynic acid continuous infusions in critically\u2010ill pediatric patients","volume":"19","author":"Miller J","year":"2014","journal-title":"J Pediatr Pharamacol Ther"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00561479"},{"key":"e_1_2_6_15_1","unstructured":"Bumetanide monograph. 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