{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:22:52Z","timestamp":1756902172512,"version":"3.44.0"},"reference-count":8,"publisher":"The Pediatric Pharmacy Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>\n          <jats:bold>OBJECTIVES<\/jats:bold> The purpose of this study is to describe whether tolerance develops in pediatric patients receiving chronic intermittent furosemide therapy, to characterize when it occurs and whether age-related variations exist. The effects of increasing total daily dose of furosemide and concurrent diuretics and vasopressors were assessed as secondary aims.<\/jats:p>\n        <jats:p>\n          <jats:bold>METHODS<\/jats:bold> Charts from patients receiving intravenous or oral furosemide for at least 3 consecutive days of therapy between June 1, 2013, and December 31, 2013, were reviewed retrospectively. Daily net fluid balance was used as the objective marker for development of tolerance. Net fluid balance (mL\/kg\/mg) was defined as the difference in a patient's daily intake and urine output (mL), normalized by weight (kg) and total daily dose of furosemide (mg).<\/jats:p>\n        <jats:p>\n          <jats:bold>RESULTS<\/jats:bold> Sixty-one patients, aged 2 days to 20 years (median 3 years), were included in this study. Median daily dose of furosemide was 1.96 mg\/kg\/day (range, 0\u201313.7 mg\/kg\/day). Average net fluid balance for all patients on the first day and last day of therapy was 6.83 and 26.66 mL\/kg\/mg, respectively (p = 0.011). Linear regression and Spearman's correlation found no significant relationship between age and difference in net fluid balance between the first and last day. Linear mixed-effects model for net fluid balance with day as covariate found that net fluid balance increases over time (p = 0.002).<\/jats:p>\n        <jats:p>\n          <jats:bold>CONCLUSIONS<\/jats:bold> Pediatric patients appear to develop tolerance to chronic intermittent furosemide therapy.<\/jats:p>","DOI":"10.5863\/1551-6776-22.6.394","type":"journal-article","created":{"date-parts":[[2017,12,19]],"date-time":"2017-12-19T15:46:36Z","timestamp":1513698396000},"page":"394-398","source":"Crossref","is-referenced-by-count":2,"title":["Development of Tolerance to Chronic Intermittent Furosemide Therapy in Pediatric Patients"],"prefix":"10.5863","volume":"22","author":[{"given":"Gloria J.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy (GJK, GR, AHT), Rady Children's Hospital San Diego, California, Department of Pediatrics (EC, AHT), University of California, San Diego, Clinical and Translational Research Institute (JAP), University of California, San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund","family":"Capparelli","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy (GJK, GR, AHT), Rady Children's Hospital San Diego, California, Department of Pediatrics (EC, AHT), University of California, San Diego, Clinical and Translational Research Institute (JAP), University of California, San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gale","family":"Romanowski","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy (GJK, GR, AHT), Rady Children's Hospital San Diego, California, Department of Pediatrics (EC, AHT), University of California, San Diego, Clinical and Translational Research Institute (JAP), University of California, San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Proudfoot","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy (GJK, GR, AHT), Rady Children's Hospital San Diego, California, Department of Pediatrics (EC, AHT), University of California, San Diego, Clinical and Translational Research Institute (JAP), University of California, San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana H.","family":"Tremoulet","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy (GJK, GR, AHT), Rady Children's Hospital San Diego, California, Department of Pediatrics (EC, AHT), University of California, San Diego, Clinical and Translational Research Institute (JAP), University of California, San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"8","key":"i1551-6776-22-6-394-b1","series-title":"Pharmacotherapy","first-page":"858","article-title":"Use of continuous-infusion loop diuretics in critically ill children","volume":"34","year":"2014","unstructured":"Miller\n              JL\n            , ThomasAN, JohnsonPN.\n          Use of continuous-infusion loop diuretics in critically ill children. 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N Engl J Med. 1998;339(6): 387\u2013395."},{"issue":"1","key":"i1551-6776-22-6-394-b4","series-title":"Am J Physiol Renal Physiol","first-page":"F11","article-title":"Loop diuretics: from the Na-K-2Cl transporter to clinical use","volume":"284","year":"2003","unstructured":"Shankar\n              SS\n            , BraterDC.\n          Loop diuretics: from the Na-K-2Cl transporter to clinical use. Am J Physiol Renal Physiol. 2003;284(1):F11\u2013F21."},{"issue":"7","key":"i1551-6776-22-6-394-b5","series-title":"Pediatr Nephrol","first-page":"603","article-title":"The clinical pharmacology of loop diuretics in the pediatric patient","volume":"12","year":"1998","unstructured":"Eades\n              SK\n            , ChristensenML.\n          The clinical pharmacology of loop diuretics in the pediatric patient. 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Vienna, Austria: R Foundation for Statistical Computing; 2015"},{"key":"i1551-6776-22-6-394-b8","unstructured":"Pinheiro\n              J\n            , BatesD, DebRoyS, \n          et al. Nlme: linear and nonlinear mixed effects models. R package version 3.1-122. 2015. http:\/\/CRAN.R-project.org\/package=nlme. Accessed October 19, 2017.","article-title":"Nlme: linear and nonlinear mixed effects models. R package version 3.1-122. 2015"}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/22\/6\/article-p394.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/22\/6\/394\/1784520\/1551-6776-22_6_394.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/22\/6\/article-p394.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/22\/6\/article-p394.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:46:54Z","timestamp":1747356414000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/22\/6\/article-p394.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":8,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-22.6.394","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2017]]}}}