Ethacrynic Acid continuous infusions in critically ill pediatric patients
Jamie L Miller1, Jared Schaefer1, Matthew Tam1
1Department of Pharmacy, Clinical and Administrative Sciences, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma.
Summary
This study explored ethacrynic acid continuous infusions in critically ill children, finding median initial doses of 0.13 mg/kg/hr and maximum doses of 0.17 mg/kg/hr. Further research is needed to confirm these findings.
Area of Science:
- Pediatric Critical Care Medicine
- Pharmacology
- Nephrology
Background:
- Continuous infusions (CI) of ethacrynic acid are used in critically ill children.
- Limited data exists on optimal dosing and outcomes for this patient population.
Purpose of the Study:
- To describe dosage regimens for ethacrynic acid CI in critically ill children.
- To evaluate treatment outcomes, including urine output, fluid balance, and adverse events.
Main Methods:
- Retrospective cross-sectional study of pediatric patients (<18 years) receiving ethacrynic acid CI >12 hours (2007-2012).
- Analysis of initial and maximum doses, urine output, fluid balance, and electrolyte abnormalities.
- Repeated measures ANOVA used to assess changes in efficacy markers and adverse events.
Main Results:
- Nine patients were included. Median initial dose was 0.13 mg/kg/hr; median maximum dose was 0.17 mg/kg/hr.
- Significant improvements in urine output and fluid balance were observed mid- and post-therapy compared to pre-therapy.
- 55.6% of patients developed metabolic alkalosis; no significant changes in magnesium or potassium levels were noted.
Conclusions:
- Ethacrynic acid CI shows preliminary efficacy in critically ill children.
- The median effective doses were established, but larger prospective studies are required for confirmation.
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