{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:35:45Z","timestamp":1786649745011,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>In term neonates with heart failure, optimizing diuresis is critical, yet evidence for best practice is sparse. This study aims to compare the effectiveness of continuous infusion versus intermittent bolus furosemide in improving pulmonary status, hemodynamics, renal function, and intensive care unit (ICU) length of stay in neonates with heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A randomized trial was conducted involving 52 infants (26 per group) to compare continuous infusion versus intermittent bolus furosemide. The primary outcomes measured were pulmonary status (oxygenation and ventilator days), hemodynamics, renal function, and ICU length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Infants receiving continuous infusion of furosemide showed more rapid improvement in ventilation and acid-base status. They had higher blood pH and lower PaCO\n                      <jats:sub>2<\/jats:sub>\n                      (mean pH 7.34 vs. 7.26, PaCO\n                      <jats:sub>2<\/jats:sub>\n                      46 vs. 53 mmHg; both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), shorter ventilator time (4.0 vs. 5.5 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009), and shorter neonatal intensive care unit stay (11.5 vs. 15.2 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) compared to the bolus group. Serum creatinine levels decreased significantly in both groups, indicating improved renal function, with no significant difference between groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). Electrolyte levels and systolic blood pressure were similar across both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Continuous infusion of furosemide provides steadier diuresis with superior pulmonary recovery, whereas intermittent bolus dosing yields comparable renal outcomes and hemodynamic stability. Clinically, continuous infusion may be preferred for neonates with pulmonary edema and ventilation needs, while bolus dosing can be used when electrolyte stability is paramount.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_249_25","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T13:00:14Z","timestamp":1767272414000},"page":"331-336","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Randomized comparison of continuous versus intermittent bolus furosemide in neonatal heart failure"],"prefix":"10.4103","volume":"18","author":[{"given":"Maryam","family":"Ahmadipour","sequence":"first","affiliation":[{"name":"Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Razi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sirjan Faculty of Medical Sciences, Sirjan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Jamali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irandokht","family":"Allahdini","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H Fateme","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"Clinical Research Development Unit, Mehrgan Hospital, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40748-018-0092-2","article-title":"Association between furosemide in premature infants and sensorineural hearing loss and nephrocalcinosis: A systematic review","volume":"4","author":"Jackson","year":"2018","journal-title":"Matern Health Neonatol Perinatol"},{"issue":"9","key":"R2-20260420","first-page":"CD001453","article-title":"Intravenous or enteral loop diuretics for preterm infants with (or developing) chronic lung disease","author":"Stewart","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.jpeds.2018.01.066","article-title":"Acute responses to diuretic therapy in extremely low gestational age newborns: Results from the prematurity and respiratory outcomes program cohort study","volume":"197","author":"Blaisdell","year":"2018","journal-title":"J Pediatr"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s13052-020-00851-2","article-title":"Furosemide use in Italian neonatal intensive care units: A national survey","volume":"46","author":"Manfredini","year":"2020","journal-title":"Ital J Pediatr"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/S0003-4975(97)00714-5","article-title":"Continuous versus intermittent furosemide infusion in critically ill infants after open heart operations","volume":"64","author":"Luciani","year":"1997","journal-title":"Ann Thorac Surg"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"c70","DOI":"10.1159\/000108641","article-title":"Frusemide administration in critically ill patients by continuous compared to bolus therapy","volume":"107","author":"Ostermann","year":"2007","journal-title":"Nephron Clin Pract"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1002\/ppul.1950030405","article-title":"Effect of early furosemide administration in neonates with respiratory distress syndrome","volume":"3","author":"Belik","year":"1987","journal-title":"Pediatr Pulmonol"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.3390\/ph6091094","article-title":"Clinical pharmacology of furosemide in neonates: A review","volume":"6","author":"Pacifici","year":"2013","journal-title":"Pharmaceuticals (Basel)"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"R134","DOI":"10.1186\/cc13952","article-title":"Continuous versus bolus intermittent loop diuretic infusion in acutely decompensated heart failure: A prospective randomized trial","volume":"18","author":"Palazzuoli","year":"2014","journal-title":"Crit Care"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"P177","DOI":"10.1186\/cc1637","article-title":"Continuous versus bolus furosemide therapy in critically ill patients with fluid overload","volume":"6","author":"Ostermann","year":"2002","journal-title":"Critical Care"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1001\/jama.2016.13995","article-title":"Consideration of sex differences in medicine to improve health care and patient outcomes","volume":"316","author":"Legato","year":"2016","journal-title":"JAMA"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"113804","DOI":"10.1016\/j.addr.2021.05.014","article-title":"Let\u2019s talk about sex: Differences in drug therapy in males and females","volume":"175","author":"Madla","year":"2021","journal-title":"Adv Drug Deliv Rev"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"Klein","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"713516","DOI":"10.3389\/fped.2021.713516","article-title":"Nasotracheal versus orotracheal intubation and post-extubation airway obstruction in critically ill children: An open-label randomized controlled trial","volume":"9","author":"Kumar","year":"2021","journal-title":"Front Pediatr"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1186\/cc13871","article-title":"The furosemide stress test to predict renal function after continuous renal replacement therapy. Authors\u2019 response","volume":"18","author":"Chawla","year":"2014","journal-title":"Crit Care"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1002\/ehf2.13286","article-title":"Continuous versus intermittent use of furosemide in patients with heart failure and moderate chronic renal dysfunction","volume":"8","author":"Zheng","year":"2021","journal-title":"ESC Heart Fail"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"155002","DOI":"10.1016\/j.jcrc.2024.155002","article-title":"Furosemide with adjunctive acetazolamide versus furosemide only in critically ill patients: A pilot two-center randomized controlled trial","volume":"86","author":"Maeda","year":"2025","journal-title":"J Crit Care"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s12890-024-02933-x","article-title":"Effect of furosemide in the treatment of high-altitude pulmonary edema","volume":"24","author":"Tenzing","year":"2024","journal-title":"BMC Pulm Med"},{"key":"R19-20260420","first-page":"11","article-title":"Lung function measured with SPECT in infants and children with bronchopulmonary dysplasia: Correlation with respiratory management and clinical grading","volume":"J3","author":"Kjellberg","year":"2019","journal-title":"Karolinska Institutet"},{"key":"R20-20260420","first-page":"17","article-title":"Continuous infusion versus bolus injection of furosemide in pediatric patients after cardiac surgery: A meta analysis of randomized studies","volume":"7","author":"Landoni","year":"2012","journal-title":"J Intesive Care Emerg Med"},{"key":"R21-20260420","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1002\/jhm.991","article-title":"Continuous infusion versus intermittent bolus furosemide in ADHF: An updated meta-analysis of randomized control trials","volume":"7","author":"Amer","year":"2012","journal-title":"J Hospital Med"}],"container-title":["Annals of Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_249_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:57:55Z","timestamp":1786647475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_249_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/apc.apc_249_25","relation":{},"ISSN":["0974-2069","0974-5149"],"issn-type":[{"value":"0974-2069","type":"print"},{"value":"0974-5149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-09-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}