Furosemide is approved in full term neonates to treat edema associated with congestive\nheart failure, cirrhosis and renal diseases. It is often administered off-label in premature neonates, to treat respiratory\nconditions and at doses greater-than-recommended. We conducted a national survey on behalf of the Neonatal\nPharmacotherapy Study Group of the Italian Society of Neonatology (SIN), to investigate its use in Italian neonatal\nintensive care units (NICUs), in conformity with current guidelines.\nMethods: Between December 2016 and June 2017, a 14-item multiple-choice online questionnaire was sent to all\nNICU directors from the SIN directory.\nGestational age, route of administration, posology, indications, referenced guidelines, adverse effects monitoring\nand the presence of Paediatric Cardiology or Cardiosurgery service on site were assessed. A chi-square test was\nperformed 1) to evaluate differences in the distribution of responses between NICUs administering furosemide at\ndoses higher-than-recommended; 2) to compare the proportion of NICUs administering furosemide at high doses\nin institutions with versus without a Paediatric Cardiology or Cardiosurgery service.\nResults: The response rate was 50% (57/114). The intravenous and oral routes were chosen primarily; the\nintravenous administration in single doses predominated over continuous infusion. Its main therapeutic indications\nwere congestive heart failure/overload (94.7%) and oligo-anuria (87.7%) however furosemide was also frequently\nused for broncopulmonary dysplasia (50.9%) and respiratory distress syndrome and/or transient tachypnea of the\nnewborn (24.6%).\nIn 28/57 NICUs furosemide was administered at doses higher-than-recommended. In most NICUs the same\nposology was used in term and preterm neonates. Compared to the total sample, a larger proportion of NICUs\nadministering doses greater-than-recommended referenced current literature for reasons to do so (19.3 and 32.1%\nrespectively). The presence of a Paediatric Cardiology or Cardiosurgery service on site did not correlate with the\nchosen posology.\nThe majority of NIC
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