WIP 156 - The Effectiveness of Using Multiple Pharmacological Modalities to Achieve Aggressive Diuresis in Very Low Birth Weight Newborn Infants who Presented with Oligo-anuric Acute Kidney Injury

Poster Number: WIP 156
Publication Number: WIP 156.2369

Background: Very low birth weight ( < 1500 grams) (VLBW) infants often have underdeveloped kidneys, increasing the risk of severe acute kidney injury (AKI). Various postnatal factors, like patent ductus arteriosus, infections, nephrotoxic medications, can harm their kidneys. Severe AKI in newborns is linked to a higher risk of death. Furosemide is commonly used in neonatal intensive care units (NICUs), but its effectiveness can vary. For VLBW infants with kidney problems and fluid overload, alternative treatments are needed to improve survival. Other comorbidities may preclude peritoneal dialysis. Evaluating the use of additional drugs like Bumetanide and Chlorothiazide alongside Furosemide is necessary to enhance diuresis, prevent fluid overload, and improve outcomes.

Objective: The aim of this study is to review the effectiveness of using multiple diuretic medications in the setting of oligo-anuria in VLBW neonates in NICU at University Hospital of Brooklyn (UHB) and Kings County Hospital (KCH) between January 2012-December 2022.
Primary hypothesis:
In place of Furosemide monotherapy, we hypothesize that the use of aggressive diuretic modality including Bumetanide and Chlorothiazide will improve the urine output and fluid balance in VLBW infants and therefore enhances survival.

Design/Methods: We'll conduct a retrospective case-control study by reviewing electronic medical records. Cases are VLBW infants with oligo-anuric AKI treated with Bumetanide and Chlorothiazide. Controls are VLBW infants with the same diagnosis managed with Furosemide alone. We'll review charts for data like sex, birth weight, gestational age, delivery method, post-natal age, intubation, ventilation duration, catheterization, comorbidities, nephrotoxic exposure, hospitalization length, SNAPPE-II scores, and AKI-related deaths. Statistical analysis will be done with parametric or non-parametric tests (Chi-square, Pearson Correlation Coefficient vs the Wilcoxon Signed Rank Test, the Mann-Whitney U Test) based on the data distribution. P-values less than 0.05 will be considered as statistically significant.